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Past PRIT Issues

A list of past Physician Regulatory Issues team issues.

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Issue Name Date Issue Created
Payment for Low Osmolarity Contrast Material 04/20/2004
Ordering of POVs 12/01/2005
Cardiac Rehab Supervision 12/01/2005
Format of Remittance Notices to Physician Practices 12/01/2005
Staffing Rural Health Clinics 12/01/2005
Availability of Tetanus Diphtheria Toxoid Adult Adsorbed (Thimerosol preservative) 12/01/2005
Use of Macros in Teaching Documentation 12/01/2005
Railroad Medicare 12/01/2005
MMA Changes to DME Prescribing 12/01/2005
CPT codes 36476 and 36479 12/01/2005
History and Physicals for Outpatient Surgical Procedures 12/01/2005
Primary Care Exception 12/01/2004
Co-signature Requirements in a Critical Access Hospital 12/01/2004
Appropriate Reimbursement for Complex Surgeries 12/01/2004
Reporting payers who are noncompliant with HIPAA transactions and code sets 12/01/2004
G 0357, Chemotherapy push, do staff need to be continuously present? 12/01/2004
Verbal Orders 12/01/2004
Post Anesthesia Reports 12/01/2003
History and Physicals by Podiatrists 12/01/2003
Security of Anesthesia Carts 12/01/2003
First assistant at a hospital with a surgical training program billing 12/01/2003
HPSA billing problems 12/01/2003
Electronic Payment for Daptomycin 12/01/2003
CPT code 58356- endometrial cryoablation with ultrasonic guidance, including endometrial curettage 12/01/2003
Proper Modifier for Pap Smear Screening Denials 12/01/2002
Evaluation and Management services associated with screening colonoscopies 12/01/2002
2005 Physician Fee Schedule Payment Chart 12/01/2004
CMS Official Letters to Beneficiaries 01/01/2004
Bariatric Ambulance Service 01/01/2004
Provider Enrollment 01/01/2004
Same Specialty Group Practice Billing for 99291 01/01/2004
Chemotherapy Codes Issue 01/01/2004
Payment for CPT 79900, Brachytherapy 01/01/2004
Same Specialty Referral Denials 01/01/2004
Reenrollment 01/01/2004
Changing Patient Status After Admission 01/01/2004
Payment for Services Provided Under a Contractual Arrangement 01/01/2004
With what POS codes can the home service codes 99341-99349 be used? 01/01/2004
SNF consolidated billing information for physicians 01/01/2004
Billing for CPT code 96400 in a SNF Part A stay 01/01/2004
Database of CMD Answers 01/01/2004
Vaccination Codes 01/01/2004
How Long Can ASC Monitor Patients 01/01/2004
Oncology Infusion Billings 01/01/2004
Osteopathic Manipulation Payment (98925-98929) 01/01/2004
Payment of NP Services Prior to a Initial Comprehensive visit in a SNF 01/01/2003
Billing for Medication Management Services 01/01/2003
How to bill for multiple endoscopy procedures 01/01/2003
Anesthesia Supervision of Residents 01/01/2004
Can Nonphysician Practitioners Refer Patients for Cardiac Rehab? 01/01/2004
Evaluation and Management Documentation Guidelines 01/01/2004
Physician Access to Their Carrier Medical Directors 01/01/2003
Advance Beneficiary Notice (ABN) 01/01/2003
Claims Resubmission 01/01/2003
Coverage/Payment of follow-up visits for cancer patients 01/01/2003
Coverage/Payment of pre-op evaluations 01/01/2003
Diabetic Glucose Monitoring Supplies 01/01/2002
Electronic Signatures 01/01/2002
Home Health Issues 01/01/2002
Eligibility Determinations 01/01/2002
Home Prothrombin Time Monitoring 01/01/2002
Hospital Privileges for Physicians Working with Medicare Managed Care 01/01/2002
Laboratory Services 01/01/2000
Medicare Summary Notices (MSN's) 01/01/2002
Payment for Concurrent Care 01/01/2001
Physician Supervision of Medical Residents/Documentation for Teaching Physicians 01/01/2001
Prior Hospitalization for Skilled Nursing Facility (SNF) Placement 01/01/2001
Reimbursement for Administration of Drugs the Patient Brings 01/01/2001
Women's Health Exam 01/01/2002
Diabetes Self Management Training (SMT) NCD 12/01/2005
ASP problems 02/10/2005
New 855 form 05/08/2006
Crossover of Anesthesia Bills 09/10/2005
Electronic Funds Transfer 05/25/2006
Written consultation orders 10/10/2006
Inaccuracies in the E&M Service Guide 07/14/2006
Duration of Prior authorizations 05/17/2006
Medically Unbelievable Edits (MUE) 12/01/2005
Availability of PDP exceptions and appeals forms on a plan's website 06/20/2006
Provider's ability to participate with the A/B Medicare Administrative Contractors (MAC) 09/22/2006
Can a patient sign a CMS-1696 form before a PDP denial occurs? 07/31/2006
Nonvalued Neurosurgical codes 02/23/2006
RVUs for Pediatric Codes 05/01/2005
CAH Provider response time 10/01/2005
RAC Audit of Drug Infusion Codes 04/20/2011
Physicians Displaced by Missouri Flooding 06/21/2011
Primary care exception and residents with less than 6 months of experience. 09/29/2011
IACS Revalidation Email 09/06/2011
Improved EOBs Associated with Recoupments 07/19/2010
Locum Tenens to replace a physician who has left a practice 06/09/2010
Chart Abstraction Requests From PFFS Plans 03/11/2008
Chart Abstraction Requests From PFFS Plans 03/11/2008
Saving 855 Form by Adobe Reader Users 04/21/2008
Consults for Medicare Hospice Patients 01/28/2010
New Medicare Retroactive Billing Policy 01/26/2009
New Medicare requirement regarding EFT payments 04/01/2009
Saving 855 Form by Adobe Reader Users 04/21/2008
Ability of PAs to Bill for Closed Reduction and Management of Fractures 04/21/2011
E-prescribing incentive payments when a physician bills through more than on practice (TIN) 03/10/2011
CR 6421, Orders for Medicare Services by Physicians Not Enrolled in PECOS 09/28/2009