What are the general billing requirements?
These billing
requirements include:
- The time limits for submitting and resubmitting claims and adjustments.
- How to bill for clients eligible for both Medicare and Medicaid.
- How to handle third-party liability claims.
- What standards to use for record keeping.
What records must be kept in the client’s file?
This includes, but is not limited to, the following tests:
- Audiogram results/graphs/tracings (including air conduction and bone conduction comparisons)
- Basic or simple hearing tests or screening, such as those done in schools
- Tympanogram
- Auditory brainstem response (ABR)
- Electronystagmogram (ENG) (not a hearing test but a special test of inner ear balance)
A valid prescription from an audiologist for replacement batteries must be kept in the client’s
chart.
How do I complete the CMS-1500 claim form?
The following CMS-1500 claim form instructions relate to the Hearing Hardware program.
Field
No : 23
Name : Prior
Authorization
Number
Field
Required : Yes
Entry : Use the social services authorization number assigned to
you.
Field No : 24D
Name : Procedures,
Services or
Supplies
CPT/HCPCS
Field Required : Yes
Entry : Enter the appropriate Current Procedural Terminology
(CPT) or Common Procedure Coding System (HCPCS)
procedure code for the services being billed.
Modifier: When appropriate enter a modifier.
