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It’s only one Medicare administrative contractor (MAC) at the moment, but expect others to join this prohibition against handwritten entries on claims.

CMS finalized its decision not to have a national policy for Medicare coverage of gender reassignment surgery; instead, individual Medicare administrative contractors (MACs) will decide whether to cover the procedure.

CMS said in an April 13 provider call that to bill advance care planning (ACP) without a preventive service, you need to show the service is “relevant to the patient’s disease state,” which would seem to mean it requires a diagnosis code.

A report live from this year's AAPC HealthCon shows some payers are accepting X modifiers in place of modifier 59 and more.
Did your practice participate in the Office of Medicare Hearings and Appeals’ settlement pilot project? If so, we’d love to hear the story of how your practice fared — regardless of whether it agreed to a settlement and got out of the massive backlog of appeals at the administrative law judge level.
 
Please contact editor Josh Poltilove at jpoltilove@decisionhealth.com or (301) 287-2593.
 

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