Appeals Process Podcast

Appeals Process Podcast

The Medicare Learning Network® (MLN) Multimedia web page recently posted a podcast explaining the Medicare appeals process. The podcast provides information about the five levels of claim appeals in Original Medicare (Part A and Part B) and how the appeals process applies to Medicare providers. To access the podcast, visit the CMS MLN Multimedia web page and search for "Medicare Appeals Process" in the Filter On field.

 

ICD-10 Resources

ICD-10 Resources

The ICD-10 compliance date is October 1, 2015. Are you ready? The CMS Medicare Fee-For-Service Provider Resources web page includes information and educational resources for providers to implement and transition to ICD-10 medical coding.

 

More C-SNAP (CMS Secure Net Access Portal) Enhancements Coming Soon

More C-SNAP (CMS Secure Net Access Portal) Enhancements Coming Soon

 •  J8 Michigan Part A providers will soon be able to submit electronic prior authorization requests for Hyperbaric Oxygen (HBO) services. Our Medical Review staff will respond with a decision letter to these requests via C-SNAP.
 •  Medical Review will also be sending notifications to providers via email on their probe and additional documentation request (ADR) review.
 •  C-SNAP appeals will be enhanced to electronically accept appeals attachments from Part B providers.

 

59 Modifier Use

59 Modifier Use

Providers may continue to use the 59 modifier after January 1, 2015, in any instance in which it was correctly used prior to January 1, 2015. Change Request (CR) 8863 established four new modifiers (XE, XP, XS, and XU) to define specific subsets of the 59 modifier, a modifier used to define a "Distinct Procedural Service." Providers who want to use the new modifiers may use them according to the published definitions. For more information, review MLN Matters® Special Edition Article SE1503.

 

Appeals Process Podcast ICD-10 Resources C-SNAP Enhancements 59 Modifier Use

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