Noridian issues Medicare provider updates

Noridian Healthcare Solutions, the management administrative contractor for Medicare for California, has recently issued numerous updates and other information of value to doctors of optometry and their staff:

• Medicare Enrollment for Part B Physicians Fact Sheet Revised: The revised “Medicare Enrollment for Physicians and Other Part B Suppliers” fact sheet is designed to provide education on Medicare enrollment, how to ensure that physicians, including doctors of optometry, are eligible to enroll in the Medicare program, along with how to report changes and a list of resources.
• ICD-10 Coding Resources: CMS has posted a complete list of the 2016 ICD-10-CM valid codes and code titles. This file will be useful for doctors of optometry and their staff who want to check to make sure that they are reporting all characters in a valid ICD-10-CM code.
• Limiting the Scope of Review on Redeterminations and Reconsiderations of Certain Claims: This article addresses revisions to the process followed by MACs in redeterminations and reconsiderations of claims denied following a post-payment review or audit. Effective for redetermination requests received on or after August 1, 2015, CMS has instructed MACs and QICs to limit their review to the reason(s) the claim or line item at issue was initially denied.
• NSV Initiative: The National Site Visit Verification (NSV) initiative is a screening mechanism to prevent questionable providers and suppliers from enrolling or maintaining enrollment in the Medicare program that includes unannounced site visits for Medicare Part A/B providers, including doctors of optometry, and suppliers.
• MREP Upgrade: The free CMS software, Medicare Remit Easy Print (MREP), has been upgraded to offer a number of special reports that users can view and download in addition to the remittance advice. The key change is an enhancement to the MREP application to suppress the PR group code (Patient Responsibility) from the glossary of the Entire Remittance Report when the only Patient Responsibility items on the claim are for Claim Adjustment Reason Code (CARC) 01 (deductible) and CARC 02 (co-insurance).
• HIPAA Basics for Providers: Privacy, Security and Breach Notification Rules Fact Sheet Released: This fact sheet is designed to provide education on HIPAA basics for providers, including: privacy, security, breach notification rules, covered entities, business associates, as well as the disposal of private health information.