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

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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. 4
Mary Muchow: Operator: Mary Muchow: Amy Green: Mary Muchow: Amy Green: Mary Muchow: Amy Green: Mary Muchow: Amy Green: Mary Muchow: Amy Green: You’re welcome. http://www.wpsmedicare.com Your next question comes from the line of Amy Green. Hello, Amy. Hi. How are you I’m doing fine, thank you. First, I have three questions, so I assume you probably want me to get in and request them after this. The first question has to do with the ARNP supervising an RN. I got the information what manual it was in but I did not catch the chapter when you’re answering the Q&A, where you can find this information. OK. I’m just looking back through my notes, Amy. It is actually information in the Medicare Benefit Policy Manual, that’s one of CMS’ internet-only manuals. All of the internet-only manuals are available on the CMS website. But specifically what you want to look for is Publication 100-02, the Medicare Benefit Policy Manual. Once you access that particular manual, you can choose Chapter 15 and then look under Section 80. And that’s where you’ll find this information. OK. And my other questions, you’d like me to get out of queue and request them again then No, go ahead, Amy. OK. My next question was when submitting questions as a contractor, I know that your options were e-mail or a fax the form. Obviously, you got my question so it must have worked. I just sent it by e-mail, but there was no way to attach the form. That form isn’t allowed to be saved. So how do people submit that by email I just actually typed in my question. You weren’t able to save the form, is that what you’re saying It was probably in a… An allowable form to be saved. Mary Muchow: …a PDF document. You can copy and paste the information into a Word document and send that Amy Green: Mary Muchow: I tried to do it into the e-mail. I think I tried to do it into a Word document also, and it just didn’t allow because of the type of the interactive form that it doesn’t allow it to happen. So I didn’t know if you guys are aware of that. OK, we are going to have to revisit that and give that some consideration. Amy, thank you for letting us know. The other option that you have is to send an e-mail with the information into medicareadmin@wpsic.com. 5
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09/11/12 Ask-the-Contractor Teleconference (ACT ... - WPS Medicare

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