Wednesday, October 30, 2013

Updated CMS-1500 form for ICD-10

CMS 1500 claim form gets an update
The National Uniform Claim Committee has updated the CMS-1500 insurance claim form to accommodate the new ICD-10 codes and current standard for electronic health care transactions.
Known as "version 02/12" and approved by both the Centers for Medicare & Medicaid Services (CMS) and the Office of Management and Budget, the updated claim form includes revisions designed to improve the accuracy of data reported. 
Two changes of note:
• Physicians can identify in Item 21 whether they are using ICD-9 or ICD-10, which will come in handy during the transition to the new codes in October 2014. As noted in a previous post, it depends on the actual date of service whether you use ICD-9 or ICD-10 on claims submitted after Oct. 1, 2014.
• The diagnosis field in Item 21 will allow up to 12 codes. The current form (version 08/05) is limited to four.
Other revisions will also help with accuracy. For instance, you will now be able to identify in Item 17 the role of the provider as “Ordering,” “Referring,” or “Supervising."
The start date for using the revised form has not yet been announced. However, Medicare anticipates implementing the revised claim form as follows:
• Jan. 6, 2014 – Medicare begins receiving and processing paper claims submitted on the revised form.
• Jan. 6, 2014, through March 31, 2014 – Providers can use either the current form or the revised one.
• April 1, 2014 – Only the revised form can be used.  
These dates are tentative and subject to change. CMS will provide more information as it is available. Also, CMS is updating the Medicare Claims Processing Internet Only Manual to instruct contractors and physicians regarding how to complete the revised form online and will post this information on the CMS website when it is available.
If you still submit paper claims, you would be wise not to purchase large quantities of the current form. If your practice submits electronic claims, you should speak to your software vendor to determine how and when your practice management system will be updated to accommodate the revised form.

Blue Cross Blue Shield of Arizona Advantage Adds Scottsdale Healthcare to Medicare Advantage Network

Published: Tuesday, Oct. 29, 2013 - 9:56 am
/PRNewswire-USNewswire/ -- Blue Cross Blue Shield of Arizona Advantage, an affiliate of Blue Cross Blue Shield of Arizona (BCBSAZ), is expanding its physician network to better serve Scottsdale-area residents. By contracting with Scottsdale Healthcare Hospitals and Scottsdale Health Partners, members of a Blue Medicare Advantage(HMO) plan now have the option of selecting doctors within the Banner Health Network or Scottsdale Health Partners.
Scottsdale Healthcare Hospitals include:
  • Scottsdale Healthcare Osborn Medical Center
  • Scottsdale Healthcare Shea Medical Center
  • Thompson Peak Hospital
"As a local company, we have the benefit of being able to talk with Arizonans directly about what they want from their healthcare plan," said Bill Harris, chief executive officer of Blue Cross Blue Shield of Arizona Advantage. "They've made it very clear they want the freedom to choose their doctors…close to home. Adding Scottsdale Healthcare to the network of our Blue Medicare Advantage plans, members will have expanded access to care."
BCBSAZ will also continue to offer six Medicare supplement plans and two Medicare Prescription Drug Plans (PDP) statewide.
To help Arizonans pick the right plan and understand their options, BCBSAZ developed several tools and resources including videos, which can be found at www.yourazmedicaresolutions.comand
The Medicare Annual Election Period for 2014 is October 15 through December 7, 2013. Coverage takes effect on January 1, 2014. The annual election period hasn't changed for Medicare, and it is different than the new Affordable Care Act open enrollment period which ends March 31.

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