I am submitting an adjustment claim to update non-covered charges. Do I use condition code D1 or D9?
You should use condition code D9 (any other changes). D1 (changes to charges) is used when you are adjusting covered charges.
Will my therapy claim be rejected with dates of service (DOS) on or after October 1, 2010, if I include value codes 50 through 53?
No. With the implementation of Change Request (CR) 6899 it is no longer required to report these value codes on therapy claims. However, if the codes are reported, FISS will not edit them.
Can we request HCPCS coding assistance from Palmetto GBA?
HCPCS-related questions must be submitted on the American Hospital Association (AHA) approved form, Request for HCPCS Coding Advice Form (PDF, 65 KB). Completed forms can either be faxed to (312) 422-4583 or mailed directly to the AHA Central Office address below.
Central Office on HCPCS
American Hospital Association
One North Franklin
Chicago, IL 60606
I have viewed the MUE listing and it is not showing the HCPCS code and units that I need for a service. Will Palmetto GBA provide the MUE limit for these HCPCS codes?
CMS only publishes some MUE values on its Web site. There are some MUE values that are confidential and are for the use of CMS and CMS contractors only. Confidential MUE values cannot be released since CMS does not publish them. Available MUEs that CMS publishes may be found on the National Correct Coding Initiatives Edits section of the CMS website.