CPT 90670 – Pneumococcal conjugate vaccine, 13 valent for intramuscular use.
    
Should you need more information from AFMC on the aforementioned coding and repricing, please e-mail or call 800-624-4277. 
                                  
Updated AFMC Provider Reference Guide
AFMC has updated our Provider Reference Guide. The Guide is designed to assist contracted providers and their office staff in the administration of AFMC’s network plans. Whenever you have a question about any aspect of AFMC’s operations, first check the appropriate section of the Guide. If you don’t find the answer to your question, contact us. We are always willing to help. Note: The guide is in a secure area of the AFMC Web site. You must be a registered AFMC Web site user to access this information. 
 
Claims Submission Protocol
AFMC will not accept claims from providers more than 18 months old. Should you have a claim older than 18 months, you will need to contact the payor. For a comprehensive listing of payors that work with AFMC, download AFMC's Listing of Administrators.The most current version can be found on this site under Provider, Administrator List/Commonly Used Forms. Please be sure to download and print a copy for your use, then check back often for updates. 
 
Important Information about Your AFMC Contract Application
Please remember to make a photo copy of your AFMC contract application prior to submission. Because this is your legally, binding contract with AFMC, it is imperative you retain a copy for your records.  Should you have any questions, please contact AFMC's Network Management Department by calling 800-624-4277 or e-mail.

Individual Providers should e-mail to: individualrenewal@azfmc.com  
Group Providers to: grouprenewal@azfmc.com   
 
 
HHS Issues Notice of Proposed Rulemaking to Implement HITECH Act Modifications to the HIPAA Rules
The Department of Health and Human Services (HHS) issued a notice of proposed rulemaking on July 8, 2010 to modify the Privacy, Security, and Enforcement Rules issued pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA).   
 
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, is designed to promote the widespread adoption and standardization of health information technology, and requires HHS to modify the HIPAA Privacy, Security, and Enforcement Rules to strengthen the privacy and security protections for health information and to improve the workability and effectiveness of the HIPAA Rules. 
 
The proposed modifications to the HIPAA Rules include provisions extending the applicability of certain of the Privacy and Security Rules’ requirements to the business associates of covered entities, establishing new limitations on the use and disclosure of protected health information for marketing and fundraising purposes, prohibiting the sale of protected health information, and expanding individuals’ rights to access their information and to obtain restrictions on certain disclosures of protected health information to health plans. In addition, the proposed rule adopts provisions designed to strengthen and expand HIPAA’s enforcement provisions. 
 
These HIPAA Rules are administered and enforced by OCR. Once it is published in the Federal Register, the notice of proposed rulemaking may be viewed and commented on for 60 days at http://www.regulations.gov/search/Regs/home.html#home 
  
  
 
Compliance deadlines approaching for “5010” standard transactions, ICD-10 code sets  
To avoid disruptions in cash flow and transaction processing, physician practices must be ready to send and receive only the updated version of Health Insurance Portability and Accountability Act (HIPAA) electronic transactions, commonly known as “5010,” beginning Jan. 1, 2012. To meet this deadline, practices will need to begin testing the upgraded electronic administrative transactions with their trading partners in 2011. In addition to the 5010 transactions, the ICD-10 code set must be used for all services provided beginning Oct. 1, 2013. The Centers for Medicare & Medicaid Services, which oversees compliance of the HIPAA standard transactions and code sets, has made it clear that the compliance deadlines will not be extended. In fact, Medicare expects to begin testing the 5010 transactions with physicians and other healthcare providers in 2011. With these deadlines approaching fast, the AMA has prepared various resources to help physicians implement the 5010 standard transactions and ICD-10 code sets.  
 
Source: American Medical Association