NEW 2012 NATIONAL ELECTRONIC CLAIMING AND CODING STANDARD FOR HOME INFUSION INDUSTRY PUBLISHED BY NHIA
Washington, DC—The National Home Infusion Association (NHIA) has released a 2012 edition of the NHIA National Coding Standard for Home Infusion Claims under HIPAA, a comprehensive guide widely used by the nation’s infusion providers and payers to code infusion health care claims transactions. The NHIA National Coding Standard is compliant with federal Health Insurance Portability and Accountability Act (HIPAA) regulations that mandate that all public and private payers use "approved" standardized coding for all of their health care transactions.
The publication presents the HCPCS (Healthcare Common Procedure Coding System) per diem "S" codes as a comprehensive coding system for home infusion therapy claims and provides procedures for their use, information about what's included in the home infusion per diem, and detailed coding examples for both typical and unusual claims scenarios that payers and providers are likely to encounter. It also includes procedures and examples for services provided in the Ambulatory Infusion Suite of the Home Infusion Therapy Provider (AIS). New to the 2012 edition of the National Coding Standard is guidance on the use of the concurrent therapy modifiers (-SH and -SJ) and on specificity of coding with HCPCS per diem "S" codes.
Updated on an annual basis, the NHIA National Coding Standard has been available since 2002 through the efforts of the National Home Infusion Association and its Home Infusion Electronic Data Interchange (EDI) Coalition (HIEC). First published to help payers and providers of home infusion services comply with HIPAA requirements, NHIA updates the standard annually to address changes in the infusion industry and modifications to the national code sets.
“The code supports NHIA’s efforts to continue to advance the standardization of claim transactions and coding for all home infusion services provided,” said NHIA President and CEO Russell Bodoff. “NHIA is dedicated to formulating, communicating, and implementing a nationally standardized coding system to describe and classify infusion products and services, and promote and advance electronic claiming for infusion therapy services,” he added.
“The NHIA National Coding Standard has been an invaluable resource to the infusion industry. Its broad acceptance by commercial insurance payers and many state Medicaid plans as the industry standard has helped to create processing efficiencies that yield administrative cost-savings and enable timely provider reimbursement,” said NHIA Board Chair Mary Ann Cope, President and CEO, HomeChoice Partners, Inc.
As in prior years, the NHIA National Coding Standard for Home Infusion Claims under HIPAA continues to be offered to the public at no charge. It is available from the National Home Infusion Association website at www.nhia.org.
Infusion therapy involves the administration of medication through a needle or catheter, and is prescribed for infections unresponsive to oral antibiotics, cancer-related pain, dehydration, gastrointestinal disorders, congestive heart failure, Crohn's Disease, hemophilia, immune deficiencies, and multiple sclerosis, among many other conditions.
The National Home Infusion Association, based in Alexandria, Virginia, is a trade association that represents and advances the interests of organizations that provide infusion and specialized pharmacy products and services to the entire spectrum of home-based patients. For more information, visit the association at www.nhia.org