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05/23/13

Cigna Sends ADR Requests in Error

CGS mailed Additional Documentation Request (ADR) letters to Physical Therapists (specialty 65) in error in the state of Ohio. These letters were mailed from May 8-22, 2013. Physical therapists (specialty 65) who received one of these letters do not need to respond. CGS is currently identifying the affected claims and will release them for routine processing whether or not a response has been received.

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05/22/13

WPS To Host SNF Teleconference

Wisconsin Physician Services, Medicare Administrative Contractor for the states of Iowa, Kansas, Missouri, and Nebraska, will be hosting a teleconference on May 29, 2013 from 2:00pm-3:30PM ET on SNF same day transfers. To register, click HERE. Wisconsin Physician Services, Medicare Administrative Contractor for the states of Indiana and Michigan, will be hosting a teleconference on May 29, 2013 from 2:00pm-3:30PM ET on SNF same day transfers. To register, click HERE.

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05/22/13

Billing Social Work & Psychological Services in CORFs

The Centers for Medicare & Medicaid Services (CMS) recently updated the list of Healthcare Procedure Coding System codes billable in comprehensive outpatient rehabilitation facilities (CORF). CMS provides new information containing billing instructions for a national coverage determination (NCD) related to CORFs that was previously omitted from the Medicare Claims Processing Manual. The new instructions clarify allowed revenue codes with type of bill 75x filed with social work and psychological services provided in CORFs. Here is the link to the MLN Matters® article: MM8257

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05/21/13

Don’t Forget The KX Modifier or Else

Effective June 20, 2013, Cigna Government Services, Medicare Administrative Contractor in the states of Kentucky and Ohio, will require additional documentation be included with all Reopening request that are being submitted for the purpose of adding a KX modifier to a therapy claim. The documentation may include but is not limited to: treatment plans, history and physicals, progress notes, consult notes and reports. After this date, if the documentation is not included with the reopening request, the claim cannot be processed for an adjustment.

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05/20/13

Physician Signature Requirements

First Coast Service Options, Inc., a Medicare Administrative Contractor, has put together a nice slide presentation on appropriate physician signatures in the medical records. This would also be applicable for therapists and assistants. Even though this was done by First Coast, the requirements are CMS requirements, hence, this presentation would be applicable for all providers in all states.

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05/20/13

CGS to Host FLR Teleconference

Cigna Government Services (CGS) invites you to participate in an Ask-the-Contractor Teleconference (ACT) specifically focused on the new claims-based data collection reporting requirement and changes to the manual medical review process for outpatient therapy services. The teleconference is scheduled for Thursday, May 23, 2013, from 9-10:30 a.m. CT/10-11:30 a.m. ET. Please mark your calendar and plan to participate in this call. No pre-registration is necessary. To join the teleconference, please click HERE and follow the instructions.

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05/20/13

Noridian Changes Name

Effective today, May 13, Noridian Administrative Services (NAS) has officially changed its name to Noridian Healthcare Solutions (Noridian) to better reflect the scope of capabilities that have grown from our core business.

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05/20/13

Appeals of Claims Decisions

First Coast Service Options, Inc., a Medicare Administrative Contractor, has put together a nice summary of the 5 different levels of the appeal process, time limit for filing the request, and where to file the appeal. This site even has an option where the provider can submit the date of the denial or decision of an appeal, and the system will tell the provider the date of when they must appeal to the next level. Even though this is on the First Coast Service Options website, this would be the same process for all Medicare Administrative Contractors, hence, would be

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