PQRI Establishment of Alternative Reporting Periods and Reporting Criteria

From MLN - 2008 Physician Quality Reporting Initiative (PQRI) Establishment of Alternative Reporting Periods and Reporting Criteria:

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6104.pdf

MLN updates from CMS

The Medicare Learning Network has some wonderful and timely information to stay on top of the latest coding rules and procedures. Here are some of this week's updates:

MM5993 – Critical Care Visits and Neonatal Intensive Care (Codes 99291 - 99292)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5993.pdf

MM6049 – July 2008 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6049.pdf

MM6084 – Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2008
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6084.pdf

MM6087 – July Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6087.pdf

Highmark "Denied Claims" system alert

On June 12, 2008, Highmark Medicare Services Inc. erroneously denied claims and adjustments with message B7 - This provider was not certified/eligible to be paid for this procedure/service on this date of service. This message will be shown on the standard provider remittance (SPR) of the claim and/or adjustment. The adjustment activity on previously paid services automatically generated a demand (refund) request through the Healthcare integrated General Ledger Accounting System (HIGLAS).

After reviewing several options to correct this situation, Highmark Medicare Services Inc. has decided to mail the demand (refund) letters. The impacted providers need to repay the amount indicated in the demand (refund) letter to Medicare. If you wish to request immediate offset, call 1-888-291-2623.

All impacted claims and adjustments will be re-adjusted to pay as appropriate under a separate payment.

HHS Takes Action to Help Medicare Beneficiaries and Providers in Iowa and Indiana

From CMS today:

In response to the emergencies resulting from the Midwest flooding, CMS is providing resources to ensure effective health care coverage and quality of care for beneficiaries. Visit the CMS extreme weather and emergencies relief activities resource link for Midwest Floods.

http://www.cms.hhs.gov/emergency/20_midwestflooding.asp

The Inaugural Post!

Welcome to the inaugural posting to the ICD9Data.com blog - Medical Coding Confidential.

My name is Max and I'm one of the folks responsible for bringing this web site to life.

This blog is going to be gateway for medical coding news, information are criticism. Hopefully we can cut down on the signal-to-noise ratio that is in our community by giving you some hard facts and information.

There are some positive developments coming down the pipe for ICD9Data.com in the coming months. I don't want to ruin another blog posting by going into it too much, but I will share that a new domain is coming with improved searching, better navigation and a lot more medical coding data.

Thank you for dropping by, and stay tuned for frequent medical coding information updates.