Medical Billing

US Federal Holidays list 2016 Friday, January 1New Year’s Day Monday, January 18Birthday of Martin Luther King, Jr. Monday, February 15*Washington’s Birthday Monday, May 30Memorial Day Monday, July 4Independence Day Monday, September 5Labor Day Monday, October 10Columbus DayFriday, November 11Veterans Day Thursday, November 24Thanksgiving Day Monday, December 26 Christmas Day

2016 USPS Holidays list Friday, January 1  New Year’s Day Monday, January 18  Birthday of Martin Luther King, Jr. Monday, February 15  Washington’s Birthday Monday, May 30  Memorial Day Monday, July 4  Independence Day Monday, September 5  Labor Day Monday, October 10  Columbus Day Friday, November 11  Veterans Day Thursday, November 24  Thanksgiving Day Monday, December 26  Christmas Day

Medicare part B deductible for 2016 - $166.00 CMS announced that the annual deductible for all Part B beneficiaries will be $166.00 in 2016.

what is ICD 10 code for depression : ICD 10 codes for depression are grouped under many categories, as listed below: F32 - Major depressive disorder , single episode The intent of this category, from what I understand, is to include single episodes of major depression. There are several ICD-10 codes that can be used here, depending on severity, the presence of any associated symptoms, and whether the episode of depression is in partial of full remission (note that F32 is NOT a billable code): F32.0 - Major depressive disorder, single episode, mild F32.1 - Major depressive disorder, single episode, moderate F32.2 - Major depressive disorder, single episode, severe without psychotic features F32.3 - Major depressive disorder, single episode, severe with psychotic features F32.4 - Major depressive disorder, single episode, in partial remission F32.5 - Major depressive disorder, single episode, in full remission F32.8 - Other depressive episodes F32.9 - Major dep

The following is a List of ICD-10 codes International Statistical Classification of Diseases and  Chapter Blocks Title I A00–B99 Certain infectious and parasitic diseases II C00–D48 Neoplasms III D50–D89 Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism IV E00–E90 Endocrine, nutritional and metabolic diseases V F00–F99 Mental and behavioural disorders VI G00–G99 Diseases of the nervous system VII H00–H59 Diseases of the eye and adnexa VIII H60–H95 Diseases of the ear and mastoid process IX I00–I99 Diseases of the circulatory system X J00–J99 Diseases of the respiratory system XI K00–K93 Diseases of the digestive system XII L00–L99 Diseases of the skin and subcutaneous tissue XIII M00–M99 Diseases of the musculoskeletal system and connective tissue XIV N00–N99 Diseases of the genitourinary system XV O00–O99 Pregnancy, childbirth and the puerperium XVI

Claims Part A – Skilled Nursing Facility (SNF) Providers There has been an increase in overlap claim situations due to Skilled Nursing Facility (SNF) providers not submitting their discharge claims correctly.   There are two situations that force a discharge from a SNF: 1) the beneficiary’s admission as an inpatient to a Medicare participating hospital or Critical Access Hospital (CAH), or 2) the beneficiary’s transfer to another SNF for inpatient services. A beneficiary cannot be an inpatient in more than one facility at a time. Consequently, the SNF must submit a discharge bill if either of these events occur.  It is inappropriate to add a 74 span code in lieu of a discharge status.  Reference IOM 100-04, Chapter 6, Section 40.3.4   SNF providers shall submit no-payment claims for beneficiaries that previously dropped to non-skilled care and continue to reside in the Medicare-certified area of the facility. The provider must only submit the final discharge bill that may span mul

Difference Between ICD 9 - ICD 10 Basic Information about ICD 9: The United States Implemented ICD 9 in 1979. But most of the countries moved to ICD 10 several years ago, it’s time for United States medical history to reflect modern Medical terms.  Difference between ICD 9 – ICD 10 Code set differences ICD-9-CM codes are very different than ICD-10-CM/PCS code sets: There are nearly 19 times as many procedure codes in ICD-10-PCS than in ICD-9-CM volume 3 There are nearly 5 times as many diagnosis codes in ICD-10-CM than in ICD-9-CM ICD-10 has alphanumeric categories instead of numeric ones The order of some chapters have changed, some titles have been renamed, and conditions have been grouped differently ICD-9-CM Diagnosis Codes ICD-10-CM Diagnosis Codes No Laterality Laterality – Right or Left account for >40% of codes 3-5 digits First digit is alpha (E or V) or n

When hospice coverage is elected, the beneficiary waives all rights to Medicare Part B payments for services that are related to the treatment and management of his terminal illness during the period his hospice benefit election is in force, except for professional services of an “attending physician” who is not an employee of the designated hospice and does not receive compensation from the hospice for those services. Professional services of an “attending physician” are submitted with the GV modifier if all conditions are met (description below). Any services provided to a patient enrolled in hospice that are not related to the treatment and management of the patient’s terminal illness are submitted with the GW modifier (description below). For purposes of administering the hospice benefit provisions an “attending physician” is defined as follows (must meet all requirements): An individual who is a doctor of medicine, doctor of osteopathy or a nurse practitioner. Is identi

Recently, Novitas Solutions has received numerous requests to provide pre-authorization for surgery scheduled to occur within days. Traditional Medicare does not provide pre-certification or pre-authorization of a surgery. Medically necessary services should not be withheld or delayed. Medically necessary services that have been provided to the patient are billed to Medicare for consideration and processing. If a service is denied, the provider and the patient have a right to request a redetermination of the denial. Title XVIII of the Social Security Act, Section 1862(a)(1)(A) allows coverage and payment for items and services that are reasonable and necessary for the diagnosis or treatment of an illness or injury or to improve the functioning of a malformed body member. Section 1862(a)(1)(A) of the Social Security Act is the basis for denying payment for types of care, specific items, services, or procedures, not excluded by any other statutory clause, meet all technical requiremen

Medicare Novitas is currently receiving a high volume of duplicate certifications/signatures for Internet-based PECOS (Provider Enrollment, Chain and Ownership System) CMS-855  submissions.  This is a result of customers submitting both an electronic signature and a hardcopy/paper certification.  When submitting an application via Internet-based PECOS, please elect only one method of submitting your signature; electronic OR hardcopy.  For additional details, please review Novitas educational article titled “Internet-based PECOS Signature Submissions” on our website in the Enrollment Center.   When submitting an application via Internet-based PECOS, please elect one form of signature submission. 1. Electronic Signature: Internet-based PECOS allows for the provider or Authorized/Delegated Official to electronically sign the application submission. Utilizing the electronic signature process will ensure faster application submission, resulting in an earlier effective date.  This feat