Medicare

Redaction of HICNs in MRNs - Revised CR8268

CMS has issued CR 8268, which instructs the MACs effective January 1, 2014 to redact Health Insurance Claim Numbers (HICNs) on all Medicare Redetermination Notices (MRNs). Make sure that your billing staffs are aware of this change.  The HICNs will be redacted by replacing 5 or more values of the HICN with Xs or asterisks (*) with the last 4 or 5 digits of the HICN displayed. This applies to HICNs with both alpha and numeric digits.

Phase 2 Ordering and Referring Denial Edits Coming January 6, 2014

 

Effective January 6, 2014, CMS will turn on the edits to deny Part B clinical laboratory and imaging, DME, and Part A HHA claims that fail the ordering/referring provider edits.

Phase 1: Informational messaging: Began October 5, 2009, to alert the billing provider that the identification of the ordering/referring provider is missing, incomplete, or invalid, or that the ordering/referring provider is not eligible to order or refer. The informational message on an adjustment claim that did not pass the edits indicated the claim/service lacked information that was needed for adjudication.

Read more: Phase 2 Ordering and Referring Denial Edits Coming January 6, 2014