Nurse visit usage crackdown key part of April CCI changes
Be careful when billing a nurse E/M visit (99211) along with a venipuncture blood draw (36415) or EKGs (93000-93010) starting April 1. All of these code pairs are new CCI edits subject to a bundling denial of the nurse visit, though CCI will allow you to use a modifier to bypass the edit.
These services would typically not be paid unless the nurse visit was for something other than the EKG or the blood draw. If they are for the same service, it would be considered to be double-billing.
MACs may change the way electronic payments are issued, processed
Medicare already required its Medicare Administrative Contractors to pay you via electronic funds transfer (EFT) in most instances. But a recent policy change that requires all private insurance plans to offer EFT may result in tweaks to how the MACs pay as well.
In transmittal 135 to its One-Time Notifications Manual, CMS instructed the MACs to follow the same standard EFT payments required of private payers under the CAQH CORE EFT/ERA Operating Rules that take effect July 7.
Have Some Extra Cash You'd like to Send to the Government?
No it isn’t tax time. But failing to follow Medicare rules when submitting claims could result in a paycheck for Uncle Sam. In fact, you could have to return money that you've already collected from the government. I know three practices that have done that this year, and all for the same reason. What was the reason? Billing for student services. What kind of students? Nurse practitioner and physician assistant students. Students are not licensed and enrolled in Medicare or in any other ...