The KMC University Help Desk is Your Practice Advocate!
Q: When initially submitting billing for a Medicare patient, what is the rule for filling out box 14? Also, what about box 15?
A: Medicare requires that box 14 is filled out. Their rule is that the date must be the date that the patient presented for care for the current complaint. This differs from some carriers where box 14 is dated with the incident date. Box 15 is always left blank when billing Medicare. Here is a link for the CMS claim form instructions: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c26.pdf
Q: Are there more specific codes for supplies rather than using 99070?
A: Yes. The HCPCS supply code series includes more specific supply codes. The HCPCS supply codes are still often overlooked and unused by providers. These supply codes are more specific and are far more accurate for reporting than the standard CPT code 99070, which is a non-specific, general supply code. Of course, coverage and benefits for these HCPCS codes, like all other codes, depends upon policy benefits and limitations of the carrier being billed. When coverage does exist, it is more efficient and effective to use a specific code for the supply rather than the general and ill-defined 99070 supply code. Also, be aware of specific modifiers that are used to further define the supply and to indicate whether the purchase was New Equipment, a Rental, etc.
These commonly asked questions shared with you here represent a few of the hundreds of questions we receive from members every month! Contact us to learn more about the benefits of Library membership, including on-demand access to certified HelpDesk Specialists. (855) 832-6562.