Tag Archives for CMS

New Medicare Advance Beneficiary Notice ABN CMS-R-131 to be used by January 1, 2012

Use New Medicare Advance Beneficiary Notice ABN CMS-R-131 by January 1, 2012 I received an e from the CMS LISTSERV today reminding me about the new Advance Beneficiary Notice ABN that we all have to start using by January 1, 2012.  I wanted to that information with you all, just in case you do not to the Medicare es.  Below is the info right from CMS. 2011 Version of Advance Beneficiary Notice of Noncoverage Must Be Used Beginning Sun Jan 1, 2012 In Continue Reading

Filed Under: Medical Billing and Coding Topics, Medicare Billing Tips

Medicare Hospice Modifier GV and GW

Medicare: How to use Modifier GV and Modifier GW We do medical billing for physician offices that do Care Plan Oversight (CPO) for Hospice Patients.  When billing for those services, G0182, we use the following Medicare modifiers: GV Modifier The GV modifier is used when a physician is providing a service that is related to the diagnosis for which a patient has been enrolled into hospice. This physician is not associated with the hospice and is providing services as the attending physician. GW Modifier Continue Reading

Filed Under: Medical Billing and Coding Topics, Medicare Billing Tips

Meaningful Use Requirements Final Rule is a Massive 864 Pages

Meaningful Use Requirements Final Rule is Out The final rule for meaningful use was just realeased by the Department of Human Services HHS, Centers for Medicare & Medicaid Services CMS. It is a masive 864 page document that includes both a core set and menu set of objectives that are specific to eligible professionals and hospitals.  There are still a total of 25 meaningful use objectives but now for Eligible Providers you need to only complete 20 objectives to qualify for the Continue Reading

Filed Under: Medical Billing and Coding Topics

Medicare Advance Beneficiary Notice (ABN): A Quick How-To

Does Your Medicare Patient Need To Sign An Advance Beneficiary Notice (ABN) CMS-R-131? Yes!  When applicable, your Medicare patients should always sign an Advance Beneficiary Notice (form CMS-R-131). An ABN is not used for commercial insurance companies. What Is An ABN? An ABN is a Medicare waiver of liability that providers are required to give a Medicare patient for services provided that may not be covered or considered medically necessary. An ABN is used when service(s) provided may not be reimbursed Continue Reading

Filed Under: Medical Billing and Coding Topics, Medicare Billing Tips

Commonly Used Medicare Modifiers – GA, GX, GY, GZ

Medicare ABN Specific Modifiers – GA, GX, GY, GZ We get a lot of questions at our medical billing company about which modifiers to use when submitting charges to Medicare. Specifically, we are often asked how to indicate whether or not an ABN (Advanced Beneficiary Notice) was given to the patient.  These are the top 4 Medicare modifiers we use. GA Modifier: Waiver of Liability Statement Issued as Required by Payer Policy. This modifier indicates that an ABN is on file and Continue Reading

Filed Under: Featured Blog Posts, Medical Billing and Coding Topics, Medicare Billing Tips

CMS Tells Medicare Contractors to Hold Claims

Center for Medicare and Medicaid Services Released the Following Statement: On June 25, 2010, President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.”  This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010.  The Centers for Medicare & Medicaid Services (CMS) has directed Medicare claims administration contractors to discontinue processing claims at the negative update rates Continue Reading

Filed Under: Medical Billing and Coding Topics