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Minnesota AUC Newsletter

December 2019

Thank you and congratulations on a productive 2019

Thank you to everyone who participated with the Minnesota AUC in making this past year a productive one.  In 2019 a general theme of “less is more” emerged, with the AUC making substantial revisions to the 835 Minnesota Uniform Companion Guide (MUCG) and comparable changes to the 837P and 837I MUCGs now being completed. The AUC worked hard and successfully to simplify and streamline the guides, reduce extraneous, dated material, and to ensure that the guides will remain useful as well as easier to maintain in the future. The AUC also developed and approved a number of important best practices, and undertook a variety of learning and information sharing to add to 2019’s accomplishments.

We wish you and yours the best during the New Year and continued success for 2020.

National News

A few last minute reminders for the start of the New Year -

As noted in previous editions of this newsletter and at AUC meetings this past year, several important health care billing and coding changes take effect January 1, 2020, two of which are briefly summarized below.

Centers for Medicare & Medicaid Services (CMS) Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging

The Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging program for Medicare begins its one-year “Educational and Operations Testing Period” on January 1, 2020, prior to the start of the full program implementation, expected January 1, 2021. During CY 2020, CMS expects ordering professionals to begin consulting qualified Clinical Decision Support Mechanisms (CDSMs) and providing information to the furnishing practitioners and providers for reporting on their claims. Situations in which furnishing practitioners and providers do not receive AUC-related information from the ordering professional can be reported by modifier MH. Even though claims will not be denied during this Educational and Operations Testing Period, inclusion is encouraged. For more information see the Medline Matters bulletin number MM11268 (revised).

Medicare Beneficiary Identifiers (MBIs)

In order to safeguard Medicare beneficiary personal information, CMS has removed Social Security Number (SSN)-based Health Insurance Claim Numbers (HICNs) from Medicare cards and is now using Medicare Beneficiary Identifiers (MBIs) for Medicare transactions like billing, eligibility status, and claim status. Starting January 1, 2020, health care claims submitted for services to Medicare beneficiaries must use MBIs (with a few exceptions), regardless of the date that the service was performed. For more information, see the CMS Appropriate Use Criteria Program webpage.

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