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Printed Date: 9/22/2015
The following questions were received during our December 13, 2016, Documenting Chest X-rays and DXA Bone Density Studies webcast.
Q. Is it required that the report be separate from the progress note? If not, is it required that there be a header or indicator stating the area containing the radiological report?
A. The report may be within the progress note but it needs to be separately identifiable.
Q. For the ADR letters for 71010,71020 and 77080 are the technical hospitals or imaging centers getting letter also?
A. Yes. The letters are being sent out to the billing provider whether that be a facility or a physician. The letters will go out to the actual billing provider.
Addendum: To clarify, ADR letters for 71010, 71020 and 77080 are sent to a facility only when the facility is the billing provider for a service. We do not send ADR letters to, or request documentation from, a facility solely because one of these services was rendered at a facility, and the facility maintains the records and/or order for the service. It is the billing provider’s responsibility to return requested records to Medical Review regardless of where those records are housed.
Q. Is there a list of approved ICD 10 diagnosis for bone density testing? 150.3
A. CMS did release a list of ICD-10-CM diagnosis codes for bone mass measurement in their MLN matters special edition article SE1525. The article is titled ‘ICD-10-CM Diagnosis Codes for Bone Mass Measurement’. That can be found on the CMS website on the Medicare Learning Network page. You can also search for that on the Change Request page because it is related to CR 9252. It is possible that there may be some new ICD-10 codes for the 2017 release that may be added. There are some CRs that CMS is in the process of implementing for some of the 2017 ICD-10 changes. The first resource I would refer you to would be MLN SE1525.
Addendum: Here are links to the ICD-10 resources.
Bone Mass Measurement is not included on any of the ICD-10 changes for NCD change requests that are currently pending implementation in 2017.
Q. What was the MLN article # for ICD 10 dx codes?
A. That would be MLN Special Edition article SE1525, which is related to Change Request 9252.
Addendum: See also Medicare Change Request 9540.
Q. Our practice uses the RISE registry from the American College of Rheumatology to assist in the quality of care for our patients. Is it acceptable to schedule bone density scans for patients who qualify and the physician create the order on the day of service.
A. Bone density scans for patients who qualify can be performed on the same day as the physician order is created.
Q. Just to be clear, do I need to complete a 'Medical Review ADR Response Cover Sheet' for each ADR letter or only if I have misplaced the ADR letter?
A. If you have the ADR letter you can use that to identify the claim you are returning the documentation for and that will be sufficient as long as we can clearly identify the patient, the claim and the date of service. If you do not have the ADR letter, we do have the ‘Medical Review ADR Response Cover Sheet’ available on our website that you can use in lieu of the letter that helps us identify exactly which claim/patient/date of service you are responding to, or sending the documentation for. We do not technically have to have both of them though. If you have the letter, that is sufficient.
Q. Today received an automated call from RR MCR that we have an open ADR for pre-pay review. The info was given quickly and no option to repeat the info before call disconnected. These calls need option to repeat. Not enough info to call, handle multiple provider.
A. Thank you for feedback. Prior to receiving the automated telephone call, an ADR letter was sent to the address on file. This calls are done as a reminder. Please refer to the ADR letter or outstanding Railroad Medicare claims to determine if you may have claims pending for payment. It is also important to be sure the address on file is up to date or the correspondence is forwarded from the billing agency or clearinghouse. The Provider Contact Center can be reached at 1-888-355-9165 for any additional questions from 8:30 to 4:30 pm for all time zones except PT which receives service until 4:00 PM PT.
Q. I missed the beginning of this. Can I hear it again in a recorded version?
A. Yes, the recorded version of this presentation will be available later this afternoon. You will be able to access the recording using the same link you received on your registration email. An email will also go out to all registrants letting them know when it is available.
Q. Would you repeat the certificate number again?
A. The course number for your certificate is RRB1315047.
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Last Updated: 01/05/2017