Category Archives: Billing

PPS Therapy Adjustments

Our calculation of the PPS therapy adjustment for final claims was off a small amount. There year-to-year factor that we used to calculate from the original base year on therapy adjustments was not correctly applied. This error had no bearing … Continue reading

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Face to Face Reporting

In the PPS assessment report found in billing, we have added an additional type of report called Face to Face Information. It will show the face to face date entered into the PPS billing information screen. This variation of the … Continue reading

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PPS Billing – PPS Billing Rejection – 7202 Missing Admission Type

Agencies are reporting that PPS claims to CMS are rejecting for this reason. We have made a change to PPS electronic billing to include the admission type in electronic claims. We will default to a ‘3-Elective’ if the admission type … Continue reading

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PPS Billing – New “G” Codes

We have made an update to the PPS Billing module. The new HCPCS “G” codes should be used on visits as of 01/01/2011 only if the assessment begins after 01/01/2011. If the assessment is from prior to 01/01/2011 the new … Continue reading

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Medicare ‘G’ HCPCS Codes

We’ve been getting a lot of calls recently concerning the use of the new ‘G’ HCPCS codes for Medicare. In the past, for Medicare billing, one revenue code usually had a HCPCS code associated with it. For example, for 551 … Continue reading

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Medicare PPS Billing – Palmetto GBA Submitters

Palmetto GBA has announced they will begin implementation of the new Jurisdiction 11 as of January 22, 2011. For our users, this will affect agencies in the states of Florida, Illinois, Indiana, Kentucky, New Mexico, Ohio, Oklahoma, Tennessee and Texas. … Continue reading

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PPS Assessment Listing

We added a new report option, Domain Level [ZPIC], to the PPS Assessment Listing found under billing reports. This report option will show the clinical, functional, and service domain levels for each assessment along with percentages for each level to … Continue reading

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New Home Health HCPCS Codes

The final rule for the Home Health PPS 2011 changes added new HCPCS codes for home health providers to report when billing physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP) and skilled nursing (SN) services. CMS has released their … Continue reading

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Version 4681 Update

If you updated last night or this morning to Version 4680 you should update to Version 4681. We had added a new checkbox in PPS Billing called “Resubmission.” When you go into PPS Billing this box is defaulting to being … Continue reading

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New Invoice Format – Statement Listing

We have added a new invoice format, Statement Listing, in the generate invoices section of billing. This is a generic type of invoice that lists all the services provided for the insurance company, without breaking by patient. The invoice includes … Continue reading

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