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July
23 , 2008
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Questions?
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MDI Achieve - Dallas Anniversaries
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In addition, we have created a new RNet Product Manager position, which has been filled by Cheryl Hannant, RN. Cheryl is an experienced clinical software development resource who will work with RNet clients to ensure that our development efforts are properly defined to meet the needs of the users. You can expect to hear from Cheryl soon. In the meantime, you can feel free to contact her via email at Cheryl.Hannant@MDIAchieve.com or call her at 800-259-7633 x1150.
Prior to this legislation, the exceptions were to expire on June 30, 2008 and providers were instructed not to submit the KX modifier on claims for services furnished on or after July 1, 2008. The extension of the therapy cap exceptions is retroactive to July 1, 2008. As a result, providers may have already submitted some claims without the KX modifier that would qualify for an exception. Such claims would be rejected for exceeding the cap. CMS has advised that providers submitting such claims using the 837 institutional electronic claim format or the UB-04 paper claim format should resubmit these claims appending the KX modifier so they may now be processed and paid. Providers submitting such claims using the 837 professional electronic claim format or the CMS-1500 paper claim format should request to have their claims adjusted in order to have the contractor pay the claim. In all cases, if the beneficiary was notified of their liability and the beneficiary made payment for services that now qualify for exceptions, any such payments should be refunded to the beneficiary. For complete information, please visit the CMS website at http://www.cms.hhs.gov/TherapyServices. Prior to this new legislation, the Therapy Caps officially expired on June 30, 2008. At that time, MDI Achieve advised RNet users to turn off the automatic KX modifier capabilities. Now that the exceptions have been restored, you will need to reverse this action. (NOTE: If you did NOT turn these features off, no further action is required since the extension of exceptions is retroactive to July 1, 2008). To
restore RNet's Automatic KX modifier capabilities, please
follow these simple steps: (Click
here for printer-friendly instructions with screen shots.)
Users can test this by going to a Productivity Log for the beginning of July; select a Medicare B resident, go to the D (detail) screen for this resident, then click on Return. If an exception has been reinstated, the user should receive the "Caution" message (as previous to July 1st), stating date/day and what type of exception is being used to apply the KX modifier. As always, if you have any questions, please call our Client Support hotline at 800-552-9846.
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