Inc250TAX COMPUTATION00Taxpayers filing on a calendar year basis must file theirreturn by April 15 of the following year.Make yourenue for the amount of tax computed and mail to:Should you need assistance, please contact the Taxpayerand Vehicle Services Division by callingYou may file your extension, return, and paymentwww.TN.gov/revenue.WRITE NUMBERS LIKE THISACCOUNT
NUMBER(If filing jointly, include first names and initials of both spouses)(800) 342-1003
(615) 253-06002.Married Filing Jointly3.Married Filing person whose legal domicile* is in Tennessee and whose taxable interest and dividend income exceeded $1,250 ($2,500 if marr2.A person who moved into or out of Tennessee during the year and whose taxable interest and dividend income during the period 3.A person whose legal domicile* is in another state, but who maintained a residence in Tennessee for more than six months of t full-time students having legal domicile in another state are not required to file.4.A person, bank, etc.acting as a Tennessee fiduciary (administrator, executor, guardian, trustee, or other acting in a similapay tax on income received by the estate until stocks and bonds have been transferred to beneficiaries.
However, effective Aprithe amount of taxable income distributed to him and the beneficiary shall be liable for the tax.
Trustees who receive taxable
required to file a return.
However, when taxable income is received on5.A Tennessee partnership whose taxable interest and dividend income exceeded $1,250.
The partnership is liable for the tax, if any.1.An exemption of $1,250, or $2,500 for married persons filing jointly, is allowed against total taxable interest and dividend 2.A person who is legally blind is exempt from the tax.
Legal blindness means that vision does not exceed 20/200 in the betteto the Department of Revenue.
A TAX RETURN IS NOT REQUIRED TO BE FILED BY SINGLE FILERS WHO ARE BLIND.(b)
For JOINT FILERS, when taxable income is received by a blind person and a sighted spouse, only the taxable income of thesighted person is required to be reported in Schedule A on the back and on Line 1, Page 1 of the return.
The income of the bliperson is exempted and may be reported in Schedule B on the back of the return.
If the taxable dividend/interest income is recjointly by a blind person and a sighted spouse, only one-half (1/2) of the jointly received income will be exempt from tax.
Th3.If a person is certified by a medical doctor to be quadriplegic, the taxable income that is derived from circumstances result case,4.For tax years beginning January 1, 2000, any person 65 years of age or older having a total annual income derived from any an1.Dividends from stock in:a.All corporations.b.Insurance companies not licensed to do business in Tennessee.c.All holding companies, including those formed by banks, savings and loan associations, and insurance companies.d.State-chartered banks outside Tennessee not doing business in Tennessee.2.Income from investment trusts and mutual funds, including capital gain distributions, whether in cash or additional stock, is taxable.3.Any distribution which does not qualify as a return of capital and is otherwise taxable.
In order to qualify as a return of c of the4.Market value of stock in a corporation given by another corporation as a dividend in the regular course of business.5.Distributions based on stock ownership to shareholders of an S corporation.6.Interest from the following, if the instrument matures in more than six months from the date of issuance (except certificates ofa.Bonds of states, counties, and municipalities outside Tennessee.b.Bonds of foreign governments.c.Church bonds.d.Bonds, mortgages, deeds of trust, personal notes, promissory notes, installment notes, commercial paper, or other written7.Interest and dividends you received as a beneficiary of a trust or estate located outside Tennessee, unless derived from a no8.Dividends or interest from money market funds which are not bank money market accounts.RV-F1300201
April 2012April 2012
BlueCross BlueShield of Tennessee, Inc.(BCBST) (Applies to all lines of business unless stated otherwise) The BlueCross BlueShield of Tennessee Medical Policy Manual has been updated to reflect the following policies.The full text Group Report on Managing Treatment - Update 2004 Immunizations Guidelines for Migraine Headache (an Disease.Global Strategy for the (Revised 2011) National Cholesterol Education the Practitioner Change Form.
*These changes will be included in the ommunication to update your prBlueCross BlueShield of Tennessee is an Independent Licensee of the BlueCross BlueShield is a registered trademark of the American Medical Association pril 2012 BlueCross BlueShield of Tennessee, Inc
.(BCBST) (Applies to all lines of business unless stated otherwise) Quantitative sensory testing (QST) systems are used as a noninvasive assessment and quantification of sensory nerve function in individuals with symptoms of, or the potential for, neurologic damage or disease.QST devices measure and quantify the amount of physical stimuli required for sensory perception to occur in the individual.
QST can assess both small and/or large fiber dysfunction based on the type of device used.
Some devices evaluate small myelinated and unmyelinated nerve fibers via vibration or thermal thresholds.large myelinated sensory nerve function by quantifying the thresholds of pressure detected with light, static and moving touch.
Current perception threshold testing (i.e., sensory nerve conduction threshold testing) involves the quantification of the sensory threshold to transcstimuli.In current perception threshold testing, three different frequencies are typically tested (there issome variability among products): 5 Hz, designed to assess C fibers; 250 Hz, designed to assess A-delta fibers; and 2,000 Hz, designed to assess A-beta fibers.
Some devices are referred to as voltage-actuated sensory nerve conduction threshold tests, but this is another type of quantitative test of sensory function and represents a modification of current perception threshold testing.The AXON-II NCSs System, Neural-Scan and Medi-DX 7000 are examples of marketed current perception threshold testing or voltage-actuated sensory nerve conduction threshold testing devices.
Sensory testing performed using any of these devices, or a similar device, does not submitted using an appropriate quantitative sensory testingprocedure code on the claim form.Billing of quantitative sensory testing using a nerve conduction study procedurecode would be
submitting a claim with the wrong
delivered.The American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) does not endorse the use of quantitative sensory testing in the assessment of sensory nerve function.Effective April 2004, CMS concluded that the use of any type of sensory nerve conduction threshold device (e.g., current perception threshold testing, voltage-nerve conduction threshold testing or pain tolerance threshold testing) to diagnosis sensory neuropathies or radiculopathies was
reasonable and necessary.
BlueCross BlueShield of Tennessee, and most other health insurers, consider all forms ofquantitative sensory testing to be investigational; thus, not eligible for Reminder: Allow adequate time When requesting status of a claim, BlueCross BlueShield of Tennessee encourages providers to wait at least 30 days from the date a claim has been submitted before calling us.This will help ensure adequate time for successful submission and claims processing.Providers may also check claims status section on BlueCross website, forward despite possible delays The U.S.
Department of Health and Human Services announced in February their intent compliance date for ICD-10.With the possible delay for transitioning from ICD-9 to ICD-10, BlueCross BlueShield of Tennessee suggests you take this opportunity to continue improving processes to be ICD-10 ready in the future.
Focusing on improving clinical documentation can make the ICD-9 to ICD-10 transition easy.
This will also have a positive effect on quality of care and reporting.
Continue making the necessary changes to get your system ready for ICD-10.This will help to avoid any further delays and allow you to get a jumpstart on being compliant by the implementation date.Take this time to invest in educating coders.The ICD-10 coding system is more specific and detailed than ICD-9.
Becoming more familiar with anatomy and physiology can benefit coders.
BlueCross is moving forward in preparation for ICD-10, so that we can continue to best serve the needs of our customers at any future compliance date.For additional information on ICD-10 implementation and BlueCross BlueShield website click on the link ICD-10 InformationTo allow electronic submitters to use the latest technologies to transmit claims, BlueCross BlueShield of Tennessee will be launching the new Secure File Gateway (SFG) tool effective May 1, 2012.The SFG Gateway Bulletin Board System.
If you submit claims electronically to BlueCross you or your vendor transitioned into the new system by following instructions located on our website at .
Please do not delay in taking action or your ability to submit electronic claims may be impacted.Also, as phase two of our Customer campaign, we are pleased to announce the merger of the Provider Outreach Department with the eBusiness marketing and support teams.
The outcome of the merger is one cohesive voice for our entire provider community for all of your
eBusiness needs.The former phone number, (423) 535-1090 for the Provider
*These changes will be included in the ommunication to update your prBlueCross BlueShield of Tennessee is an Independent Licensee of the BlueCross BlueShield is a registered trademark of the American Medical Association pril 2012 BlueCross