Laboratory Question for the Week of March 7, 2016

Laboratory Compliance Question of the Week

Question:

Our fiscal intermediary has been rejecting claims that contain code P9603 (for travel allowance) and G0471. Does Medicare not allow these codes to be billed together for an independent lab?

Answer:

According to the Centers for Medicare & Medicaid Services (CMS), there is a glitch in the fiscal intermediary shared system (FISS) that needs to be corrected when these two codes are billed together. In transmittal R1619OTN (and MLN Matters number MM9471), CMS explains that the glitch applies to claims with dates of service (DOS) on or after April 1, 2014.  

CMS also says that a system change will be implemented for claims processed on or after July 5, 2016. Once implemented, Medicare administrative contractors will:

• Reprocess claims brought to their attention for DOS on and after April 1, 2014, that were previously returned in error.

• Override timely filing, if necessary, to reprocess claims previously returned in error.

For more on this, go to https:// www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9471.pdf

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.