New Medicare cards start mailing in April 2018

New Medicare cards start mailing in April 2018

We’re removing Social Security Numbers from Medicare cards to prevent fraud, fight identity theft, and keep taxpayer dollars safe. We’ll mail the new Medicare cards from April 2018 through April 2019. Learn how we’ll mail the new Medicare cards in phases by geographic location.

What do the new Medicare cards mean for providers?

Look at your practice management systems and business processes and determine what changes you need to make to use the new Medicare Beneficiary Identifier (MBI). You’ll need to make those changes and test them by April 2018, before we mail out new Medicare cards.

If you use vendors to bill Medicare, you should contact them to find out about their MBI practice management system changes. 

Even though we’ll stop using Social Security Numbers to identify Medicare beneficiaries, what won’t change is how your Social Security Number’s used for the IRS and tax reasons, like on your W-9.

Learn, in English or Spanish, what you need to do now and see a timeline of what’s next.

What should providers do to get ready for the new Medicare cards and MBIs? 

To get ready to use the new MBIs, make and internally test changes to your practice management systems and business processes by April 2018 before we mail new Medicare cards.  Your billing and office staff might have to coordinate their work to make sure your practice is ready.  Also, if you use vendors to bill Medicare, contact them to find out about their MBI practice management system changes.  It’s especially important that you’re ready for people who are new to Medicare in April 2018 and after because they’ll only get a card with the MBI.

You may want to consider:

Automatically accepting the new MBI from the remittance advice (835) transaction.

Identifying patients who qualify for Medicare under the Railroad Retirement Board (RRB).

If you don’t already have access to your MAC's provider portal, sign up so you can use the provider MBI look-up tool starting in June 2018.  Your office/facility staff might want to coordinate with your billing/administrative staff, who may already have portal access.

If you need additional information, please contact our Support Staff:

2018 CPT Changes

Added, Revised and Deleted CPT Codes

Here is a list of the 2018 CPT code changes:

Sections	Added	Revised	Deleted
E&M	5	4	2
Anesthesia	5	0	5
Surgery	42	24	19
Radiology	7	3	18
Path/Lab	40	17	12
Medicine	13	10	4
Category II	0	0	0
Category III	41	2	22
PLA Codes	17	0	0
Total	170	60	82

Evaluation and Management (E&M) Codes

• 3 new codes for psychiatric collaborative care management services
• 1 new code for general behavioral health integration care service
• 4 observation care services revised
• Deleted: 2 anticoagulation management service codes
• 2 new codes for INR home and outpatient INR monitoring services

Surgery

• Endovascular Surgery
• The endovascular surgery section has 16 new codes, 5 revised codes and 13 deleted codes. The new codes pertain to endovascular repair of abdominal aorta and/or Iliac arteries with an emphasis upon repair using endografts, extension prosthesis, and concepts of delayed placement of prosthesis for endovascular repair of vessels.
• Coding of these procedures is now determined and guided by “treatment zone” rather than the “targeted treatment zone.” The treatment zone includes all vessel(s) that are treated by the endograft.
• Anything done to treat vessel(s) beyond the targeted treatment zone can be separately reported.
• Integumentary System
  Code 17250 for chemical cauterization of granulation tissue (ie, proud flesh, sinus or fistula) is revised to remove reference to sinus or fistula and to direct that use of chemical cauterization to achieve wound hemostasis is not reported with code 17250. Cauterization to achieve hemostasis is included in the code for wound care, excision or repair.
  Code 17250 is not to be reported:
• With removal or excision codes for the same lesion
• When chemical cauterization is used to achieve wound hemostasis
• In conjunction with active wound care management 97597, 97598, 97602 for the same lesion

Diagnostic Radiology

• There are 4 new CPT codes (71045-71048) for chest X-rays:
  71045 Radiologic examination, chest; single view
  71046 2 views
  71047 3 views
  71048 4 or more views
• There are 9 deletions associated with chest X-rays being categorized by the number of views (single through four or more reviews, as opposed to type of view.

• 3 codes have been deleted in the abdominal X-ray section and three replacements introduced, 74018-74021, which are to be reported by the number of views taken versus type of view:
  74018 Radiologic examination, abdomen; 1 view
  74019 2 views
  74021 3 or more views

New Modifiers
There are 2 new modifiers to identify Habilitative Services and Rehabilitative Services

• Modifier 96 – Habilitative Services: When a habilitative or rehabilitative service or procedure is provided for habilitative purposes, the physician or other qualified healthcare professional may add modifier 96- to the service or procedure code to indicate that the service or procedure provided was habilitative. Such services help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep or improve those learned skills.
• Modifier 97- Rehabilitative Services: When a habilitative or rehabilitative service or procedure is provided for rehabilitative purposes, the physician or other qualified healthcare professional may add modifier 97- to the service or procedure code to indicate that the service or procedure provided was rehabilitative. Rehabilitative services help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled.

For more information , please contact our office.