HCPro.com: Billing Alert for Long-Term Care

It's essential to know how to correctly submit your Medicare claims in order to get the reimbursement your facility deserves. Billing Alert for Long-Term Care provides the crucial tips and strategies that billers need for success.

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April 2008 (Volume 10, Issue 4)	view entire issue

CMS offers advice on meeting the May 23 NPI deadline
Medicare claims received by fee-for-service Medicare contractors on or after May 23 must have only national provider identifiers (NPI) in all fields (i.e., both primary and secondary billing fields) on electronic and paper claims, CMS officials said at a February 6 national NPI Roundtable on Medicare fee-for-service NPI implementation. "On May 23, 2008, Medicare will not accept or send any legacy identifiers for any claim type. This includes [electronic data interchange (EDI), direct data entry], paper, [National Council for Prescription Drug Programs], or any HIPAA transaction. This includes claims or eligibility status checks, remittance, or [coordination of benefits]." Claims or transactions with legacy identifiers will be rejected or returned.

Part B wound care supplies can bring in revenue
Editor's note: Part one of this two-part series on Part B wound care supply billing examines how to determine whether billing these supplies makes financial sense for your facility, what the core requirements are, and what roles key departments must play to ensure successful billing. Part two will review UB-04 coding issues and provide tips on auditing your wound care billing program.

Part B therapy caps: Use KX modifier for covered, medically necessary exceptions
The Medicare, Medicaid, and SCHIP Extension Act of 2007 (S.2499) extended the exceptions process to the Part B rehabilitation therapy caps through June 30. Unless Congress takes additional action, the exceptions process will expire July 1. But for now, skilled nursing facilities and other Part B therapy providers can continue to take advantage of what are called automatic process exceptions-merit-ing a quick review of the circumstances in which CMS allows providers to use the KX claim line modifier to request an exception for Part B therapy services that exceed the caps.

BALTC Q&A
Editor's note: "Q&A" was written by Lee A. Heinbaugh, president of The Heinbaugh Group, a long-term care consulting company in Lakewood, OH. Q: I work for a nursing home that is in the process of getting certified to provide Medicare services. We have never billed using the UB-04 (Form CMS-1450). To ensure that we bill properly for both Medicare Part A and Medicare Part B services and supplies, could you refer us to any Web sites that you think would be helpful?

Other recently-published articles from Billing Alert for Long-Term Care:

Hospice services: Know when and how your facility should bill

Benefits exhaust and no-pay bills

BALTC Q&A

Medicare Part D: SNFs, LTCPs, and dual-eligible residents

Recovery audit contractors: Ready or not, here they come

Take the pain out of immunizations with roster billing

Billing for ambulance services: Combat common problems and reduce costs for your facility

BALTC Q&A

Rein in the facility census

Coding patient status on the UB-04

BALTC Q&A

Don’t overlook condition codes

Don’t let your billing office bypass resident resource payments

How FIs view changes in therapy services during a payment period

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