Newly approved Recovery Auditor issues – 04/13/2016

Performant posts two new issues in one category

Performant Recovery posted two new issues to its CMS list for providers in Region A. (See link for individual state applicability.)

According to the Performant website, the new issues are:

For ambulance suppliers:

• Ambulance supplier claims billed with modifier QL and incorrect HCPCS codes - JL. When the beneficiary is pronounced dead after the ambulance is called but before the ambulance arrives on the scene, payment may be made for Basic Life Support (BLS). Neither mileage or a rural adjustment is paid. State(s) Impacted:  DC, DE, MD, NJ, PA 
• Ambulance supplier claims billed with modifier QL and incorrect HCPCS codes – JK. When the beneficiary is pronounced dead after the ambulance is called but before the ambulance arrives on the scene, payment may be made for Basic Life Support (BLS). Neither mileage or a rural adjustment is paid. State(s) Impacted:  CT, NY, MA, ME, NH, RI, VT