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Medicare fixes two billing problems

Rehab Private Practice Alert, July 12, 2006

CMS recently took steps to resolve two billing problems that were causing confusion for rehab providers, according to PT Bulletin Online.

The agency instructed fiscal intermediaries and home health intermediaries to begin reprocessing claims for electrical stimulation (HCPCS code G0283) when billed with treatment for swallowing dysfunction or oral function for feeding (CPT code 92526).

Prior to the change an erroneous Correct Coding Initiative edit caused claims with both codes to be denied after January 1, reported PT Bulletin.

CMS also corrected an inconsistency between the Medicare benefits manual and the manuals for claims processing and national coverage determination that caused many carriers and intermediaries to require the date a patient was last seen by a referring physician on the claim form, even though the benefit manual no longer requires a physician visit before treatment begins.

The correction does not apply to therapy services provided "incident to" services, which still require a prior physician visit.

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