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The Health Care Financing Administration announced in December that toll-free telephone service was available to physicians, hospitals, and home health providers who care for Medicare beneficiaries, to answer their questions about billing, claims processing, and other Medicare-related issues. Previously, providers paid long-distance phone charges to call the private insurance companies that process and pay Medicare claims.
Providers will also get information at no cost from the 68 Medicare call centers, bringing the toll-free service to providers in every state, the District of Columbia and U.S. territories. The toll-free lines serve all Medicare physicians, home health agencies, and durable medical equipment suppliers.
Each center has its own toll-free phone number, which contractors are publicizing through bulletins and Web sites. Messages informing providers about the availability of the new toll-free service have been placed on all existing toll lines.
The Health Care Financing Administration has delayed the implementation date for version 6.0 of the UB-92 until April 1, 2001, due to problems that delayed providers’ ability to test, according to Transmittal A-00-100, dated Dec. 22. In April 2000, HCFA had announced that versions other than 6.0 would not be supported after Dec. 31, 2000.
The instructions applied to all providers in addition to all coordination-of-benefits trading partners. In the meantime, fiscal intermediaries will need to support both versions (6.0 and 5.0) of the UB-92. Providers should not wait until March 31, 2001, to manage the conversion. To monitor progress made by the facility, reports must be submitted weekly on Tuesdays.
The entire transmittal is available at www.hcfa.gov/pubforms/transmit/A00100.pdf.
The Health Care Financing Administration now accepts a new current procedural terminology (CPT) code for cryosurgery of the prostate gland, according to transmittal 1689, dated Dec. 22, 2000. The new code is 55873, which is new to CPT 2001.
Because the new code includes not only the cryosurgical ablation procedure but also the ultrasonic guidance for interstitial cryosurgical probe placement, it replaced the previous two HCPCS codes, G0160 and G0161, on Jan. 1, 2001. Providers may continue to use G0160 and G0161 codes for claims with dates of service through March 31, 2001. This change requires an update in Sections 4174.3 and 4174.4 of the Hospital Medicare Manual.
To view the entire transmittal, go to www.hcfa.gov/pubforms/transmit/R1689B3.pdf.
The Inspector General has requested submission of proposals and recommendations for developing new and modifying existing safe harbor provisions and new OIG (Office of the Inspector General) Special Fraud Alerts. This request was published in the Federal Register on Dec. 14, 2000 (65 FR 78124).
Due to the broad nature of the anti-kickback statute of the Social Security Act, "safe harbor" provisions were designed to specify various payment and business practices that would not be treated as criminal offenses under the statute, even though they may be potentially capable of inducing fraud.
In addition, the OIG has also periodically issued Special Fraud Alerts to give continuing guidance to health care providers with respect to practices the OIG regards as unlawful. These Special Fraud Alerts serve to notify the health care industry that the OIG has become aware of certain abusive practices that the OIG plans to pursue and prosecute, or to bring civil and administrative action, as appropriate.
Cheryl D’Amato, RHIT, CCS, has been named chair-elect for the Society for Clinical Coding (SCC) in Chicago and will assume responsibilities as the chair of the SCC in January 2002. D’Amato is the former president and a member of the Connecticut Health Information Management Association, and has more than 20 years of professional experience. She is director of health information management at HSS Inc. in Hamden, CT.
In a memorandum dated Jan. 20, President Bush issued a moratorium on the publication and implementation of new federal regulations. The moratorium is designed to give the new administration an opportunity to review pending federal regulations. What effect will this moratorium have on the rules required by the Health Insurance Portability and Accountability Act (HIPAA) of 1996? The final rule establishing electronic transaction standards and code sets should not be affected by the moratorium at all because it went into effect on Oct. 16, 2000, says the Phoenix Health Systems in Montgomery Village, MD.
The moratorium temporarily postpones, for 60 days, the effective date of regulations that have been published in the Federal Register but have not yet taken effect.
Phoenix Health Systems, publisher of the online newsletter HIPAAlert, also took an informal poll of health care attorneys and several health care organizations, including the American Hospital Association in Chicago, about the status of the privacy regulations. The poll reveals a consensus view that the privacy regulations are entirely exempt from the moratorium. "This position is based on a careful analysis of the memorandum, which states that regulations promulgated pursuant to statutory or judicial deadlines are exempt from the president’s directive," the organization says in a statement.
The 5th Annual Distributed Medical Intelligence, "HighTech for High Touch in Next-Generation Healthcare," will be held March 11-13 in Breckenridge, CO. The focus will be technologies and health care delivery that can be applied in natural and man-made disasters as well as traditional healthcare settings.