Release Newsletter
Version 2.28
April 2011
Professional
Change Summary
We are pleased to announce the release of PC-ACE Pro32
version 2.28. This upgrade contains
several CMS Medicare Mandates and product enhancements effective 4/1/2011,
including these highlighted changes:
¨ Emergency
Update to CY 2011 Medicare Physician Fee Schedule (MPFS) Database – Removed termination dates for selected HCPCS
codes
ENCLOSED MATERIALS
· Pre-built PC-ACE Pro32 2.28 upgrade file named PCACEUP.EXE and replacement SETUP.EXE file for any new providers
·
This Newsletter
CMS MEDICARE MANDATES
CR7300 - Emergency
Update to CY 2011 Medicare Physician Fee Schedule (MPFS) Database
ª Removed the termination date on HCPCS codes L3660, L3670 and L3675
CR7299 - Addition/Deletion of HCPCS Codes -- Quarterly Update
ª Added HCPCS code "Q2040 - INCOBOTULINUMTOXIN
A" (effective 4/1/2011)
ADDITIONAL CMS MANDATED CHANGES
CR7319 - April Update to the CY 2011 Medicare
Physician Fee Schedule Database (MPFSDB)
ª Terminated HCPCS codes 90470 and 90663 (effective
1/1/2011), and HCPCS codes Q1003, S2270, S2344, and S3905 (effective 4/1/2011)
Category III Codes Update (Source – AMA Website)
ª Added the following new codes (effective 7/1/2011):
·
0262T - IMPL.TJ PULM
VLV EVASC APPR
·
0263T - IM B1 MRW CEL
THER CMPL
·
0264T - IM B1 MRW CEL
THER XCL HRVST
·
0265T - IM B1 MRW CEL
THER HRVST ONL
·
0266T - IMPLT/RPL CRTD
SNS DV TOTAL
·
0267T - IMPLT/RPL CRTD
SNS DEV LEAD
·
0268T - IMPLT/RPL CRTD
SNS DEV GEN
·
0269T - REV/REMVL CRTD
SNS DEV TOTAL
·
0270T - REV/REMVL CRTD
SNS DEV LEAD
·
0271T - REV/REMVL CRTD
SNS DEV GEN
·
0272T - INTERROGATE
CRTD SNS DEV
·
0273T - INTERROGATE
CRTD SNS W/PGRMG
·
0274T - PERQ LAMOT/LAM
CRV/THRC
·
0275T - PERQ LAMOT/LAM
LUMBAR
Provider Taxonomy
Code Quarterly Update (Source: WPC)
ª Updated
the Provider Taxonomy Code reference file with the latest WPC published code
set. Codes Added: 3 ;
Codes Deleted/Terminated: 0 ; Codes Modified: 1. The new codes are:
"174N00000X - Other Service Providers: Lactation Consultant, Non-RN",
"174V00000X - Other Service Providers: Clinical Ethicist" and
"204R00000X - Allopathic & Osteopathic Physicians: Electrodiagnostic
Medicine" (effective 4/1/2011). The modified code is: 225000000X.
CR7128 - Payment Update and Common Working File
(CWF) Editing for Influenza Virus Vaccine and Pneumococcal Vaccine Codes
ª Modified an existing professional claim edit to
bypass the non-zero service line charge amount requirement for pneumococcal
virus vaccine code 90670
CR7175 - New Specialty Code for Advanced Diagnostic Imaging
Accreditation
ª Changed the description for Provider Specialty code
95 to "Advanced Diagnostic Imaging Accreditation"
CR7209
- New Physician Specialty Codes for Cardiac Electrophysiology and Sports
Medicine
ª Changed the description for Provider Specialty code
21 to "Cardiac Electrophysiology" and code 23 to "Sports
Medicine"
CR7266 - New Waived Tests
ª Modified the Professional Claim Attachment Trigger
Control File to remove CLIA attachment entry for HCPCS code G0431
CR7277 - Healthcare Common Procedure Coding System
(HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement
Amendments (CLIA) Edits
ª Modified the Professional Claim
Attachment Trigger Control File to add CLIA attachment entries for HCPCS codes
82930, 83861, 84112, 85598, 86481, 86902, 87501, 87502, 87503, 87906, 88120,
88121, 88363, G0432, G0433, G0434, G0435 and G9143. Also removed CLIA attachment entry for HCPCS code 88172.
HCPCS Update – C
Codes (Source: CMS website)
ª Terminated HCPCS code C9278 effective 4/1/2011. This
code is being replaced with Q2040.
ª Added new HCPCS codes (effective 4/1/2011):
·
C9280 - INJECTION,
ERIBULIN MESYLATE",
·
C9281 - INJECTION,
PEGLOTICASE
·
C9282 - INJ, CEFTAROLINE
FOSAMIL
·
C9729 - PERCUT LUMBAR
LAMI"
Claim Status Response Codes Reference File
Update
ª Updated the Claim Status Response Codes reference file with the latest WPC published code set. Category Codes Added: 1 ; Status Codes Added: 9; Status Codes Deleted/Terminated: 0 ; Status Codes Modified: 61. The new category code is: "E4 - Trading partner agreement specific requirement not met: Data correction required. (Note: A status code identifying the type of information requested must be sent)". The new status codes are: "753 - Co-pay status code.", "754 - Entity Name Suffix. Note: This code requires the use of an Entity Code.", "755 - Entity's primary identifier. Note: This code requires the use of an Entity Code.", "756 - Entity's Received Date. Note: This code requires the use of an Entity Code.", "757 - Last seen date.", "758 - Repriced approved HCPCS code.", "759 - Round trip purpose description.", "760 - Tooth status code." and "761 - Entity's referral number. Note: This code requires the use of an Entity Code." The modified status codes are: 48, 252, 254, 278, 280, 285, 289, 304, 305, 317, 355 - 357, 361, 362, 367 - 373, 376 - 379, 381, 392, 393, 399, 404, 405, 410 - 413, 415, 416, 418, 421, 422, 424 - 427, 429, 436 - 440, 444 - 447, 466, 509, 514 and 750 - 752.
Claim Adjustment Reason Codes Reference File
Update
ª Updated the Claim Adjustment Reason Codes reference
file with the latest WPC published code set. Codes Added: 1 ;
Codes Deleted/Terminated: 0 ; Codes Modified: 1. The new code is: "236 -
This procedure or procedure/modifier combination is not compatible with another
procedure or procedure/modifier combination provided on the same day according
to the National Correct Coding Initiative." The modified code is: 129.
Remittance Advice Remark Codes Reference
File Update
ª Updated the Remittance Remarks Codes reference file with the latest WPC published code set. Codes Added: 2 ; Codes Deleted/Terminated: 0 ; Codes Modified: 9. The new codes are: "542 - Missing income verification.|Missing income verification." and "N543 - Incomplete/invalid income verification|Incomplete/invalid income verification.". The modified codes are: M37, M116, N62, N356, N383, N410, N428, N429 and N431.
GENERAL PRODUCT ENHANCEMENTS
View
Response Reports with Notepad Preference Setting
ª Added the new "Use Windows Notepad instead of built-in
previewer to view response reports" option to the "General" tab
of the PC-ACE Pro32 preference settings. When enabled, the various
response reports (ANSI-271, ANSI-277, ANSI-277CA and ANSI-997/999) will be
viewed using Windows Notepad. When disabled, the built-in
previewer will be used to view these response reports. This option is
disabled by default.
Professional
Claim Form Amount Paid Field Name Change
ª Modified
the professional claim form to change the field name "29 - Amount
Paid" to "29 - Patient Amount Paid" on the Line Item Details subtab of the Billing Line Items tab in order to better
reflect its contents
CORRECTIONS TO CUSTOMER-REPORTED PROBLEMS
Line-Level
“AT” Attachment Trigger Control
ª Modified
the professional claim form to correct a problem with the line-level
"AT" attachment trigger control located on the Line Item Details subtab of the Billing Line Items tab. Previously, the popup
menu for this field on the sixth (last) set of service line controls did not
function properly when right-clicked (or the <F2> function key was
pressed). This problem has been corrected.
INSTALLING THE UPGRADE
Perform a full PC-ACE Pro32 database backup before installing the upgrade. To install the upgrade, run the attached PCACEUP.EXE file using Windows Explorer or equivalent and follow the simple upgrade wizard steps. When prompted, enter the upgrade password provided by your software supplier. For networked instructions, it is recommended (but not required) that the update be run from the server’s console.
IMPORTANT: The recommended database backup is for safety purposes only, and should NOT be restored after successfully installing the update. The update program preserves all existing claims and reference file settings.