Archive for July, 2013

Introducing The CERT A/B Task Force

Medicare Administrative Contractors (MACs) announce the formation of the CERT A/B Contractor Task Force, a new partnership of all Part A and Part B MACs to educate on national issues of concern regarding improper payment errors. The CERT A/B Contractor Task Force will serve to enhance, not replace, the ongoing educational activities by CMS, the Medicare Learning Network (MLN), and the MACs within their jurisdictions. Click here to read more.

Medicare Interest Rate Updated

 Medicare Regulation 42 CFR §405.378 provides for the assessment of interest at the higher of the current value of funds rate (one percent for calendar year 2013) or the private consumer rate as fixed by the Department of the Treasury. The Department of the Treasury has notified the Department of Health and Human Services that the private consumer rate has been changed to 10.375 percent effective July 17, 2013, for Medicare overpayments and underpayments.

Insurance Claim Form 1500 Has Been Revised

The new version of the 1500 Health Insurance Claim Form (1500 Claim Form) has been approved by the Office of Management and Budget. This form was revised by the National Uniform Claim Committee (NUCC) to accommodate the reporting needs for ICD-10 and adhere to requirements in the 837P Version 5010 electronic claim. MGMA is a member of the NUCC.

The NUCC revised the form in the following areas:

  • Addition of an indicator in Item Number 21 to identify the version of the diagnosis code set reported (i.e., ICD-9 or ICD-10) (The need to identify which version of the code set is being reported will be important during the implementation period of ICD-10.)
  • Expansion in the number of diagnosis codes that can be reported in Item Number 21, which was increased from 4 to 12
  • Improvement of the accuracy of the data reported, such as being able to identify the role of the provider reported in Item Number 17 and the specific dates reported in Item Number 14

The NUCC is currently developing an implementation timeline and will coordinate that effort directly with the Centers for Medicare & Medicaid Services. An announcement will be made once the transition timeline is finalized. Practices should begin communicating this change to their practice management and/or billing software vendors and determine when the vendor will finalize the modifications to accommodate the revised 1500 Claim Form.

For more information on the revised 1500 claim form and to download a PDF version of the form go to NUCC’s website.