CMS Issues New Disaster Condition Code and Modifier for Katrina Claims, USA

Main Category: Caregivers / Homecare
Article Date: 09 Oct 2005 - 0:00 PDT

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CMS published a bulletin about new codes for disaster-related claims. The agency said to facilitate claims processing and track services and items provided to victims of Hurricane Katrina and future disasters, CMS established a new condition code and modifier for providers to use on disaster related claims. (MedLearn Matters MM4106 cms.hhs.gov/medlearn/matters/mmarticles/2005/MM4106.pdf)

The new condition code and modifier are for use by providers submitting claims for beneficiaries who are Katrina disaster patients in any part of the country and are effective for dates of service on and after August 21, 2005. The new codes are the following:

· The new condition code is DR - Disaster Related;
· The new modifier is CR - Catastrophe/Disaster Related.

For physicians or suppliers billing their local carrier or DMERC, only the modifier (CR) should be reported and not the condition code. A condition code is used in FI billing. For institutional billing, either the condition code or modifier may be reported. The condition code would identify claims that are impacted or may be impacted by specific payor policies related to a national or regional disaster. The modifier would indicate a specific Part B service that may be impacted by policy related to the disaster.

CR4106 instructs Medicare contractors to recognize the new condition code and modifier on October 3, 2005, if possible, but no later than October 31, 2005. In addition to this Medlearn Matters Article, CMS regional offices will help facilitate contractor outreach regarding provider education on the use of the new modifier and condition code.

CMS Open Door Forum October 20
The next CMS Home Health, Hospice & DME Open Door Forum is scheduled for October 20, 2005, 2:00 p.m. ET. Call 800-837-1935 and use conference ID 2865480.

Still Time to Register for Medtrade and AAHomecare Continuum of Care Conference
There is still time to register for AAHomecare's Continuum of Care Conference, October 17, and Medtrade, October 18-20. For registration information, visit: aahomecare.org/cde.cfm?event=101963.

American Association for Homecare
http://www.aahomecare.org

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