have you had any trouble with mammography claims?

ModeratorRoyModeratorRoy
in Part B Archive
I notice a few MACs are pushing mammography guidance lately - here's an example:

http://medicare.fcso.com/Billing_news/0354212.asp

I wonder why that is? Have any of you had any trouble with these claims?

Thanks,
Roy


______________________________________________________________

Roy Edroso
Part B News
http://pbn.decisionhealth.com/

Comments

  • mlewis@scrogginsgrear.commlewis@scrogginsgrear.com
    edited May 2017
    ?Perhaps because there are so many mobile units providing mammograms.


    Maxine Lewis, CMM, CPC, CPC-I, CPMA, CCS-P


    Main: 513-771-7070
    Direct: 513-672-4363

    Fax: 513-326-7640

    200 Northland Blvd

    Cincinnati, OH 45246

    mlewis@scrogginsgrear.com

    www.scrogginsgrear.com



  • ModeratorRoyModeratorRoy
    edited May 2017
    Interesting! Hadn’t thought of that. What would the POS on those be, I wonder?

    From: Maxine Lewis [mailto:MLewis@scrogginsgrear.com]
    Sent: Wednesday, September 14, 2016 12:05 PM
    To: Multiple recipients of list PARTB-L
    Subject: Re:[partb-l] have you had any trouble with mammography claims?


    ​Perhaps because there are so many mobile units providing mammograms.


    Maxine Lewis, CMM, CPC, CPC-I, CPMA, CCS-P


    Main: 513-771-7070
    Direct: 513-672-4363

    Fax: 513-326-7640

    200 Northland Blvd

    Cincinnati, OH 45246

    mlewis@scrogginsgrear.com

    www.scrogginsgrear.com



  • Karyn.Cardenas-Foray@sharp.comKaryn.Cardenas-Foray@sharp.com
    edited May 2017
    Hi I cannot access this only as I am not Florida Puerto Rico. Or virgin islands

    Karyn Cardenas-Foray, CPC, CPMA ,CHCA, CEMC,CIMC,CSEMC
    AHIMA ICD10 PROFICIENT
    Government Reimbursement Analyst-Sharp Health Care
    PFS-CCD 3rd Floor
    858-499-4382

  • ModeratorRoyModeratorRoy
    edited May 2017
    Sorry, I'll copy the main part of it here:

    Mammography coverage and certification of mammography facilities
    Providers and suppliers that furnish and bill Medicare for film, digital, or 3-D mammography services are reminded that claims for these mammography services will either deny or reject as unprocessable if:
    * There is no FDA certification number reported on the claim
    * The facility is not certified for the type of mammogram submitted on the claim (film, digital, or 3-D)
    * A facility's certificate is suspended or revoked
    * The HCPCS/CPT code billed does not match the certification on file for the facility, or
    * There is no FDA certification number on the MQSA file for the facility listed on the claim
    Note: Direct any questions/concerns regarding certification dates to the FDA MQSA Facility Hotline at 1-800-838-7715.
    For additional information, providers and suppliers that furnish and bill Medicare for film, digital, or 3-D mammography services can refer to Medicare's internet only manual (IOM) Publication 100-04, Chapter 18, Section 20 and its subsections found here: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c18.pdf [external pdf file] .


    From: Karyn Foray [mailto:Karyn.Cardenas-Foray@sharp.com]
    Sent: Wednesday, September 14, 2016 12:47 PM
    To: Multiple recipients of list PARTB-L
    Subject: RE:[partb-l] have you had any trouble with mammography claims?

  • mlewis@scrogginsgrear.commlewis@scrogginsgrear.com
    edited May 2017
    The POS is 15 mobile unit. However, if it is on the hospital grounds could be 22 outpatient.
    Maxine

    [Description: Description: R:\General\Graphics\ScrogginsGrear\Correct Colors\ScrogginsGrear One Line Signature.png]

    Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
    Main: 513-771-7070
    Direct: 513-672-4363
    Fax: 513-326-7640
    200 Northland Blvd
    Cincinnati, OH 45246
    mlewis@scrogginsgrear.com
    www.scrogginsgrear.com

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