Billing news

This fact sheet gives providers and suppliers an overview of the DMEPOS Competitive Bidding program as well as useful information regarding the benefits and inherent qualities of the program. [PERL 201003-14]

Effective January 1, 2011, the Centers for Medicare & Medicaid Services is expanding the number of ICD-9 diagnosis and procedure codes processed on institutional claims. [MM6851]

This article provides awareness of revised language in the National Coverage Determination Manual specific to embolic protection devices. [MM6839]

This article instructs Medicare contractors to download and implement new and revisions to previous quarterly updates of the average sales price (ASP) drug pricing files. [MM6805]

Information on a notice of proposed rulemaking outlining the proposed approach for establishing a certification program to test and certify electronic health records aiming towards the modernization of the health-care system. [PERL 201003-07]

The Centers for Medicare & Medicaid Services prepared a proposed rule on the electronic health record (EHR) incentive programs for public comment, which includes the definition of meaningful use and other requirements to qualify for incentive payments. The comment period for this proposed rule closes on March 15. [PERL 201003-10]

Great news for providers, clearinghouses, and billing services in Puerto Rico and the U.S. Virgin Islands -- First Coast Service Options (FCSO) implemented changes to its financial cycle that improves timeliness of your payments and cash flow.

As of January 1, 2010, CPT consultation codes 99241-99245 and 99251-99255 are no longer valid for Medicare Part B billing. A separate change request will be issued to address Part A billing as it relates to these services. [PERL 201002-42]

The conference will be held on March 18 and will offer educational sessions on Part D research and outcomes. Prior online registration from February 5 through March 5 is required. [PERL 201002-36]

A message from Dr. David Blumenthal on advancing health information exchange that announces the first cooperative agreement awards, marking a major milestone in the journey towards nationwide adoption of health information technology. [PERL 201002-37]

This article clarifies that the new requirements are effective for CMS-855A applications received on or after January 1, 2010. Applications received prior to January 1 are handled in accordance with the policies in place prior to that date. [MM6750]

This free-of-charge documentary features stories from survivors of the influenza pandemic that swept the United States in 1918. These stories serve to frame the key questions that apply to the current H1N1 pandemic. [PERL 201002-38]

Noncovered claims containing professional component are being held and will be released on or about September 6, 2010, once this processing system issue is fixed. [JSM 10144]

Adjustments performed on claims for mammography services are being held and will be released on or about September 6, 2010, once this processing system issue is fixed. [JSM 10143]

MLN Matters article MM6806 was revised February 17 to include Web links to additional information regarding this issue. [MM6806]

This information outlines the process for the 935 recoupment.

The Centers for Medicare & Medicaid Services has rescinded change request 6528 and the related MLN Matters article MM6528 on February 5, 2010. [MM6528]

This article addresses issues on claims for Medicare Advantage plan beneficiaries electing hospice, general inpatient care and continuous home care place of service, and clarification regarding ambulance transport on the date of hospice election. [MM6778]

This article is a reminder for physicians of the quarterly updates to Correct Coding Initiative edits. The last quarterly release of the edit module was issued in January 2010. [MM6819]

This article identifies Healthcare Common Procedure Coding System (HCPCS) code for 2010 that are subject to and excluded from Clinical Laboratory Improvement Amendments (CLIA) edits. [MM6812]

This article lists the latest tests approved by the Food and Drug Administration (FDA) as waived tests under Clinical Laboratory Improvement Amendments of 1988 (CLIA). [MM6800]

Change request 6709 has been revised to reflect changes to the effective and implementation dates to July 1 and 6, 2010, respectively. The CR release date, transmittal number, and Web addresses were also revised. All other information remains the same. [MM6709]

This new fact sheet, which provides general information and guidance to speech-language pathologists on enrollment and billing procedures, is now available in downloadable format. [PERL 201002-02]

To be designated, the accrediting organizations had to demonstrate that their accreditation requirements met or exceeded the standards set out in Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). [PERL 201002-01]

This article instructs Medicare contractors to download and implement new and revisions to previous quarterly updates of the average sales price (ASP) drug pricing files. [MM6804]

The Medicare Learning Network offers a variety of courses that cover the Medicare program policy topics, ranging from general overviews to specific billing and coding information, as well as important education on new initiatives. [PERL 201001-20]

This article provides information regarding manual updates that include two alternative methods for determining when not to apply the limitation and removal of the terms “purchased diagnostic test” and “purchased test interpretation.” [MM6733]

The expansion of telehealth services includes individual health and behavior assessment and intervention, initial inpatient consultations, and follow-up inpatient telehealth consultations, to include services furnished to beneficiaries in an SNF. [MM6705]

Obtain general information about the Medicare hospice benefit including coverage of hospice services, certification requirements, election periods, how payment rates are set, coinsurance, caps, and additional reporting required on hospice claims. [PERL 201001-16]

This article informs physicians of corrections to the latest package of correct coding initiative edits (version 16.0), effective January 1, 2010. These files will replace those in change request 6728, released on November 20, 2009. [MM6818]

First Coast Service Options recently discovered that some providers are responding to additional documentation requests (ADRs) by attaching a request for redetermination form.

This change request updates and clarifies medically unlikely edits (MUE) requirements established in 2006. MUEs are designed to reduce errors due to clerical entries and incorrect coding. [CR 6712]

The Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology encourage public comment on two regulations issued on December 30, 2009, addressing electronic health record technology. [PERL 200912-34]

Completion of the Overpayment redetermination request for a Medicare Part B claim form and receipt in the appropriate mailbox is critical to correct processing of an overpayment redetermination request.

For the latest news and information, visit the Centers for Medicare & Medicaid Services DMEPOS competitive bidding webpage and click on the “Latest News and Announcements” link on the left side of the page. [CR 6571]

Provider specialty page on CMS.HHS.gov

Link to DME MAC Jurisdiction C Web site.

Link to National Supplier Clearinghouse (NSC)Web site.

Comparative billing report (CBR) information is available to providers and suppliers by request. [CMS Pub 100-08, Medicare Program Integrity Manual, Chapter 3, Section 11.1.6]

Comparative billing report (CBR) information is available to providers and suppliers by request. [CMS Pub 100-08, Medicare Program Integrity Manual, Chapter 3, Section 11.1.6]

Requirements for submission of Advance Beneficiary Notices.