Medicare Nursing Facility Service Codes 99304-99318

NURSING FACILITY SERVICES (CODES 99304 - 99318) (CMS MLN Matters)

CR 5986, from which this article is taken, updates the Medicare Claims Processing Manual, Chapter 12, (Physicians/Non-physician Practitioners), Section 30.6.13 (Nursing Facility Services (Codes 99304 - 99318) Subsection F (Use of the Prolonged Services Codes and Other Time-Related Services) by noting that the typical/average time units for Evaluation and Management (E/M) visit codes in the Nursing Facility Services code family are reestablished and applicable, as of January 1, 2008.

Effective for services on or after July 1, 2008, you may bill Medicare for medically necessary prolonged services for E/M visits (codes 99356 and 99357) in a SNF or NF with Nursing Facility Services codes (99304 – 99306, 99307 – 99310 and 99318). Additionally, you may use these prolonged services codes (99356 and 99357) with Nursing Facility Services in the code range (99304 – 99306, 99307 – 99310, and 99318) to bill for counseling and/or coordination of care services that are based on time.

For more information, see this article in its entirety at:
http://www.cms.hhs.gov/MLNMAttersArticles/downloads/MM5968.pdf


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Medicare billing for NDC drug code for CMS claims

Take action by reading this Medicare notification for NDC:

MEDICARE SHARED SYSTEMS MODIFICATIONS NECESSARY TO ACCEPT AND CROSSOVER TO MEDICAID NATIONAL DRUG CODES (NDC) AND CORRESPONDING QUANTITIES SUBMITTED ON CMS-1500 PAPER CLAIMS (CMS MLN Matters)

Provider Action Needed
STOP – Impact to You - The Centers for Medicare & Medicaid Services (CMS) issued Change Request (CR) 5835 that notifies physicians and suppliers who use Claim Form CMS-1500 (those providers who qualify for a waiver from the Administrative Simplification Compliance Act (ASCA)) that changes are being made to Medicare systems to conform with instructions for submitting NDC drug code and quantity information on Form CMS-1500.

Please read this article in its entirety on the CMS Website at http://www.cms.hhs.gov/MLNMAttersArticles/downloads/MM5835.pdf

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Medicare and physicians called to active duty in Armed Forces

for those doctors that are getting called to Active Duty take a few minutes to review Medicares documentation:

EXCEPTION TO 60-DAY LIMIT ON SUBSTITUTE PHYSICIAN BILLING ARRANGEMENTS FOR PHYSICIANS CALLED TO ACTIVE DUTY IN THE ARMED FORCES RESERVES (CMS MLN Matters)

What You Need to Know
CR 5985, from which this article is taken, announces a 6-month extension of the exception to the 60-day limit on substitute physician billing for physicians called to active duty in the Armed Forces. This means that a physician who is called to active duty may continue to bill for substitute physician services furnished from January 1, 2008 through June 30 2008, which may be beyond the 60-day limit.
Make sure that your billing staffs are aware of this change.

Please read this article in its entirety on the CMS Website at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5985.pdf

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