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Showing posts from April, 2022

Home Health (HH) Billing Updates'2022

Correction to Home Health (HH) Billing for Denial Notices The implementation of the one-time home health Notice of Admission (NOA) in calendar year 2022, every claim for a home health period of care first required the submission of a Request for Anticipated Payment (RAP). Correction to the Calculation of 60-Day Gaps in Home Health Services A sequence of related home health periods of care is defined beginning with an admission to home health services and ending when there is a 60-day gap in home health services. This 60-day gap is used by Medicare systems for two purposes. It is used to validate whether a home health period of care is correctly coded as an early or later period. It is also used to identify early periods that should pay a Low Utilization Payment Adjustment (LUPA) add-on amount. Medicare administrative contractors recently identified a minor variance between the way the 60-day gap is counted and used for these two purposes. The requirements below revise the counting meth

Diagnostic Angiography and Revascularization of Lower Extremity

The Catheterization is divided into two types and there are,  Non Selective Catheter Placement Selective Catheter Placement Non Selective Catheter Placement The non selective catheter placement is not to be coded with selective catheter placement together.  And the following to be considered as non selective catheter placement, puncture of catheter, Insertion, and placement of catheter into the aorta.  Also, if the catheter does not have any further movement it should be considered as non selective catheter placement. E.g., When the documentation shows that the catheter placement was only in the aorta, the non-selective catheter placement CPT code 36200 is to be coded. Selective Catheter Placement The selective catheter placement is advanced from the original vessel of puncture sites to another vessels and it should be considered as selective catheter placement. When the catheter is advanced and/or crossed from the aorta and it should be considered as selective catheter placement. E.g.

Pneumococcal Vaccine Claims Processing Updates April 2022

The Pneumococcal Vaccine CPT codes will be payable by Medicare. The new codes will be in the 2021 Medicare Physician Fee Schedule Database file update and the annual HCPCS update.  90677-  Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use. Which is effective for Dates of Service (DOS) on or after July 1, 2021 90671 - Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use Which is effective for DOS on or after July 16, 2021  The CPT 90677 does not apply for Coinsurance and deductible. A Medicare Administrative Contractor (MAC) will pay institutional providers for these codes based on the Type of Bill (TOB) used. The two payment methods are,        1. The Medicare Administrative Contractor (MAC) will pay these institutional providers using reasonable cost if you use the following, Hospitals (TOBs 12X and 13X) Skilled Nursing Facilities (TOBs 22X and 23X) Home Health Agencies (TOB 34X) Hospital-based Renal Dialysis Facilities (RDFS) (TOB 72X) Crit