How to use Place of Service on a medical billing claim

For new billers who are starting to learn the medical lingo you may find a great benefit from this Free Medicare training video. Learn how to get claims paid correctly when using the correct Place of Service (POS) codes. This Free Medicare tutorial will take at least 30 minutes to review.

http://www.wpsmedicare.com/provider/tutorials.shtml

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Wisconsin Physician Service Website change

Prepare now for the changes coming to Wisconsin Physician Service website. They will soon be changing their website from http://www.wpsic.com/medicare to http://www.wpsmedicare.com/.

To save this new link as a favorite follow these steps:
1. Click on the new link http://www.wpsmedicare.com/
2. Click Control + D
3. Give it a short name like WPS
4. Create in: folder or Link option
5. Click Add

Delete the old website address from your favorites list


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Computer Based Training

Medicare is offering a easy to use Computer based tutorial on how to get claims paid out on. All offices that bill claims to Medicare should take 30 minutes to go through the tutorial. It explains denial reasons and has references to cross-walks.

If your office is getting a lot of denial codes such as CO16, CO4, COB18, and PR16 this training will be very informative.

Do not delay check it out now:
http://www.wpsmedicare.com/provider/unprocessable_claims_files/frame.html

Confused by Electronic Medical Claim billing then read these articles on Billing Health Insurance medical claims

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Provider Transaction Account Number (PTAN)

Provider Transaction Account Number (PTAN) is what the Provider Identification Number (PIN) will be called after May 23, 2007.

Providers will continue to receive a PTAN (PIN) and can be required to use it in certain transactions or contacts.

Currently, both terms might be used, but be aware that both terms refer to the same number. Many billing offices and doctor offices are getting confused when Medicare asks them for a PTAN number. Be aware of the name change!

To read more about Medicare updates including Billing Health Insurance Information check out Medicare Medical Coding and Billing Courses


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Designated National Provider Identifier Medicare website

Medicare has officially moved all NPI documentation to one main website for reference. All doctors are still required to register for a NPI.

http://www.wpsmedicare.com/provider/npi_medicare.shtml


Additional Medical Billing and Codingquestions are answered here: Online Medical Coding and Billing Courses

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Electronic Medicare Secondary Payer (MSP) Submitters

Did you know that after a primary insurance carrier has processed your claim the office "must" include claim adjustment reason codes (CARC) when sending it to Medicare for processing?

As of June 1st you will no longer see code 42 being used:
Code 42: "Charges exceed our fee schedule or maximum allowable amount"

This code has been replaced with code 45:
code 45: "Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement."

If you have not been using Code 45 since June 1st your claims maybe getting rejected by Medicare.

CARC codes are updated 3x's a year and can be viewed at: http://www.wpc-edi.com/custom_html/claimadjustment.htm

Please take a few minutes to review this website for additional information.

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Physician Quality Reporting Initiative (PQRI) FAQ

July 1st is around the corner and are you ready to begin billing the PQRI for the 1.5% incentive payout? For more information go here:

http://www.cms.hhs.gov/PQRI/35_2008PQRIInformation.asp


To read more about Medicare updates including Billing Health Insurance Information check out Medicare Medical Coding and Billing Courses

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Free Medicare Web-based training Courses

CMS offers over 18 hours of web based courses that are very informative and FREE!

For a complete listing of courses, you can visit CMS's website at:
http://cms.meridianksi.com/kc/main/k...t=kc0001&loc=1

Or for additional medical billing software training you can visit: www.trainingmedical.com. This website offers Microsoft Word, and specific medical billing software training videos. Click on the links to view the Video Library.

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Medicare Coverage for Smoking Cessation

Did you know Medicare will cover smoking cessation counseling for patients with certain conditions that are adversely affected by smoking?

G0375 - Smoking and tobacco-use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes.
G0376 - Smoking and tobacco-use cessation visit; intensive, greater than 10 minutes.

Diagnosis Codes should reflect the condition the patient has that is adversly affected by the use of tobacco or the condition the patient is being treated for with a therapeutic agent whose metabolism or dosing is affected by tobacco.

E&M codes can be billed on the same day as Smoking cessation visits please add modifier 25 to procedure codes 99201 - 99215.

To find out more about billing for smoking cessation counseling, visit the follow link to CMS's webpage:
http://www.cms.hhs.gov/SmokingCessation/
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM4104.pdf
http://www.cms.hhs.gov/ContractorLearningResources/downloads/JA3834.pdf

The following PDF pamphlet can be printed and handed out to patients: http://www.cms.hhs.gov/MLNproducts/downloads/smoking.pdf

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