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06/01/13

ICD-10 and Claim Submission

In the linked special edition article, the Centers for Medicare & Medicaid Services (CMS) clarifies policy for processing split claims for institutional providers that span the International Classification of Diseases, 10th Edition (ICD-10) implementation date of October 1, 2014. ICD-9 codes are effective for that portion of the services rendered on September 30, 2014, and earlier. ICD-10 codes are effective for that portion of the services rendered on October 1, 2014, and later. CMS will require providers to

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05/31/13

NGS Transition Implementation Schedule

National Government Services (NGS) will become the Medicare Administrative Contractor for the states of Illinois, Minnesota, and Wisconsin this summer. NGS has developed a website with transition information.To view the implementation schedule and obtain other important transition information, click HERE.

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05/31/13

WPS Posts New Dysphagia Policy

Wisconsin Physician Services (WPS), Medicare Administrative Contractor in Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska, has posted a new dysphagia local coverage determination (LCD) for private practices and non-private practices in the above mentioned states. To access the new LCD for private practices in Indiana and Michigan, click

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05/31/13

WPS to Host Teleconference on Common Appeal Issues

Wisconsin Physician Services (WPS), Medicare Administrative Contractor in the states of Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska, will be hosting a teleconference for non-private practice settings on July 25, 2013 from 11:00AM-12:30PM eastern time focused on avoiding common appeal issues. No registration is required for this teleconference. At the time of the call, please be prepared to provide the operator the following: your name, facility name, Medicare provider number (or NPI), and the number of participants in the room. Dial-In Number: (866) 246-6880 Conference ID: 40880277

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05/31/13

Managing Claim Submission Errors Teleconference

First Coast Service Options, Medicare Administrative Contractor for the state of Florida, will be hosting a webcast on Tuesday, June 25, 2013 from 11:30AM-1:30PM on managing claim submission errors for private practices. For additional information and to register, click HERE.

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05/31/13

Cigna to Conduct Probe Medical Review in Kentucky

On May 31, 2013, Cigna Government Services announced they will implement a service specific probe edit for type of bill (TOB) 21X for Resource Utilization Group (RUG) code RUC10. They will review approximately 100 claims as part of this probe review. For additional information and what documentation to submit if you have records requested, click HERE.

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05/28/13

WPS Retiring SLP LCD

Wisconsin Physician Services, Medicare Administrative Contractor in Indiana and Michigan, will be retiring their speech-language pathology local coverage determination effective July 15, 2013 for both private practices and non-private practice settings.

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05/26/13

Change to Payment Liability for Therapy Cap Denials

Section 603(c) of the American Taxpayer Relief Act of 2012 (ATRA) changed the payment liability for denials resulting from the outpatient therapy caps from beneficiaries to providers effective January 1, 2013. Medicare systems were not updated in time to accurately represent this change on provider remittance advices (RAs). Medicare contractors may have already processed therapy cap denials for services provided in 2013. These denials incorrectly report on RAs beneficiary liability (Group Code “PR”) when liability legally rests with the provider (Group Code “CO”). Due to differing claims processing system constraints, this inaccurate RA reporting will be corrected beginning on different

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