Latest Trends and Best Practices for Collecting Healthcare Payments

An article by Bill Marvin, taken from the July/August issue of HBMA Billing (hbma.org)
The healthcare payments industry is growing and changing rapidly, and this change is influencing the way that many in the industry, including billing services and their clients, do business. Data from the 2012 Trends in Healthcare Payments Annual Report shows that as the healthcare payments industry evolves, billing services must take steps to accommodate these changes.
Efficiency, payment best practices, interoperability, and security will be crucial areas to focus on in the future as the industry continues to change and grow. Below are the key market trends featured in the report that identify how billing services can prepare for the future in the healthcare payments industry.

1. Simplify the Payment Experience

Of providers surveyed, 37 percent said that their primary revenue cycle concern is the increase in patient responsibility.
As patient responsibility continues to rise, patients have more influence in the healthcare payments process. By delivering additional channels for consumer payments, billing services and their clients will collect more payments
Of providers surveyed, 83 percent said it took more than one month to collect from a patient after claim adjudication.
Today, billing services send out multiple paper statements and make follow-up phone calls to collect patient payments. Facilitating payments at every patient interaction point will be a key factor in reducing the time and costs to collect.

2. Expand Payment Channels

Of patients surveyed, 72 percent said they would like to pay their healthcare bills online.
It is estimated that U.S. consumers will spend more than $300 billion online in 2016. To collect more payments, billing services and their clients must look to the online payment best practices used in other industries to meet patient payment expectations as consumers.
In addition to leveraging technology, billing services must foster cultural changes among staff and patients to better prepare staff members to collect and for patients to pay. Tools and policies such as prompt pay discounts, staff incentive programs, minimum payment requirements, and scripts to use when discussing payments with patients are effective ways to collect more revenue.

3. Achieve Interoperability to Increase Efficiency

Of providers surveyed, 71 percent said that a lack of system interoperability is a major barrier to health information exchange.
Continuing provider consolidation will drive a greater need for system interoperability. The industry must also focus on administrative interoperability, including payment-related systems and processes. By integrating heterogeneous systems, billing services and their clients will automate more processes, simplify compliance requirements, and streamline employee training.

4. Focus on Data and Security

In the last decade, cloud usage in the U.S. has grown by more than 150 percent.
As billing services deliver more channels for consumer payments, private cloud technology will be crucial to efficiently collect, post, and reconcile all payments. However, cloud usage also presents new risks such as long-term downtime and loss of data during disasters. To protect data in the cloud, billing services must ask cloud vendors about disaster recovery and prevention policies and procedures.
In 2012, 27 percent of all reported data breaches occurred in the healthcare industry.
As patient payments increase, more consumer payment cards and bank accounts are exposed, which greatly increases the risk of a data breach. The financial and reputational costs of a payment card data breach are high and may result in bad publicity and loss of business. To reduce the risk of a breach, billing services should consider implementing methods to ensure payment card security and to meet the Payment Card Industry (PCI) standards more easily. In order to protect sensitive information when collecting payments, organizations will leverage new technology such as encryption at the point of interaction (POI) and prepare for the upcoming mandate around Europay, MasterCard, and Visa (EMV). The new EMV standard requires payment card issuers to include a chip that will add a layer of authentication to go along with the current magnetic strip on the back of cards. The industry is quickly beginning to issue and mandate processing for chip-based cards, including:

• Starting April 1, 2013, banks and financial institutions were required to process EMV chip transactions.
  
• Starting October 1, 2015, liability for counterfeit transactions will shift to merchants when processing an EMV card transaction on non-EMV capable devices. Additional information can be found at en.wikipedia.org/wiki/EMV.

Article source: 2012 Trends in Healthcare Payments Report, www.instamed.com/trends-in-healthcare-payments-annual-report-2012.

Final ICD-9-CM Code Set Update: ICD-10, It's Closer Than it Seems

The final updates to ICD-9-CM codes will take effect on October 1, 2013. These updates will be in effect until the ICD-10 transition takes place on October 1, 2014. You can find the last official ICD-9-CM code titles, both full and abbreviated, posted on the CMS website.
“For those of us who have been maintaining ICD-9-CM codes since the code set’s implementation in 1979, this final ICD-9-CM code update is a historic occasion,” said Pat Brooks of the CMS Hospital and Ambulatory Policy Group. “We look forward to the implementation and maintenance of ICD-10 in 2014.”

New Claim Adjustment Reason Code (CARC) to Identify a Reduction in Federal Spending Due to Sequestration

MLN Matters® Number: MM8378
Related Change Request (CR) #: CR 8378
Related CR Release Date: July 25, 2013
Effective Date: June 3, 2013
Related CR Transmittal #: R2739CP
Implementation Date: January 6, 2014

Provider Types Affected This MLN Matters® Article is intended for physicians, providers, and suppliers submitting claims to Medicare contractors (Fiscal Intermediaries (FIs), carriers, Regional Home Health Intermediaries (RHHIs), Durable Medical Equipment Medicare Administrative Contractors (DME/MACs) and A/B Medicare Administrative Contractors (A/B MACs)) for services to Medicare beneficiaries.

Provider Action Needed This article is based on Change Request (CR) 8378 which informs Medicare contractors about a new Claim Adjustment Reason Code (CARC) reported when payments are reduced due to Sequestration. Make sure that your billing staffs are aware of these changes.

Background As required by law, President Obama issued a sequestration order on March 1, 2013. As a result, Medicare Fee-For-Service claims, with dates of service or dates of discharge on or after April 1, 2013, incur a two percent reduction in Medicare payment. The Centers for Medicare & Medicaid services (CMS) previously assigned CARC 223 (Adjustment code for mandated Federal, State or Local law/regulation that is not already covered by another code and is mandated before a new code can be created) to
explain the adjustment in payment.

Effective June 3, 2013, a new CARC was created and will replace CARC 223 on all applicable claims. The new CARC is as follows:

• 253 - Sequestration - Reduction in Federal Spending

Also, Medicare contractors will not take any action on claims processed prior to implementation of CR8378.

Additional Information The official instruction, CR 8378 issued to your Medicare contractor regarding this change may be viewed at http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2739CP.pdf on the CMS website.

Disclaimer This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. CPT only copyright 2012 American Medical Association.

Courtesy of: Palmetto GBA and CMS http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~9A6QUB1811?opendocument&utm_source=J1BL&utm_campaign=J1BLs&utm_medium=email

Introducing Interactive Care Reviewer (ICR), By Anthem Blue Cross available on Availity

Anthem Blue Cross launches a new secure, online provider utilization management tool - register today!

With ICR, your practice can now initiate precertification requests online more efficiently and conveniently. Our new tool offers a streamlined precertification process, using cutting-edge IBM Watson™


 technology. Access our ICR via Availity Web Portal to request outpatient procedures* for many members covered by Anthem Blue Cross plans.

Here are just a few benefits and efficiencies your office may experience: Reduces the need to fax - Submit online precertification requests without the need to fax medical records. ICR allows both text detail and photo and image attachments to be submitted along with the request. No additional cost  -You get access to a no-cost solution that's easy to learn and even easier to use. Access almost anywhere - Submit your requests from any computer with internet access. For optimal viewing, you must have a browser that supports 128-bit encryption, including Internet Explorer 8, Chrome, Firefox or Safari. Comprehensive view of all precertification requests - You have a complete view of your UM requests submitted online, including status of your requests with views of case updates. How does a provider gain access to our Interactive Care Reviewer (ICR)? Access our ICR tool via Availity's Web Portal. If your organization has not yet registered for access, go to www.availity.com and click on Register Now. If your organization already has access to Availity's Web Portal, your Primary Access Administrator can grant you access to Authorizations and you can start using our tool right away. How can providers learn more about our Interactive Care Reviewer (ICR) tool? Attend informational webinars to learn more about the features and benefits of our new tool and how to navigate within it. Our FREE webinars provide you with an overview of our ICR tool or give you in-depth training on utilizing our ICR's many features. To register, click here or go to https://www144.livemeeting.com/lrs/1100001891/Registration.aspx?pageName=83vbvn5cvr00ngx4 What's next? Future planned enhancements to our tool include: Precertification of inpatient medical stays. Expand the use to incorporate additional procedures. Who can providers contact with questions? Click here to view FAQs. For questions regarding our ICR or on access via Availity, call Availity Client Services at 800-AVAILITY (800-282-4548) or e-mail questions to support@availity.com. Availity Client Services is available Monday - Friday,5 a.m. to 4 p.m. PST (excluding holidays) to answer your registration questions. *Note: ICR is not currently available for Medicare Advantage, Medicaid, FEP, BlueCard®, and some National Account members; requests involving Behavioral Health or transplant services; or services administered by AIM Specialty Health SM. For these requests, follow the same precertification process that you use today. Courtesy of: Anthem Blue Cross and Availity.com

Availity, an independent company, provides claims management services for Anthem Blue Cross.

Have You Checked Your Patient’s Immunization Status?

August is National Immunization Awareness Month (NIAM). This annual national health observance provides an opportunity to highlight the need for improving national immunization levels. The Centers for Disease Control and Prevention (CDC) list influenza and pneumococcal as especially serious diseases for adults 65 and older. Accordingly, CMS asks health care professionals to encourage Medicare beneficiaries to stay current on their immunizations; especially seasonal influenza, pneumococcal and hepatitis B for those who are at risk. Medicare Part B covers these immunizations and their administration for qualified beneficiaries.

• Influenza Immunizations:  Medicare covers both the costs of the vaccine and its administration by recognized providers. There is no coinsurance or co-payment applied to this benefit, and a beneficiary does not have to meet his or her deductible to receive this benefit.  
• Pneumococcal Vaccinations: Medicare provides coverage for one (1) pneumococcal vaccine for all beneficiaries. One vaccine at age 65 generally provides coverage for a lifetime, but for some high risk persons, revaccination may be appropriate. Medicare will also cover a pneumococcal vaccine for persons at the highest risk if 5 years have passed since the last vaccination. There is no coinsurance or co-payment applied to this benefit, and a beneficiary does not have to meet his or her deductible to receive this benefit.
• Hepatitis B Vaccinations:  Persons at high or intermediate risk, such as people with renal disease, hemophilia, and diabetes mellitus, are among those who are eligible to receive coverage for this immunization benefit under Medicare Part B, when administered by qualified providers. The coinsurance or co-payment applies after the yearly deductible has been met.

Courtesy of: CMS E News MLN Connects http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~9A6H9U7715?opendocument&utm_source=J1BL&utm_campaign=J1BLs&utm_medium=email

Jurisdiction 1 Part B: E/M Weekly Tip: Medical Necessity and Reasonable/Necessary

Jurisdiction 1 Part B

E/M Weekly Tip: Medical Necessity and Reasonable/Necessary

Palmetto GBA determines medical necessity largely through the experience and judgment of clinicians along with limited tools provided in the CPT code book and by CMS.
CMS issues National Coverage Determinations (NCDs) that specify whether certain items, services, procedures or technologies are reasonable and necessary under §1862(a) (1) (A) of the Act. In the absence of an NCD, Medicare contractors are responsible for determining whether services are reasonable and necessary. If no local coverage determination (LCD) exists for a particular item or service, the MACs, CERT, Recovery Auditors, and ZPICs shall consider an item or service to be reasonable and necessary if the item or service meets the following criteria:

• It is safe and effective
• It is not experimental or investigational
• It is appropriate, including the duration and frequency in terms of whether the service or item is:
  • Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the beneficiary's condition or to improve the function of a malformed body member
  • Furnished in a setting appropriate to the beneficiary's medical needs and condition
  • Ordered and furnished by qualified personnel
  • One that meets, but does not exceed, the beneficiary's medical need

There are several exceptions to the requirement that a service be reasonable and necessary for diagnosis or treatment of illness or injury in order to be considered for payment. The exceptions appear in the full text of §1862(a) (l) (A) of the Act.
Resource: Program Integrity Manual, Chapter 3 (PDF, 437 KB). 

Courtesy of: CMS E-News MLN Connects http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~9A6HHE8705?opendocument&utm_source=J1BL&utm_campaign=J1BLs&utm_medium=email
 

The Affordable Care Act and Model 4 Bundled Payments for Care Improvement

Jurisdiction 1 Part B

The Affordable Care Act and Model 4 Bundled Payments for Care Improvement 

MLN Matters® Number: MM8070
Related Change Request (CR) #: 8070
Related CR Release Date: June 27, 2013
Effective Date: July 1, 2013
Related CR Transmittal #: R1251OTN
Implementation Date: July 1, 2013

Note: This article was revised on July 26, 2013, to reflect a revised Change Request (CR). The CR added Part B MAC responsibility to the CR's business requirement 18.3. The release date, transmittal number and link to the CR was also changed. All other information remains the same.

Provider Types Affected This MLN Matters® Article is intended for hospitals, physicians, and non-physician providers participating in the Model 4 Bundled Payments for Care Improvement (BPCI) initiative and submitting claims to Medicare contractors (Fiscal Intermediaries (FIs) and A/B Medicare Administrative Contractors (MACs))
for services to Medicare beneficiaries.

What You Need to Know This article provides an overview of Medicare’s implementation of the Model 4 Bundled Payments for Care Improvement initiative. General program information is provided along with separate sections containing information of special interest to hospitals and physicians and non-physician providers. It addresses issues related to readmissions, claims crossover, remittance advice, and claims submission, among others. This pilot program is being conducted under the Centers for Medicare & Medicaid Services (CMS) Innovation Center’s model testing authority. The program is slated to be implemented in October 2013.

Background The Affordable Care Act provides a number of new tools and resources to help improve health care and lower costs for all Americans. Bundling payment for services that patients receive during a single episode of care, such as heart bypass surgery or a hip replacement, is one way to encourage doctors,
hospitals, and other health care providers to work together to better coordinate care for patients, both when they are in the hospital and after they are discharged. Such initiatives can help improve health, improve quality of care, and lower costs.

CMS is working in partnership with providers to develop models of bundling payments through the BPCI initiative. On August 23, 2011, CMS invited providers to apply to help test and develop four different models for bundling payments. Model 4, one of these four models, is discussed in this article. In Model 4, the episode of care is defined as the acute care hospital stay and includes inpatient hospital services, Part B services furnished during the hospitalization, and hospital and Part B services for related readmissions.

Information in this article is based on the change requests implemented for Bundled Payments for Care Improvement Model 4, including CRs 7887, 8070, and 8196.

General BPCI Model 4 Information
Beneficiary Eligibility In order to be eligible for Model 4, the beneficiary must meet the following requirements:

• Beneficiary is eligible for Part A and enrolled in Part B;
• At the time of admission, beneficiary either (a) has at least 1 day of utilization left and that day is also a day of entitlement or (b) has at least one lifetime reserve day remaining;
• Beneficiary does not have End-Stage Renal Disease;
• Beneficiary is not enrolled in any managed care plans;
• Beneficiary must not be covered under the United Mine Workers; and
• Medicare must be the primary payer.

If the beneficiary does not meet all of these requirements, the following codes will be assigned to rejected or cancelled NOAs:

• Claims Adjustment Reason Code (CARC) B5: Coverage/program guidelines were not met or were exceeded.
• Remittance Advice Remarks Code (RARC) N564: This patient did not meet the inclusion criteria for the demonstration project or pilot program.

Model 4 Bundled Payment Provision Hospitals that participate in the BPCI Model 4 initiative will receive a prospectively established bundled payment for agreed upon Medicare Severity Diagnosis Related Groups (MS-DRGs).

• This will not apply to claims that are paid on a transfer per-diem basis.
• This payment will include both the DRG payment for the hospital and a fixed amount for the Part B services anticipated to be rendered during the admission.

Separate payment for providers’ professional services rendered during the inpatient hospital stay will not be made.

• Participating Model 4 hospitals receiving a Model 4 payment will be responsible for paying providers who would otherwise be paid separately for professional services under the Physician Fee Schedule (PFS).
• Claims from physicians will be processed as no-pay claims if they occur between the inpatient hospital admission and discharge date in order to prevent duplicate payment of physicians under the bundled payment.

Co-payments, Co-insurance, and Deductibles

• The regular Part A deductible, including the Part A blood deductible, and daily coinsurance amounts (when applicable) will continue to be applied to the claim.
• The fixed Part B portion of the negotiated bundled payment will first be applied to the Part B deductible, if applicable.
• A fixed Part B copayment will be applied to the claim. This will be the responsibility of the beneficiary and will be calculated as an approximation of what the Part B coinsurance would have been in the absence of Model 4.
• Both the copayment and the deductible to be paid by the beneficiary for the Part B services will appear on the MSN along with the Part A deductible and any applicable coinsurance.

Appeals Payments made under Model 4 have no rights of appeal, except in the case of calculation errors.

• RARC N83: No appeal rights. Adjudicative decision based on the provisions of a demonstration project.

Information for Hospitals

Notification of Admission (NOA) Hospitals participating in this initiative should submit a Notice of Admission (NOA) when a beneficiary expected to be included in the model is admitted. Timely filing of the NOA allows subsequent Part B claims submitted before the hospital claim to be properly processed as “no-pay” claims, which indicates
that payment for these claims are to be included in hospital payments under Model 4. By extension, these Part B claims will then be included timely on weekly Part B reports provided to the hospital to be used in calculating payments for Part B providers.

• Hospitals will be paid a $500 payment upon submission of the NOA and will receive the balance of the prospectively established bundled payment when the hospital claim is processed.
  • RARC N568: Initial payment based on the Notice of Admission (NOA) under the Bundled Payment Model IV initiative.
  • If the patient ultimately does not qualify for a Model 4 prospective payment based on the MS-DRG ultimately assigned to their inpatient stay, or if the NOA is cancelled, the $500 NOA payment will be recouped.
  • Medicare systems will initiate a “look back” into the claims history records upon receipt of a canceled NOA to identify Model 4 BPCI claims- i.e., Part B physician or other professional claims - which were processed as "no pay" as a result of the NOA being opened. If such claims were processed, the Medicare contractor will adjust the claims automatically and remit payment for services rendered based on regular Medicare Fee-for-Service claims processing rules.
  • Hospitals must submit the final claim within 60 days of the beneficiary’s hospital admission or submit an interim claim during that time period to demonstrate that the beneficiary is still an inpatient. Otherwise, the beneficiary will be considered not subject to episode payment and the $500 will be recouped.
    • The following codes will be assigned when a Model 4 claim matches an NOA for admission date and beneficiary, but not provider.
      • CARC 208: National Provider Identifier - Not matched
      • RARC N562: The provider number of your incoming claim does not match the processed Notice of Admission (NOA) for this bundled payment
  • The following codes shall be assigned when an NOA is cancelled because a matching claim is not received within 60 days. A match consists of beneficiary, admit date, and provider.
    • CARC 226: Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete
    • RARC N560: This pilot program requires an interim or final claim within 60 days of the Notice of Admission. A claim was not received

Readmissions Model 4 hospitals will not be paid for readmissions that occur to the same hospital (i.e., another admission with a date of admission within 30 days of discharge of the Model 4 stay) under this model unless the MS-DRG assigned to that readmission is expressly excluded as unrelated to the MS-DRG assigned to the original admission.

• Unrelated readmissions have been defined by CMS, and a list of DRGs defining unrelated readmissions has been provided for each included MS-DRG to every Model 4 participating hospital. This list can also be found on the Bundled Payments collaboration site, accessible to Model 4 Awardees.
• Related readmissions to a hospital other than the original treating hospital, as well as payments for physicians’ services during related readmissions to hospitals other than the original treating hospital, will be reconciled retrospectively by a BPCI payment reconciliation contractor and payment will be recouped, as applicable, by the Model 4 awardee.
• If claims for a Model 4 anchor admission and a readmission are submitted out of order, the readmission claim will be canceled and must be resubmitted to receive payment. The following codes will be used in this situation:
  • CARC 249: This claim has been identified as a readmission.
  • RARC N561: The bundled payment for the episode of care includes payment for related readmissions. You may resubmit your claim to receive a corrected payment.

Payment Rate Updates and Adjustors Payment rates may be updated as often as quarterly to allow for ongoing updates to Medicare payment rates, including regular recurring changes made to the Physicians Fee Schedule (PFS) and Inpatient Prospective Payment System (IPPS). Indirect Medical Education (IME) and Disproportionate Share Hospital (DSH) payments, as well as outlier payments and hospital capital payments to Model 4 hospitals will be calculated based on the non-discounted base DRG payment that would have been made in the absence of the model. This is true for both anchor admissions and related readmissions to the Model 4 hospital. In the case of readmissions, these payments will be denoted by the following:

• CARC 249: This claim has been identified as a readmission.
• RARC N524: Based on policy this payment constitutes payment in full.

Other applicable payment adjustors will also be calculated based on the base DRG that would otherwise have applied to the case, as opposed to the prospectively established amount paid through this initiative, which will be higher as it includes payment for Part B services in addition to the base DRG
payment.

Information for Physicians and Non-Physician Providers
Claims Submission and Processing Physicians and non-physician practitioners shall submit claims for dates of service during an episode of care included in Model 4 BPCI as usual.

Physicians and non-physician practitioners shall be required to accept assignment for all claims covered under the Model 4 BPCI payment.

For those Part B services rendered during a Model 4 admission or a related readmission to that Model 4 hospital, Medicare will process claims as no-pay. In processing no-pay professional claims, Medicare will assign the following:

• CARC 234: This procedure is not paid separately.
• RARC N67: Professional provider services not paid separately. Included in facility payment under a demonstration project. Apply to that facility for payment, or resubmit your claim if: the facility notifies you the patient was excluded from this demonstration; or, if you furnished these services in another location on the date of admission or discharge from a demonstration hospital. If services furnished in a facility not involved in the demonstration on the same date the patient was discharged from or admitted to a demonstration facility, you must report the provider ID number for the non-demonstration facility on the new claim.

Physicians submitting claims should take care not to include on the same claim services that are both within the dates (admission and discharge) of a Model 4 BPCI episode and outside the dates of the episode. If such claims with both Model 4 and non-Model 4 services are received, Medicare contractors will reject the claims and advise the physician to separate the services and rebill. The following remittance messages will be used in this situation:

• CARC 239: Claim spans eligible and ineligible periods of coverage. Rebill separate claims.
• RARC N61: Rebill services on separate claims.

Incentive Payments Bonus or incentive payments calculated by CMS, such as HPSA bonus payments, will not be affected by physician or non-physician practitioner participation in the Bundled Payments initiative.

Participation Declination Physicians have the right to decline participation in this program. Declination will be indicated by including a HCPCS modifier on each claim. Further details will be provided at a future date.

Readmissions Part B services provided during a related readmission to the original treating hospital will not be paid separately. If Part B claims were processed prior to receipt of the hospital's readmission claim, Medicare will take steps to recover payments to the physician.

• CARC A1: Claim/Service Denied; and
• RARC N68: Prior payment being cancelled as we were subsequently notified this patient was covered by a demonstration project in this site of service. Professional services were included in the payment to the facility. You must contact the facility for payment. Prior payment made to you by the patient or another insurer for this claim must be returned within 30 days.

Claims Crossover In association with this initiative, CMS will make changes to allow for the reporting of two new Claim Adjustment Reason Codes (CARCs) within the 2320 Claim Adjustment Segment (CAS), so that supplemental payers can more easily determine these amounts when adjudicating Medicare Health Insurance Portability and Accountability Act (HIPAA) 837 institutional Coordination of Benefits (COB)/crossover claims.

• CARC 247 will be defined as “Part B deductible on a Part A claim.”
• CARC 248 will be defined as “Part B coinsurance on a Part A claim.”
• An adjusted RARC M137 will be defined as “Part B coinsurance under a demonstration project or pilot program.

This initiative will also result in the reporting of a new value code within the 2300 Health Care nformation Codes (HI) Value Information (qualifier BE) portion of outbound HIPAA 837 institutional COB/crossover claims.

Additional Information
The official instruction, CR8070, issued to your Medicare contractor regarding this change may be viewed at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1251OTN.pdf on the CMS website. In addition, CR8196 is available at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1189OTN.pdf and CR7887 is available at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1240OTN.pdf on the CMS website.

Disclaimer This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. CPT only copyright 2012 American Medical Association.

Courtesy of : Palmetto GBA http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~9A5Q6C6034?opendocument&utm_source=J1BL&utm_campaign=J1BLs&utm_medium=email