Changes w/ Medicare -- WSCA

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Date Posted: Fri, Jun 18 2004, 5:31:57
Author: John Angell
Subject:

Changes w/ Medicare

Most of us are aware that you need to put
your clinic information in box 32 of the CMS-1500 or
listed as the facility with e-claims. Here is another
change down the road. Effective 10/01/04, Medicare
will start enforcing the use of the �-AT� modifier.
Any CMT charges (98940, 98941, or 98942) that does not
have the �-AT� modifier will be denied by Medicare as
�maintenance therapy�. There is a �catch-22� here.
If you use the �-AT�, you cannot have the patient sign
an ABN. The ABN is used when you feel Medicare may
deny the charge as �not medically necessary�. When
you use the �-AT� modifier, you are indicating that
you believe care is medically necessary for and acute
condition. Therefore, you would not have the patient
sign an ABN.

=====
John Angell
Kirkland Billing

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