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Taxonomy Code For Therapy, Just Say No To Big Brother's Smart Meters

Enter the code identifying the general category of the payment adjustment for this line. Select the appropriate source code from the dropdown menu options, indicating the point of location/origin for this admission or visit. When using a consolidated NPI, a table will display showing the locations and taxonomy code(s) information on file with MHCP. Enter the 8-digit MHCP ID for the subscriber (recipient) indicated on the MHCP member identification card. Taxonomy for occupational therapist. Enter the name of the Medicare or Medicare Advantage Plan. This is available on the recipient's eligibility response). Other Providers (Claim Level) – Select the Other Providers accordion screen when required to report other provider information. When reporting TPL at the claim (header level), enter the non-covered charge amount. Enter the policy holder's identification number as assigned by the payer. Regular Private Duty RN.

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The first 9 skilled nurse visits in a calendar year do not require an authorization unless the recipient has a current waiver service authorization SA)]. G0154 (through 12/31/15). Skilled Nurse Visit (LPN). Home Care (Non-PCA) Services. Enter the total dollar amount of the specific adjustment for the reason code entered on this service line. Select one of the following: Subscriber. Taxonomy code for therapy. Statement Date (To). Physical Therapy Assistant Extended. Other Payers Claim Control Number. From the dropdown menu options, select the code identifying the insurance carrier's level of responsibility for payment. Enter the claim number reported on the Medicare EOMB. The zip code for the address in address fields 1 and 2. To delete, select Delete. Diagnosis Type Code.

Taxonomy Code Occupational Therapy

Situational (Continued) Claim Information. This must be the date the determination was made with the other payer. Code for occupational therapy. Enter the HCPCS code identifying the product or service. Enter the date associated with the Occurrence Code. Enter the date the item or service was provided, dispensed or delivered to the recipient. Select the radio button next to the location where the service(s) was provided. Adjustment Reason Code.

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An authorization number is required when an authorization is already in the system for the recipient. Pro cedure Code Modifier(s). Coordination of Benefits (COB). Enter the date of payment or denial determination by the Medicare payer for this service line. Use the Washington Publishing Company (WPC) health care codes lists to identify the claim status category and claim status codes displayed on the validate and submit claim response. Telephone number reported on the provider file. Other Providers- Select the Other Providers accordion panel when required to report other provider information on the service line, if different than what was reported at the claim level. Principal Diagnosis Code. From the dropdown menu options, select the code identifying type of insurance. Service Line Paid Amount. The patient control number will be reported on your remittance advice.

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Attachment Control Number. This is the determination of whether the provider has a signed statement by the recipient on file, authorizing the release of medical data to other organizations. Other Payer – Use this accordion screen when reporting COB at the line level for either (Medicare Part B and/or TPL). The last name of the subscriber. Adjudication - Payment Date. Enter the unit(s) or manner in which a measurement has been taken. Select one of the follwoing: Other Payer Na me. For Medicare this would be the Medicare health insurance claim number (HICN) or the Medicare beneficiary identifier (MBI) number. This is the determination of the policy holder or person authorized to act on their behalf, to give MHCP permission to pay the provider directly.

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Select Submit to identify if the claim will be paid, denied, or suspended for review at the claim and service line level of the claim. Once the claim filing indicator is selected, additional fields will display for reporting TPL/private insurance. Use the Home Care Service Billing Codes in the chart below to determine the revenue code used for MHCP home care services. Enter the service end date or last date of services that will be entered on this claim. Enter the code identifying the reason the adjustment was made. Private Duty Nursing RN. For new or current patients enter "1"). Claim Filing Indicator. Date of Service (From).

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Select the appropriate response from the dropdown menu options, to identify the priority of the admission/visit. Copy, Replace or Void the Claim. Home Care Servies Billing Codes. Submitting an 837I Outpatient Claim. Enter the quantity of units, time, days, visits, services or treatments for the service.

Section Action Buttons. An authorization number is not required if there is no authorization in the system and the service is a skilled nurse visit. The name of the Billing Provider: This could be an Organization, business or the Name of an individual provider identified by the NPI used to lo gin to MN– ITS. Use only when a modifier is listed on the service authorization (SA) or when a claim for private duty nursing shared services. If different than the provider reported on the claim information screen: Select one of the following screen action buttons: Note: You must always select Save/View Lines(s) after entering all lines to see the validate and submit action buttons. Enter the total charge for the service.

Non-Covered Charge Amount. Release of Information. Respiratory Therapy Visit Extended. Home Health Aide Visit Extended (waivers). Home Health Aide Visit. From the dropdown menu options select the identifier of other payer entered on the COB screen.
Enter the highest level of ICD or other industry accepted code(s) that best describe the condition/reason the recipient needed the service(s). The following fields auto-populate based on the information entered in the Subscriber ID and Birth Date fields: Subscriber First Name. Other Payer Primary Identifier. From the dropdown menu options, select the relationship of the MHCP subscriber (recipient) to the policy holder. Use only when submitting a claim with an attachment. Dates must be within the statement dates enterd in the Claim Information Screen. Enter the Identifier of the insurance carrier. Situational Claim Information - Select the situational claim information accordion screen to report situational information when required. Benefits Assignment.

For header (claim) level adjustment, select the code identifying the general category of the payment adjustment for this line from the dropdown menu options. This is the code indicating whether the provider accepts payment from MHCP. Enter the total dollar amount the other payer paid for this service line. From the dropdown menu options, select the appropriate code indicating the disposition or discharge status of the recipient on the date entered in the statement Date (To) field. To (End) date not required as must be the same as the From (start) date of this line. Outpatient Adjudication Information (MOA). Prior Authorization Number.

From the drop down menu, select whether the diagnosis code reported on this claim is in the ICD-9 or ICD-10 classification. Enter the number of units identified as being paid from the other payer's EOB/EOMB. The middle initial of the subscriber. Enter the name of the TPL insurance payer.

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