DEPARTMENT OF

1

• DEPARTMENT OF
• PUBLIC HEALTH AND HUMAN SERVICES
• HEALTH RESOURCES DIVISION
• Outpatient Prospective Payment System
• Billing Guide
• November 2005

2
OPPS

• Montana Medicaid uses Medicares Outpatient
  Prospective Payment System since August 2003
• Medicaid uses a Montana specific conversion
  factor (47.75) and updates quarterly along with
  Medicare
• Medicaid deviates from Medicare in some cases
  (I.e. therapies, obstetric observation, inpatient
  only)
• Payment is lower of OPPS payment (fees and APCs)
  or your charges
• Charge cap does not apply to line level
• Appropriate and accurate coding is the key to
  proper reimbursement under OPPS

3
OPPS/APC

• Some services paid by fee schedule
• Therapies (speech, physical, occupational)
• Laboratory
• Diagnostic
• If there is no APC, Medicare fee or Medicaid fee
  (RBRVS), some services pay hospital specific
  outpatient cost to charge ratio
• Drugs and Biologicals
• Devices
• Ambulatory Payment Classification
• Payment based on CPT/HCPCS codes
• Status Indicator tells the method of payment
• Each service is eligible for potential payment
• Emergency room
• Treatment Room
• Provider-based clinic
• Cancer care
• Ambulatory Surgery
• Capture every charge every time to insure
  payment

4
Coding

• Your claim should tell the story of what happened
  to this patient.
• Why was he there?
• What was done to him while in your care?
• What supplies/products/devises/drugs where used
  or given?
• Who provided the care to this patient
• Can I look at your claim and know what took place
  for this patient?

5
APC Status Indicators

• C Inpatient only services
• G Drugs biologicals paid by report (hospital
  specific outpatient cost to charge ratio)
• H Devices paid by report
• K Drugs and biologicals paid by APC
• M Paid by a Medicaid specific fee or not a
  covered service (fee schedule will show as not
  allowed)
• N Service is bundled into an APC (If all your
  codes are N on your claim, your claim will pay at
  zero)

6
APC Status Indicators (cont)

• Q Lab fee schedule (60 for non-sole community,
  62 for sole community)
• S Significant procedure paid by APC that the
  multiple procedure discount DOES NOT apply to
• T Significant procedure paid by APC that the
  multiple procedure discount DOES apply to
• V Medical visits in the clinic, critical care
  or emergency department (includes codes for
  direct admits)
• X Ancillary services paid by their own APC
• Y Medicaid fee for therapies (90 of RBRVS
  office fee)

7
Allowed Charge Source Codes Allowed Charge
Source codes tell MMIS how to price a claim-this
is what PR sees

• 0-Bundled code pays zero
• 1-Priced using QMB Pricing
• 2-Lab panel bundled
• 4-Priced using RBRVS
• 5-Anesthesia pricing
• 7-APC priced
• 8-APC priced
• 9-Lower level screening fee
• A-Manually priced
• B-By report
• C-Maximum fee

• D-Percent of charges
• E-Reimbursement Rate
• G-Billed Charges
• H-Denied
• I-Medicare Coins and deductible
• K-Medicare allowed amount
• M-Medicare prevailing
• P-DRG
• R-DRG w/cost outlier
• U-DRG priced by proration
• V-Mid-level priced
• Z-ATP Bundled

8
HOSPITAL OUTPATIENT MODIFIERS

• Medicaid uses Medicare Outpatient Claim Edits
• Medicaid does not allow reporting separate codes
  for related services when there is 1 code that
  includes all related services
• Medicaid does not allow breaking out bilateral
  procedures when 1 code is appropriate

9
OPPS Modifiers

• The paper UB-92 can accommodate 1 modifier
• The 837 can accommodate 4 modifiers
• Always report the payment modifier 1st as ACS
  processes the claim using only the first modifier

10
OPPS Modifiers

• Modifiers are used to indicate that
• A service was provided more than once
• A bilateral procedure was performed
• A service or procedure has been increased or
  reduced
• Only part of a service was performed
• A distinct procedure was performed
• A service was discontinued

11
Common Outpatient Modifiers

• Level I Modifiers
• 25 significant separate EM service
• 27 multiple EM same day
• 50 bilateral procedure
• 52 reduced services
• 58 staged or related service
• 59 distinct procedure
• 73 procedure terminated prior to anesthesia
• 74 - procedure terminated after anesthesia
• 76 repeat procedure by same physician
• 77 repeat procedure by another physician
• 91 repeat clinical diagnostic lab test

12
Modifiers More Modifiers

• Level II Modifiers
• LT left side
• RT right side
• LC left circumflex coronary artery
• LD left anterior descending coronary artery
• RC right coronary artery
• GN service under speech language pathology plan
  of care
• GO - service under occupational therapy plan of
  care
• GP - service under physical therapy plan of care
• TC - technical component

13
Modifiers Approved for Hospital Outpatient Use

• 25-significant, separately identifiable EM
  service by the same physician on the same day
• Only used with EM codes 92002-92014,
  99201-99499, G0101, G0175 G0264
• The Outpatient Code Editor (OCE) only requires
  the modifier if procedures with a status of T
  or S are present

14
Modifiers Approved for Hospital Outpatient Use

• 27-multiple outpatient hospital EM encounters on
  the same day
• Only used with EM codes 92002-92014,
  99201-99499, G0101, G0175 G0264
• Use on the second EM code for the same date of
  service

15
Modifiers Approved for Hospital Outpatient Use

• 50 Bilateral Procedure
• Used to report bilateral procedures performed at
  the same operative session
• Bill one line with the procedure code
• RT LT are not used when 50 is used
• DO NOT use if the code description indicates
  bilateral

16
Modifiers Approved for Hospital Outpatient Use

• 59 Distinct Procedural Service
• Used to report two procedures that are not
  normally reported together
• Different session or patient
• Different procedure or surgery
• Different site or organ system
• Separate incision
• Separate injury that is not normally encountered
  or performed by the same physician on the same
  day

17
Modifiers Approved for Hospital Outpatient Use

• 76- Repeat procedure by same physician
• 77- Repeat procedure by another physician
• Use 76 to indicate that a procedure or service
  was repeated in the same session on the same day
  by the same physician
• Use 77 to indicate that a procedure performed by
  one physician had to be repeated in a separate
  session on the same day by another physician
• Attach modifier to the second procedure
• Enter the number of times the procedure was
  repeated in the unit column
• Can be used for procedures performed by the
  physician or performed by the technician (e.g.,
  EKGs)

18
Modifiers Approved for Hospital Outpatient Use

• 91- Repeat Clinical Diagnostic Lab
• Use when the same lab test is repeated on the
  same day to obtain subsequent test results
• Do not use when tests are re-run to confirm
  initial results, when there were testing problems
  with specimens or equipment or for any other
  reason when a one-time result is all that is
  required
• Attach modifier to the second lab test
• Enter the number of times the subsequent lab test
  was done in the unit column

19
Modifiers Approved for Hospital Outpatient Use

• TC- Technical Component
• Under certain circumstances, a charge may be made
  for the technical component alone. Under those
  circumstances adding modifier TC to the usual
  procedure number identifies the technical
  component charge
• Note The TC modifier should not be appended to
  procedure codes that represent the technical
  component (example 93005)
• Do not use this modifier to designate the UB
  facility portion of provider based claim

20
Observation Services

• Four qualifying conditions for payment
• Chest Pain
• Asthma
• Congestive Heart Failure
• Obstetric Complications (pre-delivery
  complications)
• Starting April 1, 2005, the qualifying diagnosis
  must be in either
• Admitting diagnosis (FL 76) or
• Principal diagnosis (FL 67)

21
Observation Services

• Medicare/Medicaid Rules
• OBS services must be reasonable and necessary
• There must be a physician order prior to
  initiation
• Physician order must be by a physician with
  privileges
• Physician must be actively directing patient care
• During OBS, patients must be actively assessed
• Observation is not a substitute for inpatient
• Observation is not for continuous monitoring
• Observation is not for patients waiting for NH
  placement
• Observation is not to be used for convenience or
  as routine prior to IP status

22
Observation Services

• Four ways to reimbursement
• Direct admit for qualifying condition pays
  observation (APC 339-342.11)
• ED, clinic or critical care admit for qualifying
  condition pays observation (APC 339-342.11)
• Direct admit for non-qualifying condition pays
  APC 600 (Low Level Clinic Visit-43.13)
• ED, clinic or critical care admit for a
  non-qualifying condition pays APC 600 (Low Level
  Clinic Visit-43.13)
• Also pays any other separately payable codes on
  the claim

23
Qualifying Observation Requirements

• Chest Pain
• Required Diagnosis 411.0, 411.1, 411.81,
  411.89, 413.0, 413.1, 413.9, 786.05, 786.50,
  786.51, 786.51, 786.59
• These diagnostic tests are NO LONGER REQUIRED 2
  sets of cardiac enzymes (either two CPK 82550,
  82552, or 82553) or two troponin (84484 or 84512)
  and two sequential electrocardiograms
• Asthma
• Required Diagnosis 493.01, 493.02, 493.11,
  493.12, 493.21, 493.22, 493.91, 493.92
• These diagnostic tests are NO LONGER REQUIRED A
  breathing capacity test (94010) or pulse oximetry
  (94760 or 94761 or 94762)

24
Qualifying Observation Requirements

• Congestive Heart Failure
• Required Diagnosis 391.8, 398.91, 402.01,
  402.11, 402.91, 404.01, 404.03, 404.11, 404.13,
  404.91, 404.93, 428.0, 428.1, 428.20, 428.21,
  428.22, 428.33, 428.30, 428.31, 428.31, 428.33,
  428.40, 428.41, 428.42, 428.43, 428.9
• These diagnostic tests are NO LONGER REQUIRED A
  chest x-ray (71010, 71020 or 71030) and an
  electrocardiogram (93005) and pulse oximetry
  (94760, 94761, or 94762)

25
Qualifying Observation Requirements

• Obstetric Complications (Pre-delivery)
• Required Diagnosis
• 640.00, 640.03, 640.80, 640.83, 640.90, 640.93,
  644.00, 644.03, 644.10, 644.13, 630.00, 631.00,
• 641.03, 641.13, 641.23, 641.30, 641.33, 641.83,
  641.93, 642.03, 642.13, 642.23, 642.33, 642.43,
• 642.50, 642.53, 642.60, 642.63 642.70, 642.73,
  642.93, 643.00, 643.03, 643.10, 643.13, 643.20,
• 643.23, 643.80, 643.83, 643.90, 643.93, 644.20,
  645.13, 645.23, 646.03, 646.10, 646.13, 646.20,
• 646.23, 646.33, 646.43, 646.53, 646.60, 646.63,
  646.70, 646.73, 646.80, 646.83, 646.93, 647.03,
• 647.13, 647.23, 647.33, 647.43, 647.53, 647.63,
  647.83, 647.93, 648.03, 648.13, 648.23, 648.33,
• 648.43, 648.53, 648.63, 648.73, 648.83, 648.93,
  651.03, 651.13, 651.23, 651.33, 651.43, 651.53,
• 651.63, 651.83, 651.93, 652.03, 652.13, 652.23,
  652.33, 652.43, 652.53, 652.63, 652.73, 652.83,
• 652.93, 653.03, 653.13, 653.23, 653.33, 653.43,
  653.53, 653.63, 653.73, 653.83, 653.93, 654.03,
• 654.13, 654.23, 654.33, 654.43, 654.53, 654.63,
  654.73, 654.83, 654.93, 655.03, 655.13, 655.23,
• 655.33, 655.43, 655.53, 655.63, 655.73, 655.83,
  655.93, 656.03, 656.13, 656.23, 656.33, 656.43,
• 656.53, 656.63, 656.73, 656.83, 656.93, 657.03,
  658.03, 658.13, 658.23, 658.33, 658.43, 658.83,
• 658.93, 659.03, 659.13, 659.23, 659.33, 659.43,
  659.53, 659.63, 659.73, 659.83, 659.93, 660.03,
• 660.13, 660.23, 660.33, 660.43, 660.53, 660.63,
  660.73, 660.83, 660.93, 661.03, 661.13, 661.23,
• 661.33, 661.43, 661.93, 662.03, 662.13, 662.23,
  662.33, 663.03, 663.13, 663.23, 663.33, 663.43,
• 663.53, 663.63, 663.83, 663.93, 665.03, 665.83,
  665.93, 668.03, 668.13, 668.23, 668.83, 668.93,
• 669.03, 669.13, 669.23, 669.43, 669.83, 669.93,
  671.03, 671.13, 671.23, 671.33, 671.53, 671.83,

26
Billing for Obstetric Observation

• Direct Admit for Qualifying Condition
• Revenue Code 762 with G0263
• Units 1, charges are necessary on this line
  (even 1)
• DO NOT BILL USING G0244
• DO NOT USE G0263 on a non-direct admit (claims
  with 510 or 450 revenue codes)
• Must have qualifying diagnosis for Obstetric
  Complications (pre-delivery complications)
• If qualifying condition is obstetric
  complications, you must also have a 2nd revenue
  code 762 with 99234, 99235,or 99236
• Units 1-72, must have actual charges on this
  line

27
Billing for Obstetric Observation

• ED, Clinic or Critical Care Admit for Qualifying
  Condition
• DO NOT BILL USING G0244
• Must have qualifying diagnosis code for Obstetric
  Complications (pre-delivery complications)
• Must bill either an ED visit with rev code 45X or
  a clinic visit with rev code 51X or critical care
  visit
• Must use modifier 25 with the EM code for the
  visit
• If qualifying condition is obstetric
  complications, you must also have a 2nd revenue
  code 762 with 99234, 99235 or 99236
• Units 1-72, actual charges are necessary on
  this line

28
Billing for Other Covered Observation Services

• Direct Admit for Qualifying Condition
• Revenue Code 762 with G0263
• Units 1, charges are necessary on this line
  (even 1)
• Revenue Code 762 with G0244
• Units 8-72, actual charges must be on this line
• Must have Medicare required tests for Chest Pain,
  Asthma or Congestive Heart Failure under
  appropriate revenue codes or must have qualifying
  diagnosis for Obstetric Complications
• G0244 is the code that drives payment. G0244 is
  not payable if billed with services that have a
  status indicator of T (other than 90780)
• If qualifying condition is obstetric
  complications, you must also have a 3rd revenue
  code 762 with 992XX (99217-99220 or 99243-99236)
• Units 1, charges are necessary in this field
  (even 1)

29
Billing for Other Covered Observation Services

• ED, Clinic or Critical Care Admit for Qualifying
  Condition
• Revenue Code 762 with G0244
• Units 8-72, actual charges MUST be on this line
• Must have Medicare required tests for Chest Pain,
  Asthma or Congestive Heart Failure under
  appropriate revenue codes or must have qualifying
  diagnosis code for Obstetric Complications
• Must bill either an ED visit with rev code 45X or
  a clinic visit with rev code 51X or critical care
  visit DO NOT BILL G0263
• Must use modifier 25 with the EM code for the
  visit
• If qualifying condition is obstetric
  complications, you must also have a 2nd revenue
  code 762 with 992XX (99217-99220 or 99243-99236)
• Units 1, charges are required on this line
  (even 1)
• G0244 is the code that drives payment. G0244 is
  not payable if billed with services that have a
  status indicator of T (other than 90780)

30
Billing for Other Covered Observation Services

• Direct Admit for Non-Qualifying Condition
• Revenue Code 762 with G0264
• Units 1 (one), actual charges MUST be on this
  line
• Must have 762 with 992XX (99217-99220 or
  99243-99236) for all non-qualifying conditions
• Units hours, charges are necessary (even 1)
• If there are other services on the claim with
  status codes of S or T you must use modifier
  25 with G0264

31
Billing for Other Covered Observation Services

• ED, Clinic or Critical Care Admit for
  Non-Qualifying Condition
• Revenue Code 45X or 51X with the appropriate CPT
  code
• Units 1 (one), actual charges MUST be on this
  line
• Must have 762 with 992XX (99217-99220 or
  99243-99236) for all non-qualifying conditions
• Units hours, charges are necessary on this line
  (even 1)
• The OCE requires modifier 25 if procedures with a
  status of T or S are present

32
Outpatient Lab

• Clinical diagnostic laboratory services including
  automated multichannel test panels (commonly
  referred to as "ATPs") and lab panels are
  reimbursed on a fee basis
• The fee for a clinical diagnostic laboratory
  service is the lesser of the provider's charge or
  the applicable percentage of the Medicare fee
  schedule as follows
• 60 of the prevailing Medicare fee schedule where
  a hospital laboratory acts as an independent
  laboratory, i.e., performs tests for persons who
  are non-hospital patients
• 62 of the prevailing Medicare fee schedule for a
  hospital designated as a sole community hospital
  or
• 60 of the prevailing Medicare fee schedule for a
  hospital that is not designated as a sole
  community hospital

33
Outpatient Lab

• For clinical diagnostic laboratory services where
  no Medicare fee has been assigned, the fee is 62
  charges for a hospital designated as a sole
  community hospital or 60 of charges for a
  hospital that is not designated as a sole
  community hospital
• Specimen collection is reimbursed 3.00 for
  drawing a blood sample through venipuncture or
  for collecting a urine sample by catheterization.
  
• No more than one collection fee is allowed for
  each patient visit, regardless of the number of
  specimens drawn.
• Crossover claims are not subject to lab panel
  bundling logic

34
Outpatient Lab Bundling

• If a claim has procedure codes that bundle to
  multiple lab panels, the program will bundle the
  codes into a regular panel (if all the codes are
  present)
• The remaining codes will bundle into an ATP
• The OB panel (80055) pays a fee schedule price of
  44.68 for both non-sole and sole community
  hospitals
• The General Health panel (80050) pays a fee
  schedule price of 56.77 for both non-sole and
  sole community hospitals
• Lower of pricing applies to bundling.
• If the total billed charge for all bundled lines
  on the claim is less than the allowed charge for
  the lab panel, the claim pays the billed charge

35
Outpatient Lab Reimbursement

• Allowed Charge Source codes tell ACS and the
  Department how the system reimbursed your lab
  claim
• 2 is Panel bundled
• 7 or 8 are APC
• A is manually priced
• M is Medicare fee
• Z is ATP bundled
• If the allowed chg source code on the line is 7,
  8 or A the line is excluded from bundling
• If the line has a modifier of 76 or 91 the line
  is excluded from bundling
• Bundling only occurs on procedures with the same
  date of service

36
Outpatient Lab Reimbursement

• For multi-procedure panels, the highest number of
  tests is priced first.
• For example, 80438 is 84443x3 and 80439 is
  84443x4. These lines would group to panel 80439
  if 4 tests are present rather than panel 80438
  and 1 individual 84443.
• System logic always bundles to the highest level.
• If the procedure code is a component of a Panel
  or ATP, the system prices to APCs 1st, Lab Panel
  2nd , ATPs 3rd and individual fees last.

37
Outpatient Lab Billing

• You need to bill one line with the procedure code
  and multiple units. If you bill the same code on
  more than 1 line, your remittance advice will
  show the bundled payment on the 1st line and will
  show the additional lines as denied (even though
  they did not)
• Lines that have been bundled will show reason
  code 042 and remark code M75
• The remittance advice will NOT show the panel or
  ATP code to which the lines bundled
• The current remittance advice shows revenue codes
  for UB-92 claims, it does not display the
  procedure codes that bundled

38
Tidbits

39
Provider-Based Billing

• Claims are billed for all of your provider-based
  facilities and clinics similar to how you would
  bill a claim in the Emergency Department
• There is a UB and a 1500 for each billable visit
• 1500 claim must have place of service 22
  outpatient
• UB claim uses revenue code 510 for the facility
  side of the office visit
• All other services are billed on the UB except
  procedures that the doctor or midlevel performed
  (10021 to 69990)
• If you cannot bill a 1500 (such as for a global)
  you cannot bill a UB and visa-versa
• DO NOT BILL TC on the facility claim unless it is
  a technical component only code you would
  normally use TC for

40
Provider Based Billing Issues

• Obstetrics
• Billing for complete service, antepartum,
  delivery and postpartum
• Bill as usual which means a global bill with POS
  21 on the 1500 side and delivery paid as a DRG on
  the UB side
• Billing for incomplete services, antepartum or
  postpartum     
• Bill appropriate code for number of visits on
  1500 and UB.
• Codes such as 59425 are not turned on for
  facility side so bill a matching EM on the UB
  side
• VFC
• Where there is an EM
• Bill EM and administration code on the 1500 with
  POS 22, bill EM and injectibles on UB
• Where there is an not an EM
• Bill administration code with modifier SL and the
  VFC code on the 1500 with POS 22, bill
  administration code on the UB, SL does not apply
  on the UB side

41
ED Definitions

• Emergency Medical Condition means
• A medical condition manifesting itself by acute
  symptoms of sufficient severity (including severe
  pain, psychiatric disturbances and/or symptoms of
  substance abuse) such that the absence of
  immediate medical attention could reasonably be
  expected to result in
• Placing the health of the individual (or, with
  respect to a pregnant woman, the health of the
  woman or her unborn child) in serious jeopardy
• Serious impairment to bodily functions or
• Serious dysfunction of any bodily organ or part
  or

42
More ED definitions

• That there is inadequate time to effect a safe
  transfer to another hospital before delivery or
• With respect to a pregnant woman who is having
  contractions
• That transfer may pose a threat to the health of
  safety of the woman or the unborn child.
• Some intoxicated individuals may meet the
  definition.
• Individuals expressing suicidal or homicidal
  thoughts or gestures, if determined dangerous to
  self or others, would meet the definition.

43
Common Claim Edits

• 102 Duplicate claim
• 112 A readmission has been detected
• 119 Claim is for a potentially unbundled
  service
• 120 Date of service is more than 365 days from
  date received
• 215 Claim should pay by APC or OPPS but system
  could not group. These hit for 4 reasons
• Invalid bill type (usually you see 851 which
  should be 131)
• Bad date- the span date doesnt match the line
  dates
• There is no APC to group to (department boo-boo)
• Revenue code 636 is used wrong-this rev code can
  only be used for RX or vaccination codes, not for
  the injections
• 280 (physician claim) - diagnosis code or
  procedure code is not on emergent list
• 335 Procedure code requires review (unlisted
  code)

44
Common Claim Edits

• 342 Diagnosis code requires a review (these are
  almost always V codes)
• 343 Diagnosis code may not be a covered service
• 345 Sterilization review
• 347 Hysterectomy review
• 370 Abortion review
• 371 DRG 468 (this DRG pays of charges so is
  always reviewed for correct coding) this means
  that there was a procedure on the claim that was
  not related to the main diagnosis and procedures
• 460 Claim requires a prior authorization

45
Common Claim Edits

• 472 This exception will post when the PASSPORT
  provider number is missing or invalid
• 487 This edit will fail when the client is a
  Team Care client and the Team Care provider did
  not submit the claim or did not refer the client
  and the service requires PASSPORT approval
• 905 Line dates of services are inconsistent
  with the header level dates of service or the
  line level date of service is blank (usually see
  on bundled claims)
• 920 Diagnosis code and procedure dont match-
  this means that a claim hit before or after the
  new quarterly grouper was installed and a
  diagnosis code on the claim now needs a fifth
  digit or is invalid or the provider used an
  invalid diagnosis code
• 928 Inpatient only services performed in an
  outpatient setting-needs review to determine if
  appropriate
• 929 EM code on the same date as a surgical or
  significant procedure without modifier 25 or 27
  present on the EM code (must be on the EM code
  not on the code with a SI of T or S)

46
The ICN

• Format R YY JJJ MM BBB SSSSSS
• R Type of medium on which claim came into
  system
• 0paper
• 2electronic
• 4system generated (usually an adjustment)
• YY Year
• JJJ Julian Date
• MMMicrofilm machine number
• 00electronic
• 11paper claims
• 22system generated

47
More ICN

• BBBBatch range
• 100 and 900pharmacy
• 200HCFA 1500
• 300UB92 Inpatient
• 350UB92 outpatient
• 375UB92 Laboratory
• 400Nursing Home
• 500Dental
• 600Institutional Crossover
• 700Professional Crossover (799electronic
  x-over)
• 800Adjustments
• SSSSSSSequence Number

48
Resources

• www.mtmedicaid.org THIS IS YOUR BEST RESOURCE!!
• www.cms.hhs.gov/providers/hopps/cciedits/
• www.cms.hhs.gov/providers/hopps Addendums A B
• www.cms.hhs.gov/manuals/transmittals/
• Program Memorandum Transmittal A-01-80
• Program Memorandum Transmittal A-03-066
• Medicare Part A Hospital Bulletin 905
• Medicare Part A Hospital Bulletin 1187
• Medicare Part A Hospital Bulletin 1149
• Medicare Part A Hospital Bulletin 1242
• Medicare Part A Hospital Bulletin 1313
• Med-Manual 3112.8 Outpatient Observation
  Services
• Transmittal R404CP
• Medlearn Matters Article MM3610

49
Contacts

• Debra Stipcich, Transplant and PPS Hospital
  Program Officer [phone] dstipcich_at_mt.gov
• Rena Steyaert, Claims Resolution Specialist
  [phone] rsteyaert_at_mt.gov
• ACS, Inc. Provider Relations [phone]
  in-state [phone] out of state