CMS-1500 Billing
Presented by
EDS Provider Field Consultants
October 2009
Agenda
• Objectives
• CMS-1500
• Claim Form Billing Guidelines - Various
Specialties
• Crossover Claims
• Consent Form, Sterilization and Partial
Sterilization
• Incontinence, Ostomy, and Colostomy Supplies
• Program Guidelines
• Prior Authorization
• Code Sets
• Fee Schedule
• Common Denials
• Helpful Tools
• Questions
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/ October 2009
Objectives
• Following this session, providers will be able to:
–Identify their provider classification
–Bill claims correctly for various specialties
–Submit crossover claims successfully
–Understand the sterilization consent completion
–Know the program exclusions
–Have more information about prior authorization
–Identify the various provider code sets
–Find and understand how the fee schedule can
assist providers
–Know the common denial causes and resolutions
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/ October 2009
CMS-1500 Claim Form
DRAFT
17a: Enter qualifier ZZ and referring provider
taxonomy number (if applicable) or qualifier 1D
and referring provider or PMP (atypical
providers) LPI.
24I and J: Qualifier ZZ and rendering
provider taxonomy or 1D and rendering
provider LPI for atypical providers.
17b: NPI of the referring
provider.
24J: Rendering
provider NPI
33: Billing provider service
location – must include ZIP Code
+ 4.
33a: NPI for billing provider and 33b: Qualifier ZZ and billing
provider taxonomy or qualifier 1D and billing provider LPI.
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Billing Guidelines
Provider Classifications
• Billing Provider – Provider classification
assigned to a billing entity or solo practitioner
at a service location
• Group Provider – The classification given to a
corporation or other business structure that has
rendering providers linked that are the
performers of the services provided
• Rendering Provider – A provider that performs
the services for a group or clinic and is linked
to the group or clinic
• Dual – A billing provider performing services as
a sole proprietor at an assigned service location
and is also a rendering provider working for a
group
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Billing Guidelines
Anesthesia
Effective October 16, 2003, and after:
• Use Current Procedural Terminology
(CPT®) codes 00100-01999 (refer to
IHCP Provider Manual for more
information)
• Bill the actual time in minutes and
include it in field 24G
• One unit = 15 minutes
• Additional units are allowed based on
a patient’s age when billing for
emergency services (bill using
procedure code 99140)
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/ October 2009
Billing Guidelines
Anesthesia
• Providers bill postoperative pain
management using code 01996
• The IHCP does not separately
reimburse this code on the same day
the epidural is placed
– However, it is reimbursed for
subsequent days when an epidural
is managed
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/ October 2009
Billing Guidelines
Chiropractic Services
• Package A
services are limited to 50
chiropractic services per member, per
calendar year
– The IHCP reimburses for no more
than five office visits within the 50
visits
• Package B reimbursement is available
for medically necessary pregnancyrelated services. The following are
appropriate chiropractic diagnosis codes
for package B members:
– 646.93, 648.73, 648.93
• Package C members are allowed five
office visits and 14 therapeutic physical
medicine treatments per member, per
calendar year
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/ October 2009
Billing Guidelines
Chiropractic Services
• The following are covered codes for
office visits:
–99201, 99202, 99203, 99211,
99212, 99213
• The following are covered codes for
manipulative treatment:
–98940-98943
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Billing Guidelines
Injections
• The IHCP reimburses for physician
office injectable drugs using
Healthcare Common Procedure
Coding System (HCPCS) J codes and
CPT immunization codes
• Pricing includes the current average
wholesale price plus a $2.90
administration fee
• The IHCP reviews pricing for a
physician office administered drug
each quarter
• To price appropriately, HCPCS code
J3490 must be submitted with the
appropriate NDC, name, strength,
and quantity
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/ October 2009
Billing Guidelines
Injections and NDC Codes
• The IHCP Provider Manual contains lists of J
codes that require a National Drug Code (NDC)
–Chapter 8, Section 4
• For paper CMS-1500 claims forms, report NDC
information in the shaded area of field 24 of
the CMS-1500 claim form
• The NDC is not used for provider
reimbursement
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/ October 2009
Billing Guidelines
Mental Health RBMC
• Effective January 1, 2007, outpatient mental health
services are carved-in to the risk-based managed care
(RBMC) delivery system
• Services provided to RBMC members by the following
specialty types are the responsibility of the managed
care organizations (MCOs), effective January 1, 2007:
– Freestanding Psychiatric Hospital
– Outpatient Mental Health Clinic
– Community Mental Health Center
– Psychologist
– Certified Psychologist
– HSPP
– Certified Clinical Social Worker
– Psychiatric Nurse
– Psychiatrist
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Billing Guidelines
Mental Health RBMC
• Services that are the MCO’s responsibility:
–Office visits with a mental health
diagnosis
–Services ordered by a provider enrolled
in a mental health specialty, but
provided by a non-mental health
specialty (such as a laboratory and
radiology)
–Mental health services provided in an
acute care hospital
–Inpatient stays in an acute care hospital
or freestanding psychiatric facility for
treatment of substance abuse or
chemical dependency
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Billing Guidelines
Mental Health RBMC
• MCOs
–Anthem
www.anthem.com
–Managed Health Services (MHS)
www.managedhealthservices.com
–MDwise
www.mdwise.org
• Behavioral Health Organizations (BHOs)
–Magellan (Anthem)
www.magellanhealth.com
–Cenpatico (MHS)
www.cenpatico.com
–MDwise
www.mdwise.org
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Billing Guidelines
Surgical Services
Cosurgeons:
• Cosurgeons must append modifier 62 to the surgical
services
• Modifier 62 cuts the reimbursement rate to 62.5
percent of the rate on file
Bilateral Procedures:
• To indicate a bilateral procedure, providers bill with
one unit in field 24G, using modifier 50
• Use of this modifier ensures that the procedure is
priced at 150 percent of the billed charges or the rate
on file
Note: If the CPT code specifies the procedure as
bilateral, then the provider must not use modifier 50
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Billing Guidelines
Surgical Services
• Postoperative care for a surgical procedure
includes 90 days following a major procedure
surgical procedure and 10 days following a
minor surgical procedure
• Separate reimbursement is available for care
during the global postoperative period for:
- Services unrelated to the surgical procedure
- Care not considered routine
- Postoperative care for surgical complications
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Billing Guidelines
• Submit claims on Web interChange, including the following:
– Surgery payable at reduced amount when related
postoperative care paid
– Postoperative care within 90 days of surgery
– Preoperative care on day of surgery
– Surgery payable at reduced amount when preoperative care
paid same date of service
• In the claim note, the IHCP accepts the following:
– Information that documents the medical reason and unusual
circumstances for the separate evaluation and management
(E/M) visit
– Information supporting that the medical visit occurred
because of a complication, such as cardiovascular
complications, comatose conditions, elevated temperature for
two or more consecutive days, medical complications due to
anesthesia other than nausea and vomiting, postoperative
wound infection requiring specialized treatment, or renal
failure
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/ October 2009
Billing Guidelines
Multiple Surgery Procedures
• When two or more covered surgeries are
performed during the same operative
session, multiple surgery reductions
apply to the procedure based on the
following adjustments:
– 100 percent of the global fee for the most
expensive procedure
– 50 percent of the global fee for the second
most expensive procedure
– 25 percent of the global fee for the
remaining procedures
• All surgeries performed on the same
day, by the same rendering physician,
must be billed on the same claim form;
otherwise, the claim may be denied and
the original claim may be adjusted
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/ October 2009
Billing Guidelines
Therapy Services
• Per 405 IAC 5-22-6, prior review and authorization by the office
is required for all therapy services with the following exceptions:
– Initial evaluations
– Emergency respiratory therapy
– Any combination of therapy ordered in writing prior to a
member’s release or discharge from inpatient care, which may
continue for a period not to exceed 30 units, sessions, or visits
in 30 calendar days
– Deductible and copayment for services covered by Medicare
Part B
– Oxygen equipment and supplies necessary for the delivery of
oxygen with the exception of concentrators
– Therapy services provided by a nursing facility or large private
ICF/MR, included in the facility’s per diem
– Physical therapy, occupational therapy, and respiratory
therapy ordered in writing by a physician to treat an acute
medical condition, except as required in Sections 8, 10, and 11
of this rule
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Billing Guidelines
Therapy Services – Physical Therapist Assistant’s Rule Change
• Physical therapy assistants
(PTAs) are eligible for
reimbursement using the HM –
Less than a bachelor’s degree,
modifier
• The IHCP reimburses services
rendered by PTA at 75 percent
of the reimbursement level for a
physical therapist
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/ October 2009
Billing Guidelines
Therapy Services – Physical Therapist Assistant’s Rule Change
• Indiana Administrative Code (IAC) 405 IAC 1-
11.5-2 was amended to allow for the
reimbursement of services provided by certified
PTAs, whether independent or hospital-based
• The PTA is precluded from performing and
interpreting tests, conducting initial or
subsequent assessments, and developing
treatment plans
– Under direct supervision, a PTA is still
required to consult with the supervising
physical therapist daily to review treatment
– The consultation can be either face-to-face
or by telephone
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/ October 2009
Billing Guidelines
Podiatric Services – Routine Foot Care
• Routine foot care is only covered if a
member has been seen by a medical doctor
or doctor of osteopathy for treatment or
evaluation of a systemic disease during the
six-month period prior to rendering routine
foot care
• A maximum of six routine foot care
services is covered per rolling 12-month
period when the member has one of the
following:
– Systemic disease of sufficient severity that a
treatment of the disease may pose a hazard
when performed by a nonprofessional
– Systemic conditions that result in severe
circulatory embarrassment or has had areas
of desensitization in the legs or feet
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Billing Guidelines
Podiatric Services – Routine Foot Care
• ICD-9-CM diagnosis codes that
represent systemic conditions that
justify coverage for routine foot care:
– Diabetes mellitus: ICD-9-CM codes
250.00-250.91
– Arteriosclerotic vascular disease of lower
extremities: ICD-9-CM codes 440.20440.29
– Thromboangitis oblierans: ICD-9-CM
code 443.1
– Post-phlebitis syndrome: ICD-9-CM code
459.1
– Peripheral neuropathies of the feet: ICD9-CM codes 357.1-357.7
• Routine foot care is not a covered
service for Package C members
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/ October 2009
Billing Guidelines
Podiatric Services – Routine Foot Care
• Reimbursement is limited to one office visit using
procedure code 99211, 99212, and 99213 per member,
per 12 months, without obtaining prior authorization
• New patient office visits, using procedure codes 99201,
99202, and 99203 are reimbursable at one per member,
per provider, within the last three years as defined by
the CPT guidelines
• A visit can be billed separately only on the initial visit
• For subsequent visits, reimbursement for the visit is
included in the procedure performed on that date and
not billed separately
–Exception: If a second, significant problem is
addressed on a subsequent visit, the visit code may
be reported with the 25 modifier
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Billing Guidelines
Evaluation and Management Codes
• Reimbursement is available for office visits to a
maximum of 30 per rolling 12 month period, per
IHCP member, without prior authorization (PA), and
subject to the restrictions in Section 2 of 405 IAC 59-1
• Per 405 IAC 5-9-2, office visits should be
appropriate to the diagnosis and treatment given
and properly coded
Procedure Codes
99201-99215
99241-99245
99381-99397
99401-99429
99271-99275
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Billing Guidelines
Evaluation and Management Codes
• Professional services rendered during the
course of a hospital confinement must be
submitted on the paper CMS-1500 claim form
or using the electronic 837P transaction
• The IHCP makes reimbursement in accordance
with the appropriate professional fee schedule
• The inpatient diagnosis-related group (DRG)
reimbursement methodology does not provide
payment for physician fees, including the
hospital-based physician fee
• New patient office visits are limited to one visit
per member, per provider – once every three
years
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Crossover Claims
Processing Electronic Claims
• The Coordination of Benefits Contractor (COBC)
crosses over HIPAA-compliant Medicare claims
to the IHCP
–The Centers for Medicare & Medicaid Services
(CMS) selected Group Health, Inc. (GHI) to
be the COBC
• When Medicare-denied services cross over to
the IHCP, IndianaAIM adjudicates these with a
denied status
• The IHCP created edits for these claims
–The edits are 0592 and 0593 – Medicare
denied details
–Resubmit denied details separately from paid
details and include the MRN from Medicare
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Crossover Claims
Processing Paper Claims
• Allow 60 days for claims to automatically
cross over to the IHCP
• Bill denied charges to the IHCP and include
the Medicare Remittance Notice (MRN)
• Complete field 22 as follows:
- Left side = Coinsurance, deductible, and
psychiatric reduction
- Right side = Medicare payment
• Include the commercial payment amount in
field 29 (not used for traditional Medicare)
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Billing Guidelines
Obstetric Services
• The IHCP covers the following 14 antepartum visits:
– Three visits in trimester one
– Three visits in trimester two
– Eight visits in trimester three
• Providers use the following codes to bill for visits:
– First visit – Evaluation and management (E/M) – 9920199205
– Visits one through six – 59425
– Seventh and subsequent visits – 59426
• Providers use the following modifiers with procedure codes:
– U1 for trimester one – Zero through 14 weeks
– U2 for trimester two – 14 weeks, one day through 28
weeks
– U3 for trimester three – 28 weeks, one day through
delivery
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Billing Guidelines
Pregnancy-Related Claims
• For pregnancy-related claims,
indicate the last menstrual period
(LMP) in MM/DD/YY format in
field 14
– The IHCP does not process claims
for pregnancy-related services if
there is no LMP
• Indicate a pregnancy-related
diagnosis code as the primary
diagnosis when billing for pregnancyrelated services
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Billing Guidelines
Pregnancy Diagnosis Codes
• Use normal low-risk pregnancy diagnosis
codes:
–V22.0
–V22.1
• Use high-risk pregnancy codes:
–V60.0 through V62.9
For additional information, refer to the IHCP
Provider Manual, Chapter 8, Section 4
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Consent Form
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Sterilization and Partial Sterilization
Partial Sterilization
• A sterilization form is not necessary when a
patient is rendered sterile as a result of an
illness or injury
– Providers must note partial sterilization with
an attachment to the claim indicating
“Partial Sterilization” and no consent
required
• Partial sterilization can also be submitted on
the electronic 837P transaction when “Partial
Sterilization” is indicated in the claim notes
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Sterilization Procedure
Essure
• Can be performed in the office, as an
outpatient or an ambulatory surgical
center (ASC)
• Device billed separately on CMS-1500
form using sterilization HCPCS code
A9900- Miscellaneous supply, accessory,
and/or service component of another
HCPCS code
• Use primary diagnosis code of ICD-9-CM
V25.2 Sterilization
• Submit cost invoice with claim
• Submit a valid, signed Sterilization
Consent form
• Print Essure Sterilization on the claim
form or on the invoice
Refer to BR200734 for more information
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Mail Order Incontinence, Ostomy, and
Colostomy Supplies
• Effective February 1, 2008, the Office of
Medicaid Policy and Planning (OMPP) contracted
with three vendors to provide incontinence,
ostomy, and urological supplies to fee-forservice members:
– Binson’s Home Health Care Center
1-888-217-9610
www.binsons.com
– Healthcare Products Delivery, Inc (HPD)
1-800-291-8011
www.hpdinc.net
– J & B Medical
1-866-674-5850
www.jandbmedical.com
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Mail Order Incontinence, Ostomy, and
Colostomy Supplies
• Members obtain supplies via mail order
• The policy applies to Traditional Medicaid and Care
Select members only
• Only paid Crossovers and TPL claims are excluded
from the program
– If Medicare or the TPL denies the claim, the
services are limited to the 3 contracted vendors
• The contracted vendors began providing services
February 1, 2008 (partial implementation)
• Full implementation was completed
June 1, 2008
• A full listing of codes affected by this change is listed
on BT200823
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Prior Authorization
• Providers must verify member eligibility to determine
the care management organization (CMO) that will
process the PA or Update request
– CMO information via Web interChange is real time
– Send the PA request to the assigned CMO as of the date of
the request
– Send PA updates to the original CMO
• Example:
Member is assigned to MDwise on 4/3/08, when the PA
is requested. On 4/15/08, the member transitions from
MDwise to ADVANTAGE. On 4/23/08, the primary
medical provider (PMP) requests a System Update to
the PA.
The PMP must request the System Update from
MDwise.
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Prior Authorization
• Members can change between traditional Medicaid
fee-for-service, Hoosier Healthwise/RBMC, and Care
Select
• When the member changes programs, the receiving
organization must honor PAs approved by the prior
organization for the first 30 days following the
reassignment, or for the remainder of the PA dates of
service, whichever comes first
• Example:
Member transitions from Hoosier Healthwise/RBMC to
a Care Select CMO on September 15, 2008. The MCO
approved PA for dates of service 9/6/08 through
10/30/08.
The Care Select CMO must honor the approved PA for
30 days from September 15, 2008.
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Prior Authorization
Member Changes within a Program
• When members transition from one CMO to
another CMO, or from Traditional Medicaid to a
CMO, the receiving organization must honor the
approved PA until the PA expires
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Prior Authorization
• Each CMO is responsible for processing medical
service PA requests and updates for members
assigned to their organization at the time of the
request
• Traditional Medicaid fee-for-service PA requests are
processed by ADVANTAGE Health Solutions
• The PA number format is alphanumeric
– Alphanumeric PA numbers will identify the CMO
that processed the PA
– The three Eligibility Verification Systems (EVS)
will accommodate the alphanumeric value
• Pharmacy PA requests continue to be processed by
Affiliated Computer Services (ACS)
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Prior Authorization Contact Information
• ADVANTAGE Health Solutions (fee-for-service)
P.O. Box 40789
Indianapolis, IN 46240
1-800-269-5720
1-800-689-2759 (Fax)
• ACS (Pharmacy)
1-866-879-0106
1-866-780-2198 (Fax)
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Prior Authorization Contact Information
• MDwise – CMO
P.O. Box 44214
Indianapolis, IN 46244-0214
1-866-440-2449
1-877-822-7186 (Fax)
• ADVANTAGE Health Solutions – CMO
P.O. Box 80068
Indianapolis, IN 46280
1-800-784-3981
1-800-689-2759 (Fax)
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Code Sets
The following provider types have specific code sets:
• Chiropractic – April 28, 2005
• Durable Medical Equipment – February 12, 2009
• Hearing Services – February 1, 2005
• HIV Care Coordination – October 1, 2004
• Home Medical Equipment – February 12, 2009
• Optician – February 1, 2005
• Optometrist – June 24, 2008
• Transportation – September 16, 2004
• Vision – October 1, 2004
• All Code Sets can be referenced on the
www.indianamedicaid.com home page
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Fee Schedule
• The IHCP Fee Schedule is available
on the IHCP Web site and provides
the following information:
– Pricing for procedure codes
– PA requirements for individual
procedure codes
– List of noncovered codes
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Common Denials –
CMS-1500 Claims
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Edit 1111
Refer/PMP NPI Information Submitted Reports to Multiple LPIs
• Cause
— A one-to-one match cannot be established
between the PMP’s National Provider Identifier
(NPI) and the Legacy Provider Identifier (LPI)
— Affects claims for Care Select and the Restricted
Card Program
• Resolution
— Add the PMP’s taxonomy code to the claim in
addition to the NPI
— CMS-1500
•
PMP Taxonomy Code: Box 17a
Precede the taxonomy with Qualifier “ZZ”
•
PMP NPI: Box 17b
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Edit 558
Coinsurance and Deductible Amount Missing
• Cause
— Coinsurance and deductible amount is
missing indicating this is not a crossover
claim
• Resolution
— Add coinsurance and/or deductible amount
and/or Medicare paid amount to the CMS1500
— CMS-1500
•
Add coinsurance and/or deductible
amount on the left side of field 22
•
Add the Medicare Payment amount on the
right side in field 22
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Edit 1049
Care Select Member’s PMP is Missing
• Cause
— The member is enrolled in the Care Select
Program
— Affects claims for Care Select and the Restricted
Card Program
• Resolution
— Add the member’s PMP information to the claim
— CMS-1500
•
PMP Taxonomy Code: Box 17a
Precede the taxonomy with Qualifier “ZZ”
•
PMP NPI: Box 17b
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Edit 2505
Recipient Covered by Private Insurance
• Cause
— This member has private insurance, which must
be billed prior to Medicaid
• Resolution
— Add the other insurance payment to the claim
— CMS-1500
•
Add other insurance excluding Medicare
payments to field 29
– If the primary insurance denies, the explanation
of benefits (EOB) must be sent with the claim,
either on paper with a paper claim, or as an
attachment if claim is sent on Web interChange
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Edit 1047
Certification Code Missing – Care Select Member
• Cause
— This is a Care Select member
•
Must have two-digit certification code from the
primary medical provider
• Resolution
— Add the two-digit certification code from the
primary medical provider for that quarter
— CMS-1500
•
PMP Certification Code – Box 19
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/ October 2009
Edit 2017
Recipient Ineligible on Date of Service Due to
Enrollment in a Managed Care Organization
• Cause
–The member was not eligible for fee-forservice medical assistance on the date of
service because he or she was enrolled in the
risk-based managed care program
• Resolution
–Verify eligibility on any EVS and bill the
appropriate managed care organization
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Edit 5001
Exact Duplicate
• Cause
–Claim being processed is an exact duplicate
of a claim on the history file or another claim
being processed in the same cycle
• Resolution
–Research prior claims billed for “paid” status
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Edit 0593
Medicare Denied Detail
• Cause
–Occur when Medicare denies a detail line
–Are not crossover claims
–Do not include the paid detail lines on the
new claim
–Processed as third-party liability (TPL) claims
–Include the Medicare Remittance Notice
(MRN) with the claim
• Resolution
–Denied detail lines must be billed on a
separate claim form
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Edit 4021
Procedure Code vs. Program Indicator
• Cause
–Procedure code billed is restricted to a
specific program
• Resolution
–Verify eligibility and submit claim with
appropriate procedure code
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Edit 0513
Member Name and Number Disagree
• Cause
–The member name and the member
identification number (RID) on the claim do
not match the member database
• Resolution
–Verify member name and RID on any EVS
–Resubmit claim with corrected name and/or
RID
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Helpful Tools
Avenues of Resolution
• IHCP Web site at www.indianamedicaid.com
• IHCP Provider Manual (Web, CD-ROM, or
paper)
• HCBS Waiver Provider Manual (Web)
• Customer Assistance
–1-800-577-1278, or
–(317) 655-3240 in Indianapolis local area
• Written Correspondence
–P.O. Box 7263
Indianapolis, IN 46207-7263
• Provider Relations field consultant
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Questions
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Office of Medicaid Policy and Planning (OMPP)
402 W. Washington St, Room W374
Indianapolis, IN 46204
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950 N. Meridian St., Suite 1150
Indianapolis, IN 46204
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October 2009