Billing Reminders for the New Year
Resolve to get it right the first time.
Durable Medical Equipment
- When submitting corrected billing: please attach a copy of the EOR with any documentation you are submitting. For submission of a corrected bill, please clearly write “Corrected Billing” on the billing form.
- When submitting additional information: attach a copy of the EOR with additional information.
- Corrected billings and/or additional information should be sent to:
Montana State Fund
PO Box 4759
Helena, MT 59604
Or fax to:406-444-5963
When submitting refunds for payments received directly from CorVel, please send refunds to Montana State Fund. If payment was received from Montana Health Systems, please send the refund to MHS. Please attach any supporting documentation with your refund.
Exception: If returning a CorVel check that has not been cashed, the check should be returned to:
121 N. Last Chance Gulch
Helena, MT 59601
MT001: Please remember this code is a timed code. The time spent must be documented in the notes or by the signature. Submitting time only on the CMS 1500 is not sufficient for reimbursement. This is a Montana unique code, which replaced CPT code 97799 for purposes of workers’ compensation services. It has an RVU of .5 per 51-minute unit. It should only be used for the following services:
- Face-to-face conferences with payor representative(s) to update the status of a patient upon the request of the payor.
- A report associated with non-physician conferences required by the payor.
- Completion of a job description or job analysis. (Signature must be dated.)
- Note: Do not use 99080 for the above services to avoid denial of your bill.
Independent Medical Examinations (IME) and Impairment Ratings (IR): For detailed instructions on billing these services and correct coding, see the Provider Bulletin for Summer 2008. Requests for these services originate from a claims examiner or Montana Health Systems, and specify what service is being requested. If uncertain which type of service is being requested, please contact the requestor.
PT, OT, Chiro Reminder:. No more than a total of five codes may be billed per visit without prior written authorization. Each 15 minutes of a timed code is equivalent to the billing of one code. Timed codes must have the time clearly documented in the medical record for each code. Each therapy code must have part of body treated or clearly identified in the documentation or on the flow sheet. If the notes do not support the procedures billed but refer to a flow sheet, please be sure the flow sheet is attached.
Pre-authorization Required: If providing any durable medical equipment with a purchase price of greater than $200.00, it must be preauthorized by a claims examiner at Montana State Fund.
- All bills submited must be on a CMS 1500 or UB04 form with HCPCS code to indicate procedures/supplies and ICD-9 code to indicate the diagnosis.
- MSF has a Preferred Provider Network for DME supplies and services. This network must be used when prescribing DMW, O2 equipment and supplies, bone growth stimulators, TENS equipment and supplies, orthotics and prosthetics, and home health services. A list of providers can be found on our website
Radiology Services in a Clinic Setting:
Billing Technical Component (TC): When billing only the technical component (TC) of a radiology service provided in a clinic setting, the service must be billed on a separate CMS 1500 with the clinic listed in Box 31.