From the Thursday, May 21, 2015 MLN Connects Provider eNews from Medicare Learning Network
Medicare Learning Network® Educational Products
MLN
Matters® Special Edition Article #SE1516, “Chronic Care
Management (CCM) Services Frequently Asked Questions (FAQs)” has been released
and is now available in downloadable format. This article is designed to
provide education on Medicare’s requirement for 24/7 access by individuals
furnishing CCM services to the electronic care plan, rather than the entire
medical record. It includes FAQs regarding billing CCM services to the
Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System
(OPPS) under CPT code 99490.
The “Power
Mobility Pearls for the Practicing Physician” Web-Based Training Course (WBT)
was released and is now available. This WBT is designed to provide education on
the fundamentals of the Power Mobility Devices compliance program. Continuing
education credits are available to learners who successfully complete this
course. See course description for more information.
To access the
WBT, go to MLN Products, scroll to
the bottom of the web page and under “Related Links” click on “Web-Based
Training Courses.”
The “Clarification
of the Use of Modifiers When Billing Wrong Surgery on a Patient” Podcast
(ICN 909189) was released and is now available. The podcast, based on MLN
Matters® Article SE0927, clarifies the correct use of certain
Healthcare Common Procedure Coding System (HCPCS) modifiers, specifically when
billing for wrong surgery on a patient.
The “Co-Surgery
Not Billed with Modifier 62” Podcast (ICN 909209) was released and is now
available. This podcast, based on MLN Matters® Article SE1322,
provides clarification on existing policy regarding significant payment errors
because of failing to properly apply the co-surgeon modifier when two or more
surgeons of different specialties participate in one operative session and each
separately submit claims to Medicare.
The “Chronic Care Management Services” Fact Sheet (ICN 909188)
was released and is available in downloadable format. This fact sheet is
designed to provide background on the separately payable Chronic Care
Management (CCM) Services for non-face-to-face care coordination services
furnished to Medicare beneficiaries with multiple chronic conditions. It
includes information on eligible providers and patients; Physician Fee Schedule
billing requirements; and a table aligning the CCM Scope of Service Elements
and billing requirements with the Certified Electronic Health Record or other
electronic technology requirements.
A new fast fact
is now available on the Medicare
Learning Network Educational Web Guides web page. This web page provides
information on Evaluation and Management services; Guided Pathways that contain
resources and topics of interest; lists of health care management products; and
easy-to-understand billing and coding educational products. It is designed to
provide educational and informational resources related to certain CMS
initiatives. Please bookmark this page and check back often as a new fast fact
is added each month.
The following
product is now available as an electronic publication (EPUB) and through a QR
code. Instructions for downloading EPUBs and how to scan a QR code are
available at “How To Download a Medicare Learning Network®
Electronic Publication.”
The “Home
Health Prospective Payment System” Fact Sheet (ICN 006816) is designed to
provide education on the Home Health Prospective Payment System (HH PPS). It
includes the following information: background; consolidated billing
requirements; criteria that must be met to qualify for home health services;
therapy services; elements of the HH PPS; updates to the HH PPS; billing and
payment for home health services; and Home Health Quality Reporting Program.
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#HCC #ICD10 #CMS #ICD9 #RiskAdjustment #MedicalCoding #Coding
Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations. The information presented herein is for general informational purposes only and is accurate as of the date of publication.
#HCC #ICD10 #CMS #ICD9 #RiskAdjustment #MedicalCoding #Coding
Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations. The information presented herein is for general informational purposes only and is accurate as of the date of publication.
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