NGS to Adjust MPPR-related Claims
National Government Services (NGS), a Medicare contractor, issued an electronic alert today regarding therapy claims submitted earlier this year. NGS has acknowledged that the organization incorrectly applied a multiple procedure payment reduction (MPPR) to some therapy claims with dates of service on or after January 1, 2011 and for some therapy HCPCS codes, regardless of dates of service. NGS noticed the issue and implemented an administrative fix in February, and mass adjustments of claims are expected to be completed by mid-June. Providers do not need to resubmit claims or take any action on these claims, they are just advised to be aware that positive adjustments are forthcoming.
Below is the alert in full:
UPDATE: Multiple Procedure Payment Reduction Being Incorrectly Applied to Some Therapy Claims
Description of Problem
The Multiple Procedure Payment Reduction (MPPR) was being incorrectly applied to some therapy claims with dates of service on or after 1/1/2011 and for some therapy HCPCS codes regardless of dates of service.
What This Means to You
Providers were advised not to take any action on these claims.
06/13/11: The release was installed into production on 06/06/2011. Mass adjustments were done on these claims and should be completed this week.
02/08/2011: The fix for this issue was implemented on February 7. We are awaiting instructions for addressing claims that processed incorrectly due to this issue. No provider action is needed. Providers will be updated as additional information becomes available.
01/12/2011: The fix for this issue will be released on February 6, 2011.