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Providers

Two Important NPI Requirement Dates
As of August 1, 2008, Wellmark requires your National Provider Identifier (NPI) on electronically submitted and paper claims. Claims that use legacy provider number(s) only will be rejected. Wellmark will accept claims submitted with both an NPI and legacy provider number until November 15, 2008. At that time, Wellmark will reject claims submitted with both numbers.
 
Wellmark Using Up to 18 Diagnosis Codes to Determine DRG
For admissions on or after July 1, 2008, Wellmark began using up to 18 diagnosis codes to determine the Diagnostic Related Grouping (DRG). Previously, Wellmark was only able to use nine diagnosis codes to determine the DRG payment.
Medical Policy Updates
New medical policies are now available for prostate saturation biopsy and analysis of proteomic patterns in serum to identify ovarian cancer. Information has been updated for the following medical policies:
ICD-9 Videoconference
Sign up for the ICD-9 Coding Videoconference taking place in September.
Treating Posttraumatic Stress Disorder (PTSD) in Primary Care Setting
Military members returning from deployment may experience PTSD. It is important for primary care managers to know the implications of PTSD so that the disorder can be identified and treated.

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