Oct. 25, 2010
Over 16,000 incontinence supply service lines have been converted to reflect new services codes and rates with an effective begin date of Oct. 1, 2010. The purpose of the information below is to clarify what has occurred to date and what to expect in the next several days.
We appreciate the ongoing cooperativeness from everyone involved and thank you for assisting us with this challenging project!
FAQ #1: What service lines have been converted?
A-Code Service Lines: Using the information submitted by DME agencies over 16,000 A-code lines have been converted to new T-code rates with an effective authorization begin date of October 1st. The former A-Code lines now have an end-date of September 30th.
Existing T-Code Lines - without modifiers: New rates for existing T-Code lines have been applied with an effective authorization begin date of October 1st.
FAQ #2: Where are the 6gs confirming authorizations and converted service lines?
ADvantage Case Management and Durable Medical Equipment (DME) providers will receive a password protected email attachment containing a spreadsheet listing all members for the provider (Service or Case Management) and related conversion.
The information on the spreadsheets reflects authorizations as of October 1st!
If you have received a 6g since October 1st, the authorization on the 6g supersedes or overrides the information on the spreadsheet.
We have identified some batches of services lines that need additional conversion or correction and we are striving to resolve these remaining issues within the next few working days.
If you receive a 6g that lists an A-Code ending 09/30/2010 with no T-Code added, please submit an addendum request to add the appropriate T-Code service, thereby avoiding an interruption of service to the member.
FAQ #3: How are denied claims addressed?
If you have denied claims after 10-29-2010, please follow the ADv21 process to initiate review of the denial. (See attached ADv21 form and Instructions.)
If you have any questions or concerns regarding the information provided above, please feel free to contact us via email at Provider Questions.