Here is a history of letters we have sent to various groups regarding issues impacting the Medicare Part B program. Click any letter's heading to view it.
| Date | SENT TO / REGARDING |
|---|---|
| October 02, 2006 | Letter to Physician/Healthcare Professionals This letter addresses efforts to reduce the claims payment error rate by educating physicians, non-physician practitioners (NPP), and other Medicare providers on the accurate submission of claims. |
| March 23, 2006 | Letter to Physician/Healthcare Professionals This letter addresses procedure codes and diagnosis codes that should be used when billing Medicare for screening and diagnostic pap smears and prostate specific antigens. |
| February 24, 2006 | Letter to Physicians/Healthcare Professionals This letter addresses Nail Avulsions billed to Medicare by Podiatrists. |
| December 21, 2005 | Letter to Urologists This letter addresses service billed to Medicare for Transurethral Microwave Thermotherapy (TUMT) by Urologists. |
| December 07, 2005 | Letter to Ambulance Suppliers This educational letter addresses Air Ambulance transport services to the closest hospital with the appropriate facilities for treatment needed. |
| November 14, 2005 | Letter to Ambulance Suppliers Effective for dates of service on and after January 1, 2006 the full implementation of the Ambulance Fee Schedule for ground and air transportation will be in effect. All medically necessary services will be reimbursed at 100% of the Ambulance Fee Schedule amount. |
| August 19, 2005 | Letter to Physicians and Healthcare Professionals This letter provides information about a pilot effectiveness project the Local Provider Education and Training (LPET) Program is conducting with a focus on consultation coding errors, which contribute significantly to the Comprehensive Error Rate Testing (CERT) error rate in Pennsylvania. |
| August 12, 2005 | Letter to Physicians and Healthcare Professionals This letter addresses the documentation requirements when billing for vascular surgery services. |
| July 28, 2005 | Letter to Physicians and Healthcare Professionals This letter addresses services billed to Medicare by Radiation Oncologists. |
| June 28, 2005 | Letter to Physicians and Healthcare Professionals This letter addresses documentation guidelines for EKG interpretation and results for procedure codes 93000, 93005, and 93010. |
| May 16, 2005 | Letter to Physicians and Healthcare Professionals This letter addresses billing discharge management codes 99238 and 99239 being billed to Medicare by family practice and internal medicine. |
| April 20, 2005 | Letter to Physicians and Healthcare Professionals This letter addresses the documentation requirements involving the total time spent with the patient when billing critical care procedure codes. The letter also addresses medical necessity and the definition of critical care |
| March 31, 2005 | Letter to Physicians and Healthcare Professionals This letter addresses billing an evaluation and management service with the '-25' modifier in addition to a chiropractic manipulation, physical therapy , or routine foot care service, being billed to Medicare by general practice, family practice, internal medicine, and podiatry. |
| March 07, 2005 | Letter to Chiropractors This letter addresses documentation requirements for chiropractic services for initial and follow-up visits for procedure codes 98940, 98941, 98942. |
| February 28, 2005 | Letter to Physicians and Healthcare Professionals This letter highlights documentation requirements for paravertebral facet joint nerve block procedure codes being billed to Medicare by anesthesiology. |
| January 28, 2005 | Letter to Physicians and Healthcare Professionals This letter highlights documentation requirements for implantable cardioverter-defibrillator procedure codes being billed to Medicare by cardiology, cardiac surgery and general physician groups, multiple specialty. |
| August 18, 2004 | Letter to Chiropractors Important changes effective for dates of service on and after October 1, 2004 relating the chiropractic spinal manipulation services |
| July 09, 2004 | Letter to Multi-Specialty Clinics and Group Practices This letter addresses the Comprehensive Error Rate Testing (CERT) Program and the rationale for error rates associated with Multi-Specialty Clinics and Group Practices. |
| April 21, 2004 | Letter to Nephrologists This letter will assist with billing the new "G" for End Stage Renal Disease (ESRD) related services. |
| April 07, 2004 | Letter to Physicians This letter addresses obturator procedure codes being billed to Medicare by oral surgeons. |
| December 30, 2003 | Letter to Physicians and Healthcare Professionals The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, recently passed by Congress and signed into law by the President, establishes an average 1.5 percent increase in the physician payment rates to be effective on January 1, 2004. Because this change has happened so late in the year, the Centers for Medicare & Medicaid Services (CMS) is extending the participation enrollment period for 2004. |
| September 04, 2003 | Letter to Physicians and Healthcare Professionals This letter addresses screening pap smears and prostate cancer screening services being billed to Medicare by laboratories and pathologists, with diagnostic procedure codes. |
| February 25, 2003 | Letter To Dietitians/Nutritionists This letter contains important information regarding Medicare Part B billing privileges. |
| January 14, 2003 | Letter To Clinical Social Workers This letter contains important information regarding Medicare Part B billing privileges. |
| December 01, 2002 | Letter To Clinical Laboratories This packet contains the 2003 Clinical Laboratory Fee Schedule. |
| October 14, 2002 | IDTFs This letter highlights reporting requirements relative to changes in the information previously submitted vis the HCFA/CMS 855 form. |
| September 27, 2002 | Letter To All Providers Important changes regarding Advance Beneficiary Notices (ABNs) and time limitations for requesting a Part B review. |
| December 20, 2002 | Ambulatory Surgical Centers The Centers for Medicare and Medicaid Services (CMS) has advised Highmark Medicare Services of new eligible procedure codes that can be performed in an Ambulatory Surgical Center (ASC). |
| December 17, 2001 | Independent Diagnostic Testing Facility As of December 31, 2001, we will be retiring Local Medical Review Policy (LMRP) M-56-A (IDTF). This LMRP is being replaced with an Independent Diagnostic Testing Facility (IDTF) Billing Guide which includes IDTF enrollment criteria. |
| August 01, 2001 | Opthalmologists, Optometrists and the Carrier Advisory Committee Implementation of Policy Z-22, Optometrists' Services, Postponed by CMS. |
| June 22, 2001 | Ambulatory Surgical Centers Letter sent to all ASC regarding new eligible procedure codes which can be performed in an ASC setting. In addition, coverage was added for procedure code G0121. |
| June 06, 2001 | Opthalmologists, Optometrists and the Carrier Advisory Committee Letter regarding the revision to Medical Policy Z-22 F, Optometrists' Services. |
| May 01, 2001 | Health Professionals Effective for claims received on and after July 1, 2001, all services paid under the Medicare Physician Fee Schedule Data Base (MPFSDB) will be subject to jurisdictional payment. |
| December 11, 2000 | ASC letter Regarding new eligible replacement codes which can be performed in an Ambulatory Surgical Center (ASC). |
| October 18, 2000 | IDTFs Letter regarding the postponement of policy M-56. |
| August 21, 2000 | Podiatric Community Letter sent regarding the utilization of several podiatric procedure codes. |
| August 03, 2000 | Ambulance Suppliers HGAS will be conducting educational sessions with Ambulance billers, focusing on EMT and paramedic fraud. |
| April 28, 2000 | Ambulatory Surgical Centers New eligible replacement procedure codes which can be performed in an Ambulatory Surgical Center. |
| February 10, 2000 | Ambulance Suppliers HCFA clarification for situations when ambulance providers are unable to obtain a PMNC for unscheduled non-emergency transports. |
| December 30, 1999 | Chiropractic Community Provides revised requirements which are effective for dates of service on and after April 1, 2000 |
| September 14, 1999 | Chiropractors and State and County Medical Societies Possibility of inappropriate payments for claims that did not meet the X-ray requirements. |
| May 19, 1999 | PA Ambulance Associations Guidelines to carriers relative to payment of claims containing paramedic intercept services. |
| February 12, 1999 | Health Providers Encouraging the use of new Y2K compliant format of MMDDCCYY when reporting the date of birth on the HCFA-1500 claim form. |
| October 01, 1998 | PA Physicians Office Billing Staff Medicare workshops in the Erie, Mount Pocono, Oil City, and Clearfield. |
| September 15, 1998 | Clinical Laboratories Advises of changes to the reporting and payment mechanism of travel allowances. |
| September 04, 1998 | Podiatric Community Advises providers of inappropriate denials that occurred with Routine Footcare services. |
| July 30, 1998 | PA and NJ Providers Detailed information on the billing of multiple and bilateral surgeries in the MCS system. |
| January 26, 1998 | Anesthesia CAC Members & CRNA Associations Payment for the services of a CRNA and a anesthesiologist in a single anesthesia case - New Modifier QY. |
| August 29, 1997 | Independent Physiological Laboratories New effective date for Medical Policy Bulletin M-22A. |
| August 06, 1997 | Independent Physiological Laboratories Changes to Medical Policy Bulletin M-22A. |
| July 17, 1997 | Independent Physiological Laboratories The effective date of policy M-22A published in our June 1997 Medicare Report has been changed to September 1, 1997. |
| July 08, 1997 | Health Care Professionals Issues recently published in the paper version of the June 1997 Medicare Report. |
| June 27, 1997 | Radiology Societies & Radiologists Expanded coverage of magnetic resonance angiography (MRA) services to the peripheral vessels of the lower extremities. |
| June 02, 1997 | Health Care Professionals (Delaware) Participation in the complementary crossover process. |
| May 08, 1997 | Radiology Societies & Radiologists Reporting of Mammography Services. |
| May 02, 1997 | Podiatric Societies The implementation date of May 1, 1997 for the new version of the Q1 modifier has been retracted by HCFA. |
| January 20, 1997 | Podiatric Societies and Physicians Clarifications on podiatry procedure codes and modifier reporting. |
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