Professional/Public Relations for HCPCS

20.6 - Professional/Public Relations for HCPCS (Rev. 1, 10-01-03) A/B MACs (A), (B), (HHH), and DME MACs must perform the following professional/public relations activities: • Designate a knowledgeable person as a focal point for physician, supplier and provider inquiries. This person must be able to address coding and payment questions. • Notify physicians, suppliers and providers by newsletter and Web site at least 30 days before codes are changed, added or deleted. Also, notify them when general problems arise including coding issues. • A/B MACs (B) should share Level III codes/modifiers with the Medicaid State agency in the A/B MAC (B)’s jurisdiction. • Advise physicians and providers to obtain new copies of CPT-4 annually from the AMA. Orders can be placed by calling 1-800-621-8335 or order online at www.ama-assn.org/catalog • A/B MACs (A) and (HHH) supply providers with CMS’ alpha-numeric code updates and with any local codes. See §20 for sources. A/B MACs (B) supply the current HCPCS local codes/modifiers (alpha-numeric W-Z) since they are the only source. • A/B MACs (A), (B), (HHH), and DME MACs inform physicians, suppliers, and providers when the annually and quarterly updated HCPCS codes become available and effective in the claims processing system. • All codes/modifiers contained in the current version of the HCPCS will be recognized and processed unless they have been deleted or are indicated as not valid for Medicare. • It is important for physicians, practitioners, suppliers, and providers to note that code/modifier recognition does not imply that a service is covered by Medicare. In addition, a separate code does not mean that the payment level will be different from similar services identified by different codes. • Since local changes can occur throughout the year, continue professional relations activities to provide as much information as possible to providers.