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03/09/2009

Q. A referring provider for whom we did a consult maintains that since he only does elective procedures, he is not required to have a National Provider Identifier (NPI). If he's not required to have an NPI, can we bill Medicare for the consult? What would I put in the referring physician field?

03/09/2009

Providers must have their Tax Identification Number (TIN) handy to identify themselves when calling their Medicare Administrative Contractors (MACs) with a problem or inquiry.

03/09/2009

President Obama nominated Kansas Gov. Kathleen Sebelius to be the next HHS secretary on March 2.

03/09/2009

Denials for wound care services (11040-11044) cost you and your peers more than $40 million in 2007, according to the latest available CMS claims data.

03/09/2009

This chart shows utilization growth by region - based on geographic practice cost index (GPCI) locations - from 2006 to 2007.

03/09/2009

You shouldn't see improper denials much longer for the 20 PQRI tracking codes we told you about last week (PBN 3/2/09). Corrections to the status indicators for those codes top the list of April fee schedule changes detailed by CMS in transmittal 1691 to the Medicare Claims Processing Manual.

03/09/2009

At least four different Medicare carriers are sporadically rejecting claims for dialysis services after their codes were changed from HCPCS to CPT on Jan. 1, Part B News has learned.

03/09/2009

Don't make yourself an easy target to the recently rolled-out Medicare Recovery Audit Contractors (RACs) (PBN 2/16/09). Attorneys with experience with government auditors say you can protect yourself by taking proactive steps, including developing a strategy for appealing unfavorable RAC determinations.

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