Providers who currently submit paper claims to Medicare must begin using CMS-1500 form 02/12 for paper claim submissions received on or after April 1, 2014. On June 10, 2013, the White House OMB approved the revised CMS-1500 claim form, version 02/12, OMB control number, 0938-1197. The CMS-1500 claim form is the required format for submitting claims to Medicare on paper. If providers submit paper claims via the CMS-1500 08/05 version on or after April 1, 2014 to their Medicare Administrative Contractor, the claim(s) will be rejected and returned as unprocessable. Providers will be instructed to resubmit a claim(s) using the

Gold Members, please log in to read about breaking new information concerning the 2014 therapy cap exception process, payment update for services reimbursed under the Medicare Physician Fee Schedule and breaking news about ICD-10 implementation. Not yet a Gold Member? Join HERE and get access to all the information on the website, monthly electronic member only newsletters, and member only breaking news email updates. On March 31, the United States Senate passed

The Centers for Medicare and Medicaid Services have issued clarification instructions on the use of the skilled nursing facility (SNF) Advance Beneficiary Notice (ABN) of Non-Coverage form pursuant to the Jimmo vs Sebelius settlement. The instructions cover common denial reasons why the extended care items or services are noncovered under Medicare. The SNF may use these denial paragraphs as inserts in the “Because” and “Items or Services” sections of the SNF ABN. Denial paragraphs provided by CMS include, but are not limited to, teaching and training activities – partial denial, teaching and training activities – no skilled services, teaching or