Regulatory Changes

New Q Codes for 2010-2011 Seasonal Influenza Vaccine

Information Regarding the Billing of New Q Codes for 2010-2011 Seasonal Influenza Vaccines for Medicare Fee for Service Providers The Centers for Medicare and Medicaid Services (CMS) has created specific HCPCS codes and payment rates for Medicare billing purposes for the 2010-2011 influenza season. Effective for claims with dates of service on or after January 1, 2011, CPT code 90658 will no longer be payable by Medicare. Effective for dates of service on or after October 1, 2010, the following new influenza Q codes will be payable by Medicare: Q2035 (Afluria), Q2036 (Flulaval), Q2037 (Fluvirin), Q2038 (Fluzone), and Q2039 (Not Otherwise Specified flu vaccine). Physicians, other practitioners, and suppliers may submit their claims with the new influenza Q codes on an individual basis or via the roster billing process. CMS has instructed Medicare contractors to hold all claims containing the influenza Q codes with dates of service on or after October 1, 2010, until their systems are able to accept them for processing. The Medicare contractors' systems will be ready to process claims containing the Q codes no later than February 7, 2011. Physicians, other practitioners, and suppliers also have the option to hold their claims containing the new influenza Q codes until February 7, 2011. For further information, please see Transmittal 815, Change Request 7234, issued on November 19, 2010. http://www.cms.gov/MLNMattersArticles/downloads/MM7234.pdf

President Obama Signs the Medicare and Medicaid Extenders Act of 2010

This new law prevents a scheduled payment cut for physicians who treat Medicare patients from taking effect. The Centers for Medicare & Medicaid Services is pleased that this law has addressed key issues for beneficiaries and providers and they are actively engaged in implementing these changes. https://www.highmarkmedicareservices.com/bulletins/all/news-12212010.html

Red Flag Rules

Congress Exempts Physicians from the Red Flag RulesThe legislation keeps physicians from having to comply with ID theft regulation, but some aren't sure if the issue is resolved with the FTC. http://www.gpo.gov/fdsys/pkg/BILLS-111s3987enr/pdf/BILLS-111s3987enr.pdf

Recovery Audit Contracting (RAC)Program for Region A

Centers for Medicare & Medicaid Services (CMS) has retained DCS to carry out the RAC program for Region A. DCS Healthcare is a Division of Diversified Collection Services. DCS website provides important information for physician practices and lists issues being reviewed.
More information: http://www.dcsrac.com