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

Thank you, Paula, for submitting this request. This provides WPS Medicare a
perfect opportunity http://www.wpsmedicare.com
to address this question that does indeed come up very,
very often. WPS Medicare has always instructed that the date of service must
reflect the date that the provider actually performed the service. For services
with professional and technical components, the date of service could be
different depending on when the interpretation is performed.
This is the same message that WPS Medicare has always given to providers.
Our message has never changed. The CMS Internet-Only Manual is
Publication 100-04, the Medicare Claims Processing Manual in Chapter 26,
which is entitled "Completing and Processing Form CMS-1500 Data," it’s
actually Section 10, includes instructions for completing the Medicare claim.
Instructions for completion of Item 24A or the electronic equivalent, if you
submit claims electronically, specifically states, “Enter a six-digit or eight-digit
date for each procedure, service, or supply.”
Item 24D instructions inform the provider to enter the procedure, service, or
supply using the CMS Healthcare Common Procedure Coding System or
HCPCS code, and when applicable, show the HCPCS code modifiers along
with that HCPCS code. So based on the CMS claim form instructions found in
publication 100-04, a provider who performs the professional component of a
service will list the date that he or she performed the service in Item 24A or
the electronic equivalent and will report the appropriate HCPCS code and the
PC modifier in Item 24D.
At this time, I’d like to invite Angie to once again inform participants how they
may post their questions.
Operator:
If you would like to ask an audio question, please press star 1 on your
telephone keypad. We’ll pause for just a moment to compile the Q&A roster.
Your first question comes from the line of Barb Carter.
Mary Muchow:
Barb Carter:
Mary Muchow:
Hi, Barb.
Hello. We have a question. We are getting denials on our lesions, on one of
the codes on the lesions that does the related or qualifying claim or service
was not identified on this claim and we need help to solve that.
That is a claim-specific denial. And what you’re going to need to do with that
is call customer service. They are better equipped to help you. Those of us
that have assembled for this call, we’d love to help you, but unfortunately, we
don’t have any system access. We can’t look at your claim and look at the
other claim that pended up against it to let us know additional information and
to provide additional information on why your claim denied.
So if you’ll give customer service a call, they’ll be happy to assist you.
Barb Carter:
OK, thank you.
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