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01/21/19

Skilled Nursing Facility ABN

The Centers for Medicare and Medicaid Services (CMS) has released an updated transmittal providing instructions when a skilled nursing facility (SNF) should and should not issue an advance beneficiary notice of non-coverage (ABN) to a Medicare beneficiary. To read the SNF ABN instructions of when to and when not to issue a SNF ABN, ABN specific delivery issues, special rules for SNF ABN’s, establishing when beneficiary Is on notice of non-coverage, and sources of beneficiary notification, click

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01/14/19

NCCI Edit Version 25.0 Released

The National Correct Coding Initiative (NCCI) edits Version 25.0 has been released and is in effect for dates of service January 1, 2019 – March 31, 2019. There are many changes in this version due to the 2019 new and deleted CPT codes. There are several new CPT codes related to Adaptive Behavior as well as Developmental Testing. To access the NCCI Edit Version 25.0 “cheat sheet” applicable to physical therapy, occupational therapy and speech-language pathology services, click HERE. Thank you for being a Gold Member!

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01/14/19

First Coast Revises Therapy LCD

First Coast Service Options, Inc, Medicare Administrative Contractor for Florida, Puerto Rico and the Virgin Islands, has revised their local coverage determination (LCD) for Therapy and Rehabilitation Services. To access the revised LCD, log into your account and click

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01/14/19

Palmetto Revises PT, OT and SLP LCD’s

Palmetto GBA, Medicare Administrative Contractor for the states of Alabama, Georgia, North Carolina, South Carolina, Tennessee, Virginia and West Virginia, have revised their physical therapy, occupational therapy and speech therapy local coverage determinations (LCD’s). The effective date for the revisions for all 3 LCD’s is January 1, 2019. To access the revised LCD’s, log into your Gold Member account and click on the following titles below

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01/14/19

WPS to Remain MAC in Indiana and Michigan

Wisconsin Physician Services will remain the Medicare Administrative Contractor (MAC) has been awarded a contract for the administration of Medicare Part A and Part B Fee-for-Service claims in the states of Indiana and Michigan (A/B MAC Jurisdiction 8). The previous MAC contract for A/B MAC Jurisdiction 8 was awarded to Wisconsin Physicians Service Insurance Corporation (WPS) in September 2011. Click HERE to read the Fact Sheet regarding this award.

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01/07/19

2019 New CPT Codes

It’s a new year and this means we have some new CPT codes that are available for physical therapists (PT’s), occupational therapists (OT’s) and/or speech-language pathologists (SLP’s) to use in calendar year 2019. CPT codes, description, and material are copyright 2018 American Medical Association. CPT is a trademark of the American Medical Association. All rights reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. The 2019 new CPT codes applicable to PT’s, OT’s and SLP’s are:  

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01/07/19

2019 Deleted CPT Codes

It’s a new year and this means we have some deleted CPT codes that are no longer available for physical therapists (PT’s), occupational therapists (OT’s) and/or speech-language pathologists (SLP’s) to use in calendar year 2019. CPT codes, description, and material are copyright 2018 American Medical Association. CPT is a trademark of the American Medical Association. All rights reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. The 2019 deleted CPT codes applicable to PT’s, OT’s and SLP’s are:  

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01/07/19

New Adaptive Behavior Services CPT Codes

It’s a new year and this means we have some new CPT codes that are available for physical therapists (PT’s), occupational therapists (OT’s) and/or speech-language pathologists (SLP’s) related to adaptive behavior services to use in calendar year 2019. CPT codes, description, and material are copyright 2018 American Medical Association. CPT is a trademark of the American Medical Association. All rights reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. The 2019 new CPT codes related to adaptive behavior services are:

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