09/11/12 Ask-the-Contractor Teleconference (ACT ... - WPS Medicare

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Kristine Aprenger: OK. And then the second question is, has there been any discussions about recognizing hospitalist http://www.wpsmedicare.com as a specialty Mary Muchow: Dr. Boren: I’m not aware of anything. Dr. Boren here. The decision to create a separate physician specialty or other specialty right rest solely with CMS. Kristine Aprenger: OK. Dr. Boren: And so there would be solely a decision by CMS. Kristine Aprenger: All right, thank you. Dr. Boren: Operator: Lauren Craig: Carol: Lauren Craig: Carol: Lauren Craig: Carol: Operator: Cathy Smith: Mary Muchow: Cathy Smith: You’re welcome. Your next question comes from the line of Lauren Craig. Hi. My question is actually policy related to the policy for application of skin substitute. We work with the skin substitute indicated for diabetic with ulcer and we’re just wondering if the application for the ankle would be covered given that CPT considers the ankle to be a part of the leg. This is Carol. Dr. Boren, unless you have anything to add, I’m going to ask that that question be submitted in the policy comment box so that it can be researched. Would you mind… I’ve also researched it just a little bit on the website and it does appear that the CPT 15271 is the payable code for podiatrist, but I do have a number of podiatrists that are a little bit concerned, and we just want a little bit of clarification. I think if you put it in writing and send it in through the email so we can get it researched. OK That would be great. Thank you. Thanks. Your next question comes from the line of Cathy Smith. Hello. Hi, Cathy, go ahead. I’ve got a question regarding take-backs. I believed you mentioned that in your opening. As far as take-back requests go, can you tell me how that process is and what information is on the remit for us to know who that take back is being taken back from 14
Jenny: Cathy Smith: Jenny: Cathy Smith: Jenny: Cathy Smith: Jenny: Cathy Smith: Jenny: Cathy Smith: Jenny: Cathy Smith: Jenny: Cathy Smith: Dr. Boren: Oh, this is Jenny with Payment Recovery Area. Are you referring to at the bottom of the remittance notice, remark code WO http://www.wpsmedicare.com Probably. I do not know that it’s there. I can’t remember exactly where it is or exactly what the information is. I have seen it. I don’t have one in front of me now, but we are having a lot of take-backs right now because we had to go back and correct a lot of billing errors for procedures. So we’re getting takebacks from the remits. But we just need to know the best way to get the information to know who that money is being taken back from. All right. So to match up your withholdings or your offsets on your remit notice, there’s a couple of different things you can do. Do you keep a copy of your demand letters that you received Yes, ma’am. On the demand letters, all of them have an accounts receivable number or an invoice number. If you keep that letter and then match it up to your remittance notice, at the bottom there’s the WO. That will give you the invoice number that matches your letter and then it will give you a patient account number if you bill with the patient account number. OK. If you do not bill with the patient account number then the Medicare number will be provided. OK. Another option you can do is if you have that invoice number, you could take that into C-SNAP and you can put in the invoice number and it’ll give you the patient’s name and date of service. OK, good. What is the difference in getting the request for a refund Like, if we get a request from you on a refund and it’s not on our remit versus it only being on the remit, or is that – does that even happen The request for refund, the letter, you’ll first receive a demand letter. Then after 41 days or whenever that demand is offset, then the WO will appear on your remittance notice. OK. It’s not at the same time. You’ll have to wait if the claim is offset. Right. OK. All right, thank you. Mary, I don’t want to interrupt, but to answer the question that Natalie asked about the VAD. It is not a CCI issue unless it’s the date it was inserted. Because on the date it’s inserted, it hits a modifier. But that would not be an 15
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09/11/12 Ask-the-Contractor Teleconference (ACT ... - WPS Medicare

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