By: Susan Sumrell
Wanted to make sure everyone was aware of the latest information from CMS on Medicare corrections to preventive service claims from certain institutional providers (including FQHCs). Below is the relevant text from an email from CMS to institutional providers received on May 17, 2011:
Corrections Being Made to Claims for Certain Institutional Preventive Services Codes
CMS has identified a Medicare claims processing system issue that is causing certain preventive services rendered in an institutional setting to be processed incorrectly. The following information provides the action that will be taken by Medicare claims administration contractors:
Federally Qualified Health Centers (FQHC)
FQHCs (77X TOB) claims with dates of service on and after Sat Jan 1, 2011, containing HCPCS codes G0402, G0389, G0436, G0437, Q0091, G0101, G0130, 77078, 77079, 77080, 77081, 77083, and 76977 are being processed and paid incorrectly due to coinsurance being incorrectly applied. Medicare contractors have been instructed to hold claims impacted by this problem until a correction is implemented. A software correction is scheduled for June 2011.
Please let us know if you are experiencing any issues with your Medicare claims. You can read more on the new claims reporting requirements here.