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Tag Archives: Beginning
Get the revised SNFABN and instructions, mandatory for use beginning May 7
Diagnoses for Baseline Labs prior to beginning bioloigics
Hello All,
I am fairly new to Dermatology coding. We do a lot of treatment and prescribing of biologics for psoriasis. These are powerful drugs that can affect the organ systems negatively; therefore baseline laboratory tests are required prior to starting the patient on these medications. AFTER the patient has been on these meds, we continue to run lab tests to monitor if/how these medications are affecting the organ systems. Z79.899 usually works for monitoring (there are a few NCD/LCDs that do not cover with this code), but I’m wondering what ICD-10 code should be used for the initial baseline lab testing? We are not monitoring the patient’s response to the medicine since they aren’t on it yet, but simply getting a baseline. Many of these lab tests have NCDs and we’re having trouble finding appropriate diagnosis codes? Thoughts anyone?
I am fairly new to Dermatology coding. We do a lot of treatment and prescribing of biologics for psoriasis. These are powerful drugs that can affect the organ systems negatively; therefore baseline laboratory tests are required prior to starting the patient on these medications. AFTER the patient has been on these meds, we continue to run lab tests to monitor if/how these medications are affecting the organ systems. Z79.899 usually works for monitoring (there are a few NCD/LCDs that do not cover with this code), but I’m wondering what ICD-10 code should be used for the initial baseline lab testing? We are not monitoring the patient’s response to the medicine since they aren’t on it yet, but simply getting a baseline. Many of these lab tests have NCDs and we’re having trouble finding appropriate diagnosis codes? Thoughts anyone?
Revised CMS-855R Application to Be Used Beginning January 1, 2017: Reassignment of Medicare Benefits
Physicians and non-physician practitioners must use the revised CMS-855R (Reassignment of Benefits) application beginning January 1, 2017. Medicare Administrative Contractors will accept both the current and revised versions of the CMS-855R through December 31, 2016.
The revised form makes the primary practice location section optional. However, this information is shared with other programs, such as the Physician Compare Initiative, to help beneficiaries identify your practice.
Visit the Medicare Provider-Supplier Enrollment webpage for more information about Medicare enrollment.
Helpful Links
Revised CMS-855R: Click Here to Download
The Medical Management Institute – MMI – Medical Coding News & MMI Updates
[Announcement] Private Payor Prices Will Be Used By Medicare to Set Payment Rates for Clinical Diagnostic Laboratory Tests Beginning in 2018
On June 17, CMS released a final rule implementing Section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA), requiring laboratories performing clinical diagnostic laboratory tests to report the amounts paid by private insurers for laboratory tests. Medicare will use these private insurer rates to calculate Medicare payment rates for laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS) beginning January 1, 2018.
The final rule includes provisions to ease administrative burdens for physician office laboratories and smaller independent laboratories. The final rule will generally require reporting entities to report private payor rates and test volumes for laboratory tests if an applicable laboratory receives at least $ 12,500 in Medicare revenues from laboratory services paid under the CLFS and more than 50 percent of its Medicare revenues from laboratory and/or physician services.
For the system’s first year, laboratories will collect private payor data from January 1, 2016, through June 30, 2016, and report it to CMS between January 1, 2017, and March 31, 2017. CMS will calculate and post the new Medicare rates by early November 2017. These rates will take effect on January 1, 2018.
For More Information:
See the full text of this excerpted CMS press release (issued June 17).
The Medical Management Institute – MMI – Medical Coding News & MMI Updates