Displaying Ambulance Articles 1 to 25 of 67

Topic	Date	Description
Questions and Answers on Reporting Physician Consultation Services	Thursday, February 25, 2010	This article pertains to change request (CR) 6740, which alerts providers that effective January 1, 2010, the CPT consultation codes (ranges 99241-99245 and 99251-99255) are no longer recognized for Medicare Part B payment. Effective for services furnished on or after January 1, 2010, providers should report each E/M service, including visits that could be described by CPT consultation codes, with an E/M code payable under the Medicare Physician Fee Schedule (MPFS) that represents WHERE the visit occurs and that identifies the COMPLEXITY of the visit performed.
Medicare Systems Edit Refinements Related to Hospice Services	Tuesday, February 16, 2010	This article is based on Change Request (CR) 6778 which: 1. Revises existing Medicare standard systems edits to allow Medicare fee for service (FFS) claims to process for beneficiaries in a Medicare Advantage plan on the date of a Medicare hospice election. 2. Adds new edits ensuring the appropriate place of service is reported for hospice general inpatient care (GIP), respite, and continuous home care (CHC); and 3. Provides a technical correction to the Medicare Benefit Policy Manual regarding the requirement for nursing care related to hospice continuous home care. Be certain your billing staffs are aware of these Medicare changes.
Call Center Closing Times (Part A)	Friday, February 12, 2010	To better serve the provider community, the Centers for Medicare and Medicaid Services (CMS) is allowing Provider Contact Centers across the nation to conduct customer service training during normal business hours. The Medicare Program is very complex with continuous changes and this initiative will help prepare Provider Customer Service Representatives (CSR's) to give quality answers to substantive Medicare related questions or inquiries. Pinnacle Business Solutions, Inc. the Medicare Part A Intermediary for the States of Arkansas, Louisiana and Mississippi will be participating in this program. We have developed a comprehensive training plan that includes closing our Provider Contact Center for up to eight hours each month. The following closure dates are scheduled for February 2010 and March 2010.
Call Center Closing Times (Part B)	Friday, February 12, 2010	To better serve the provider community, the Centers for Medicare and Medicaid Services (CMS) is allowing Provider Contact Centers across the nation to conduct customer service training during normal business hours. The Medicare Program is very complex with continuous changes and this initiative will help prepare Provider Customer Service Representatives (CSR's) to give quality answers to substantive Medicare related questions or inquiries. Pinnacle Business Solutions, Inc. the Medicare Part B Carrier for Arkansas and Louisiana will be participating in this program. We have developed a comprehensive training plan that includes closing our Provider Contact Center for up to eight hours each month. Using Provider Contact Center call distribution data to determine the least possible impact for our customers, we have selected the following closure dates and times for February 2010 and March 2010.
Web Site Satisfaction Survey	Thursday, February 04, 2010	Pinnacle Business Solutions, Inc. (PBSI) is asking that you please take a few minutes and fill out our Web Site Satisfaction Survey that may pop up while you are browsing the PBSI web site. We want to know how well the entire site and specific site elements address your needs. As our web site is constantly changing, we would appreciate your input every six weeks or so. It is your feedback that makes changes possible.
Verification of Legalized Status	Wednesday, February 03, 2010	This article, based on CR 6748, states that a carrier and Part A and Part B Medicare Administrative Contractor (A/B MAC) must verify that a physician or non-physician practitioner enrolling, reactivating a deactivated billing number or responding to a contractor request for revalidation must be legally authorized to furnish medical services to Medicare beneficiaries.
Providers Randomly Selected to Participate in the Medicare Contractor Provider Satisfaction Survey (MCPSS) Urged to Respond	Monday, January 25, 2010	This Special Edition article alerts providers that the Centers for Medicare & Medicaid Services (CMS) has launched the fifth annual national administration of the MCPSS. If you received a letter indicating you were randomly selected to participate in the 2010 MCPSS, CMS urges you to take a few minutes to go online and complete this important survey via a secure Internet website. Responding online is a convenient, easy, and quick way to provide CMS with your feedback on the performance of your FFS contractor. Survey questionnaires can also be submitted by mail, secure fax, and over the telephone.
Billing for Services Related to Voluntary Uses of Advance Beneficiary Notices of Noncoverage (ABNs)	Friday, January 22, 2010	Note: This article was revised on January 16, 2010, to reflect a revised CR6563, which was issued on January 15, 2010. The article was revised to reflect a new CR release date, transmittal number, and Web address for accessing CR 6563. All other information remains the same. CR 6563, from which this article is taken, announces recent instructions for the use of modifiers in association with Advance Beneficiary Notices (ABN). Specifically, effective April 1, 2010, two HCPCS level 2 modifiers have been updated to distinguish between voluntary, and required, uses of liability notices. Those modifiers are: Modifier – GA has been redefined to mean "Waiver of Liability Statement Issued as Required by Payer Policy," and should be used to report when a required ABN was issued for a service. A new modifier (-GX) has been created with the definition "Notice of Liability Issued, Voluntary Under Payer Policy" and is to be used to report when a voluntary ABN was issued for a service. Make sure that your billing staffs are aware of these ABN modifier changes.
Emergency Update to the 2010 Medicare Physician Fee Schedule Database (MPFSDB)	Friday, January 15, 2010	Note: This article was revised on January 8, 2010, to reflect a new Change Request (CR) 6796 that was released on January 6, 2010. The transmittal number (see above), CR Release Date and Web address for accessing CR 6796 has been changed. All other information remains the same. The files associated with CR 6796 include a legislative change to the CY 2010 conversion factor update and changes as a result of technical corrections to the malpractice relative value units. The conversion factor for CY 2010 is $36.0846. This article is based on Change Request (CR) 6796 which amends payment files that were issued to Medicare contractors based on the 2010 Medicare Physician Fee Schedule (MPFS) Final Rule. Be sure your billing staff is aware of these changes.
Summary of Policies in the 2010 Medicare Physician Fee Schedule (MPFS) and the Telehealth Originating Site Facility Fee Payment Amount	Monday, January 04, 2010	Note: This article was revised on December 30, 2009, to reflect a revised CR 6756, which was issued on December 29, 2009. The CR release date, transmittal number (see above), and the Web address for accessing CR 6756 were changed. All other information remains the same. This article is based on Change Request (CR) 6756 which provides a summary of the policies in the 2010 MPFS and announces the telehealth originating site facility fee payment amount. Be sure billing staff are aware of these Medicare changes.
Expiration of Medicare Processing of Certain Indian Health Service (IHS) Part B Claims - Sunset of Section 630 of the Medicare Modernization Act (MMA) of 2003 for Payment of Indian Health Services (IHS)	Thursday, December 31, 2009	Note: This article has been replaced by article SE0930, which is available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0930.pdf on the Centers for Medicare & Medicaid Services website.
Web Site Satisfaction Survey	Friday, December 11, 2009	Pinnacle Business Solutions, Inc. (PBSI) is asking that you please take a few minutes and fill out our Web Site Satisfaction Survey that may pop up while you are browsing the PBSI web site. We want to know how well the entire site and specific site elements address your needs. As our web site is constantly changing, we would appreciate your input every six weeks or so. It is your feedback that makes changes possible.
2010 Arkansas Ambulance Fee Schedule	Tuesday, December 08, 2009	The following payment allowances have been established effective 01/01/2010.
Ambulance Inflation Factor (AIF) for Calendar Year (CY) 2010	Wednesday, December 02, 2009	Change Request (CR) 6631, from which this article is taken, provides the AIF for CY 2010. The AIF for CY 2010 is zero (0).
Update to Medicare Deductible, Coinsurance, and Premium Rates for 2010	Wednesday, November 18, 2009	This article is based on Change Request (CR) 6690, which provides the Medicare rates for deductible, coinsurance, and premium payment amounts for calendar year (CY) 2010.
Ambulance Services	Wednesday, November 18, 2009	This article, based on CR 6707, advises you that the Medicare Benefit Policy Manual Chapter 10 – Ambulance Service section 10.3 has been revised to incorporate consistent manual language to the definition of "The Destination." There is no change to policy. Please make sure your billing staffs are aware of this update.
Ensuring the Denial of Claims for Ambulance Services Rendered to Beneficiaries in Part A Skilled Nursing Facility Stays	Tuesday, November 10, 2009	This article is based on Change Request (CR) 6700 which implements additional Medicare system checks to ensure that ambulance services that are subject to Skilled Nursing Facility Consolidated Billing (SNF CB) rules (but that are billed separately as a Part B service) are denied when the date of service (DOS) on the ambulance claims overlap outpatient hospital claims that are rejected for SNF CB. SNF and ambulance billing staff should be aware of this issue.
Alternative Process for Individual Eligible Professionals to Access Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Feedback Reports	Friday, October 16, 2009	CMS has created an alternative process that individual EPs may use to request 2007 Re-Run and 2008 PQRI feedback reports based on their individual NPI. Based on the nature of your questions (e.g., status of your PQRI incentive payment, measures, coding, or the feedback reports), you may need to contact different entities. E-Prescribing feedback reports for data submitted in calendar year 2009 will be available in late 2010. CMS will notify EPs when they can begin requesting these reports using this alternative process. You should make sure your billing staffs are aware of this information. Please refer to the information below for more details.
2009 - 2010 Seasonal Influenza (Flu) Resources for Health Care Professionals	Tuesday, October 13, 2009	Note: This article was revised on October 7, 2009, to include a link on page 3 to MLN Matters® article number MM6608, which includes the payment allowances for the 2009-2010 influenza vaccine. All other information remains the same. Keep this Special Edition MLN Matters article and refer to it throughout the 2009 - 2010 flu season. Take advantage of each office visit as an opportunity to encourage your patients to protect themselves from the seasonal flu and serious complications by getting a seasonal flu shot. Continue to provide the seasonal flu shot as long as you have vaccine available, even after the new year. Don’t forget to immunize yourself and your staff.
Billing for an Ambulance Transport with More than One Patient Onboard	Monday, September 28, 2009	This article advises ambulance suppliers that CR6621 communicates claims processing instructions for ambulance service claims submitted for trips with more than one patient onboard. These changes are to be added to the Ambulance chapter of the Medicare Claims Processing Manual (Chapter 15). Please inform your billing staffs of these changes.
Medicare Administrative Contractor (MAC) Transition and Outbound Health Insurance Portability and Accountability Act (HIPAA) Transactions	Thursday, September 24, 2009	This article, based on CR 6599, informs all physicians, and providers who operate in multiple states under a single NPI that, beginning with the effective date of January 1, 2010, they will receive HIPAA outbound transactions separated by the appropriate contractor identifier (ID) number assigned to a MAC in files generated by Medicare’s Multi-Carrier Claims System (MCS) that process Part B claims. Ensure that your billing staffs are aware of this change.
Influenza Pandemic Emergency - The Medicare Program Prepares	Wednesday, September 16, 2009	Note: The Centers for Medicare & Medicaid Services rescinded this article on September 11, 2009. The MLN Matters article for SE0836 in its entirety is available on the CMS web site at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0836.pdf.
Fractional Mileage Amounts Submitted on Ambulance Claims	Friday, September 04, 2009	This article was rescinded on August 28, 2009, because the Centers for Medicare & Medicaid services rescinded related CR 6543 on that date. The MLN Matters article for MM6543 in its entirety is available on the CMS web site at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6543.pdf.
New Workload Number for and Transition of the Part A Louisiana and Mississippi Workloads to Pinnacle Business Solutions, Inc. (PBSI)	Friday, August 07, 2009	The Part A Louisiana and Mississippi workloads are currently processed by TriSpan Health Services. The Centers for Medicare & Medicaid Services (CMS) anticipates that TriSpan’s Title XVIII contract will end no later than September 30, 2009. CMS had originally planned to move that workload to the J7 A/B MAC contractor. However, because that award has been protested, CMS will instead move that workload to Pinnacle Business Solutions Inc. (PBSI), an existing Title XVIII Fiscal Intermediary (FI). Additionally, the Electronic Data Interchange (EDI) Front End system for this workload is being subcontracted to Palmetto GBA during this interim period. The purpose of this change request (CR) is to notify all interested parties of this transition and that CMS needs to change the contractor workload number for the Part A workloads in the states of Louisiana and Mississippi when that workload is transitioned to PBSI. That change is being made so that when the workload is processed by PBSI, it can be distinguished from the workload processed by TriSpan Health Services for purposes of tracking and accounting. This workload will be transitioned to PBSI as indicated below.
Guidance on Using Internet-based Provider Enrollment, Chain and Ownership System (PECOS)	Wednesday, August 05, 2009	This Special Edition (SE) 0914 article alerts physicians, non-physician practitioners, providers and suppliers that the Centers for Medicare & Medicaid Services (CMS) is reaching out to assist those providers and suppliers who wish to use Internet-based PECOS for enrollment in Medicare and/or to maintain the currency of the enrollment data they have on file with Medicare. Internet-based PECOS offers physicians, non-physician practitioners, and organization providers and suppliers a means of applying for enrollment and updating their enrollment information faster than the paper enrollment process that required the use of the paper CMS-855 series of forms. The documents that describe Internet-based PECOS are available at http://www.cms.hhs.gov/MedicareProviderSupEnroll/04_InternetbasedPECOS.asp#TopOfPage on the CMS website.
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