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Frequently Asked Questions

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Question	Date Updated
Can there be a standing order for observation services?	6/20/2008 1:13 PM
How will the 2007 Physician Quality Reporting Initiative (PQRI) 1.5 percent bonus be calculated, and when will it be paid?	6/20/2008 1:12 PM
Has the required timing of therapy recertifications changed from 30 days to 90 days?	6/20/2008 1:12 PM
Where can a provider find a list of Medicare denial codes and explanations?	6/20/2008 1:11 PM
I received a Remittance Advice (RA) from my carrier with a denial indicating that PQRI quality data codes are not payable. Will the quality data codes still be counted for PQRI bonus calculation?	6/20/2008 1:11 PM
How many records can be placed in an envelope when medical records are requested and then scanned by POWER (Paperless Operational Workflow Electronic Routing System)?	6/20/2008 1:10 PM
Will POWER (Paperless Operational Workflow Electronic Routing System) accept an “electronic medical record”? If so, how would that be sent to POWER?	6/20/2008 1:10 PM
I heard a nine-digit zip code is now required when billing anesthesia, could you explain?	6/20/2008 1:09 PM
Relating to the Initial Preventive Physical Exam (a preventive service available as of January 1, 2005), is there a specific diagnosis that must be used to identify it as the IPPE?	6/20/2008 1:07 PM
Has the required timing of therapy recertifications changed from 30 days to 90 days?	6/20/2008 1:05 PM
Can there be a standing order for observation services?	6/20/2008 1:05 PM
When does the 30-day transfer period start for patients that are admitted to a Skilled Nursing Facility?	6/20/2008 1:04 PM
Why was a Medicare Fee-for Service informational claim for a Medicare Advantage beneficiary paid by Medicare?	6/20/2008 1:04 PM
What HCPCS code should be used if one can not be found for the medication that is being administered?	6/20/2008 1:04 PM
How should medications be billed?	6/20/2008 1:04 PM
Is it necessary to bill both the technical and professional components of diagnostic radiology services on the same date of service if both are not performed on the same date?	2/27/2008 9:43 AM
How do you bill with the Q6 modifier when billing diagnostic radiology interpretations on the same day as the radiology procedure performed, when the interpretation was actually performed a day later than the procedure?	2/27/2008 9:43 AM
What specifically is the difference between and an expanded problem focused exam vs. a detailed exam?	2/27/2008 9:43 AM
If a patient is seen in the emergency room and then is admitted as an inpatient, does Medicare pay for both the emergency department evaluation and management visit on the same day as well as an initial hospital visit?	2/27/2008 9:42 AM
Why are claims denying when the provider submitted with his individual NPI and his incorporated NPI numbers?	2/27/2008 9:42 AM
Relating to the Initial Preventive Physical Exam (a preventive service available as of January 1, 2005), is there a specific diagnosis that must be used to identify it as the IPPE?	2/27/2008 9:41 AM
Can you bill two Emergency Department (ED) services on the same day by two different physicians?	2/27/2008 9:41 AM
When you compile CERT errors, at what level are they compiled?	2/27/2008 9:41 AM
When billing for a locum tenens should the statement "Dr. X, UPIN X, provided services for X dates be on every claim with a Q6 modifier or is this just a statement of clarification when documentation is requested?	2/27/2008 9:40 AM
When billing with a Q6 modifier should the UPIN/PIN of the locum tenens be on the claim or just be on record?	2/27/2008 9:40 AM
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