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January 2007  
MIR-2007-01AB

CPT five-digit codes, descriptions, and other data only are copyright 2007American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein.   Applicable FARS/DFARS clauses apply.

In This Issue:

 

Key Part A & B Contents
Part A Part B Title
A A

2007 Annual Update for Clinical Laboratory Fee Schedule and Services Subject to Reasonable Charge Payments

H F, P

2007 Update of HCPCS Codes and Payments for ASC

H P Cavernous Nerves Electrical Stimulation with Penile Plethysmograph
A A Claims Submitted with Only a National Provider Identifier (NPI) During the Stage 2 NPI Transition Period
A A

Fee Schedule Update for 2007 for DMEPOS

A A

Flu Shot Reminder

H, S P

Infrared Therapy Devices

A A

January 2007 Quarterly ASP Medicare Part B Drug Pricing File

A A

Laboratory Competitive Bidding Demonstration - Revised

A A Laboratory Competive Bidding Demonstration
A A

Medically Unlikely Edits (MUE)

A A

Medicare Immunization Billing Chart Available to Order

H, S P

New 2007 Current Procedural Terminology Mammography Codes

A A

NPI: Get It, Share It, Use It

H P

One-Time Only Ultrasound Screening for Abdominal Aortic Aneurysms, Referred from an Initial Preventive Physical Exam

A A

Outpatient Therapy Cap Exceptions Clarifications

A A

Remittance Advice Remark Code and Claim Adjustment Reason Code Update

A A

Revised Fee Amounts for HCPCS Codes for Power Mobility Devices

 

Key Part A Only
Part A
Title
H , E

Changes in End Stage Renal Disease Payment for Calendar Year 2007

A

Empire Medicare Services to Become National Government Services

A

Hospice Payment System Fact Sheet

H

Hospital Outpatient Prospective Payment System (PPS) Fact Sheet

H

Inpatient Psychiatric Facility Prospective Payment System (PPS) Fact Sheet

M

Medicare Home Health PPS Rate Update for Calendar Year 2007

A

Optical Character Recognition Interface in the Fiscal Intermediary Standard System (FISS)

H, S

Reporting Taxonomy Codes to Identify Provider Subpart on Institutional Claims

A

Revised ANSI X12N 837 Institutional Healthcare Claim Companion Document

 

Key Part B Only
Part B
Title
P, C

Cardiac Output Monitoring by Thoracic Electrical Bioimpedance

A Competitive Acquisition Program - Claim Processing for Not Otherwise Classified Drugs
A

Empire Medicare Services to Become National Government Services

A

Medicare Part B Drug Competitive Acquisition Program: Do Not Bill a Prescription Order Number More than Once

A

Multiple Procedure Reduction on the Technical Component of Certain DiagnosticImaging Procedures and Cap on the TC of Imaging Procedures - Correction

A

New Waived Tests

A

New Web-Based Training Course for Professional Providers

A

Quarterly Update to Correct Coding Initiative Edits, Version 13.0

A

Reasonable Charge Update for 2007 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, and Certain Intraocular Lenses

 

Part A Contact Information
Automated IVR Inquiries 1 (877) 567-7205
Monday - Friday 6:00 a.m. to 6:00 p.m.
Saturdays 9:00 a.m. to 2:00 p.m.

These hours represent minimum availability. System access is generally available until 10:00 p.m. on weekdays and 6:00 p.m. on weekends.

Provider Inquiries : 1 (888) 855-4356
Monday & Friday 9:00 a.m. to 4:00 p.m.
Tuesday - Thursday 8:00 a.m. to 4:00 p.m.

You will be able to transfer to a provider representative only during these hours. Please have your provider number, the HIC number and service dates available when you call.

The Provider Inquiries TTY number for the Hearing Impaired is: 1 (877) 425--2370
Monday & Friday 9:00 a.m. to 4:30 p.m.
Tuesday - Thursday 8:00 a.m. to 4:30 p.m.
Beneficiary Inquiries:
English and Spanish 1-800-MEDICARE
(1-800-633-4227)
TTY for the Hearing-Impaired: 1 (877) 486-2048
EDI Help Desk: 1 (877) 273-4334
Monday-Wednesday, Friday 8:00 -11:30 a.m. (EST) 12:00 Noon - 4:00 p.m.
Thursday 8:00 - 11:30 a.m. (EST) 12:00 Noon - 3:00 p.m.
EDI Part A Web Address NGS.EDI.A@Anthem.com
EDI Part B Web Address NGS.EDI.B@Anthem.com
Medicare Fraud Hotline:
To report fraud and abuse in the Medicare and Medicaid programs:

1(800) HHS-TIPS/1(800) 447-8477

The Hotline TTY Number for the Hearing-Impaired is: 1(877) 623-6190
Part B Information
Part B New Jersey Contact Information
Beneficiary TDD:
(800) 992-0165
Beneficiary Telephone Inquiries & ARU:
(800) 633-4227
DMERC:
(866) 419-9458
EMC:
(866) 488-0546
Fax-on-Demand (FOD):
(888) 281-8586
Part B Provider IVR:
(877) 567-9235
Part B Provider Customer Service:
(888) 855-4346
Part B Enrollment:
(866) 309-0486
Provider TDD:
(888) 897-7542
Provider Enrollment Mail claims to:
National Government Services
Provider Enrollment
P.O. Box 69218
Harrisburg, PA 17106-9218
National Government Services
Provider Claims
P.O. Box 69201
Harrisburg, PA. 17106-9201

Part B Appeals & Correspondence

National Government Services.
P.O. Box 69202
Harrisburg , PA 17106-9202
Part B New York Contact Information
Part B Provider Telephone Inquiries (STAR)
Claim Status and information, eligibility
deductible, pricing and seminar
information:
(877) 869-6504

 

DMERC:
(866) 419-9458
EMC Technical Support Help Desk:
(866) 889-7322
Fax-on-Demand (FOD):
(866) 709-1905
General Provider Enrollment Information:
(866) 837-0241
Health Professional Shortage Area (HPSA)
and EMC Audit:
(315) 442-4600
Provider Enrollment: Mail Assigned Claims to:
National Government Services
Reimbursement Dept.
P.O. Box 1200
Crompond , NY 10517-1200
National Government Services,
P.O. Box 100
Yorktown Heights , NY 10598
Unassigned Claims to: Health Professional
Shortage Area (HPSA) & EMC Audit:
National Government Services
P.O. Box 355
Crompond, NY 10517
National Government Services
P.O. Box 4716
Syracuse, NY 13221-4716
UPIN Directories (CD/ROM version)
Quality Assurance and Coordination Dept.
P.O. Box 1201
Crompond , NY 10517
Back Issue Requests Part B Appeals & Correspondence
National Government Services
MIR-Back Issues
800 2nd Avenue
3rd Floor
New York, NY 10017
National Government Services
P.O. Box 2280
Peekskill, NY 10566

 

 

 

 

This key is provided as a convenience to alert providers/suppliers to articles with topics that may pertain to their particular field. This key is not a guarantee that information in other articles will not also apply. It is each provider’s/supplier’s responsibility to become familiar with the contents of each newsletter.

Part A Key: A-All Providers, C-Community Mental Health Centers (CMHC), E-Renal Dialysis (ESRD) Providers, F-Federally Qualified Health Centers (FQHC), H-Hospitals, M-Home Health Providers,
O-Comprehensive Outpatient Rehabilitation Facilities (CORF) and Outpatient Physical Therapy Providers, P-Hospice Providers, R-Rural Health Center (RHC), S-Skilled Nursing Facilities (SNF), NA-Not Applicable

Part B Key: A-All Providers, B-Ambulance, C-Cardiovascular, D-DMEPOS, E-Drugs & Biologicals, F-ASC, G-Anesthesia, H-Physical & Occupational Therapy, I-Beneficiaries, J-Insurers, K-Home Health Care, L-Laboratory, M-Medicine, N-Non-Physician Practitioner, O-Nuclear Medicine, P-Physicians, Q-Mental Health R-Radiology, S-Surgery, T-Nephrology, U-Urology, V-Chiropractor, W-Ophthalmology & Optometry, X-Podiatry, Y-Radiation Z-Oncology, NA-Not Applicable

 

Contact Information can be found on each of the National Government Services legacy Web sites which can be accessed through: http://www.NGSMedicare.com.
Medicare policies can be found on our Web site in the Local Coverage Determination section. You can access these through the http://www.NGSMedicare.com homepage. Providers without access to the Internet can request hard copies from National Government Services.

 

This bulletin should be shared with all health care practitioners and managerial members of the provider staff. Bulletins are available at no cost from our Web site at www.NGSMedicare.com.

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