The Common Working File (CWF), one of the primary tools utilized by CMS to maintain national Medicare records, determine eligibility of individuals, and track usage of Medicare benefits, is on its last leg. In a September 2012 issue of MLN Matters, CMS announced that it would be replacing the CWF with the HIPAA Eligibility Transaction System (HETS) to track beneficiary information.
With 42 new nonpayable G-codes and seven new severity modifiers, billing departments have plenty of work to do between now and July 1, the end of the test period for the new therapy claims-based data collection functional coding system. Although the final deadline is months away, SNFs should start training therapists and billers on how to use the new codes now so their claims aren't rejected in July.
Given the quantity and exhaustive nature of CMS regulations regarding billing for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), SNFs are usually left with more questions than answers when it comes to Medicare reimbursement and billing claims.