decisionhealth Newsletters, Part B News - 2001 Issue 9 (September)
A new way to bill for services likely to be denied, effective Jan. 1
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Article Overview
This article covers CMS guidance on reporting services that are likely to be denied beginning January 1, including the introduction of new modifiers, changes affecting existing non-covered-service reporting, and the handling of certain non-covered item codes. It is relevant to coders, billers, compliance staff, and providers who submit Medicare claims and need to understand the scope of the policy update and related form-reporting requirements.
Why This Topic Matters
The policy affects how claims are submitted for non-covered or expected-denial services and may influence whether a claim is processed or denied automatically. It also matters because it changes how certain non-covered service indicators are used and clarifies documentation expectations for claims using NOC reporting.
What You Will Learn
- What CMS changed about reporting services likely to be denied
- Which new modifiers are introduced in the policy update
- How the article frames updated handling of non-covered services and item codes
- What general claim-submission and form-reporting issues are associated with NOC coding
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Compliance staff
- Physician practices
- Supplier billing staff
Codes Discussed
Modifiers Discussed
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