April 2007 Medicare Bulletin - North Carolina Insert
Posted April 6, 2007
Download a PDF copy
of this issue 
Table of Contents
- 2007 NC Statewide Spring Workshop Series
- Changes Included in Change Request (CR) 5528 for the April Update to the 2007 Medicare Physician Fee Schedule Database
- Corrections to 2007 North Carolina Fees for HCPCS Codes Newly Classified as Carrier Priced
- North Carolina Health Professionals Shortage Areas (HPSAs)
- North Carolina Mental Health Professional Shortage Areas (HPSAs)
- Vision Specialty Workshop
Top2007 NC Statewide Spring Workshop Series
The North Carolina Provider Relations team at CIGNA Government Services is pleased to present the upcoming 2007 Statewide Spring Workshop Series. These workshops are scheduled for April and May 2007 in the following cities: Asheville, Hickory, Charlotte, Greensboro, Durham, Fayetteville, Wilmington, Rocky Mount, and Greenville.
These workshops will be dedicated to 2007 Medicare updates, tips, and helpful resources for Medicare providers in North Carolina, including the following topics:
- 2007 Medicare Fees and Reimbursement
- New Screening Services
- Coding Updates
- Revisions to the CMS-1500 form
- Physician Quality Reporting Initiative
- Competitive Acquisition Program
- National Provider Identifier (NPI)
- Provider Enrollment Updates
- Electronic Data Interchange (EDI) Initiatives
- Medical Review Strategy and Error Rates
- Resources for Medicare Providers
- And much more!
These half-day workshops will last from 9am until 1 pm, with sign-in beginning at 8:30am. There will be a $25.00 registration fee per participant, payable online or by check, which covers the cost of continental breakfast, meeting materials, and the meeting facility.
Registration and additional details are available online at: http://www.cignagovernmentservices.com/wrkshp/nc/wrkshp_sem_NC.html.
For questions regarding these workshops, please contact our Customer Service Call Center at 1.866.655.7996.
Space for these workshops is limited! Register today!
Vision Specialty Workshop
CIGNA Government Services will be conducting a “Vision Specialty” workshop in Greensboro, North Carolina on Wednesday, March 28, 2007, at the Greensboro Airport Marriott. This workshop is scheduled from 9am-12pm ET, with sign-in beginning at 8:30am ET.
Topics to be covered include:
- Medicare coverage and billing guidelines for Vision-related services
- Multiple Surgery & Global Surgery guidelines
- Low Vision Rehabilitation Demonstration Project
- Proper use of the Advance Beneficiary Notice (ABN)
- Principles of medical record documentation
- National Provider Identifer (NPI)
- Medicare tools and resources
Additional details and online registration are available on the CIGNA Government Services Web site:
http://www.cignagovernmentservices.com/wrkshp/nc/wrkshp_sem_NC.html.
Space is limited, so register now!
Corrections to 2007 North Carolina Fees for HCPCS Codes Newly Classified as Carrier Priced
Corrections to 2007 North Carolina Fees for HCPCS Codes Newly Classified as Carrier Priced
Changes Included in Change Request (CR) 5528 for the April Update to the 2007 Medicare Physician Fee Schedule Database
Based on changes to the Transitional Non-Facility and/or Transitional Facility Practice Expense Relative Value Units, the fees for the following list of CPT codes will be updated. In addition, the Multiple Procedure Indicator for CPT codes 17311 and 17313 will be changed from “Standard payment adjustment rules for multiple procedures apply” to “No payment adjustment rules for multiple procedures apply.” These changes will be implemented April 2, 2007 for dates of service on or after January 1, 2007.
April 2007 MPFSDB Updated Fees - North Carolina
| CPT Code Code | PAR | NON-PAR | Limiting Charge |
| 36478 | 1,695.14 | 1,610.38 | 1,851.94 |
| 37210 | 3,166.62 | 3,008.29 | 3,459.53 |
| 93225 | 41.74 | 39.65 | 45.60 |
| 93226 | 70.78 | 67.24 | 77.33 |
| 93231 | 48.75 | 46.31 | 53.26 |
| 93232 | 71.94 | 68.34 | 78.59 |
| # 95991 | 33.52 | 31.84 | 36.62 |
# These amounts apply when service is performed in a facility setting.
Limiting charge applies to unassigned claims by non-participating providers.
© All Current Procedural Terminology (CPT) codes and descriptors are copyrighted by the American Medical
Association
North Carolina Mental Health Professional Shortage Areas (HPSAs)
Designated Geographic Areas
|
1 Classified as a Mental Health HPSA, Effective February 2, 2005
2 Classified as a Mental Health HPSA, Effective June 30, 2005
3Classified as a Mental Health HPSA, Effective December 15, 2006
North Carolina Health Professional Shortage Areas (HPSAs)
Designated Geographic Areas
|
1 No longer classified as a HPSA, effective August 1, 2002.
2 Classifed as a HPSA, effective June 1, 2004.
3 No longer classified as a HPSA, effective December 1, 2004.
4No longer classified as a HPSA, effective September 8, 2006
