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MLN Matters®

Modified: 4/7/2021
This table of MLN Matters articles includes articles released by CMS April 1 through June 30.
Modified: 4/7/2021
This table of MLN Matters articles includes articles released by CMS January 1 through March 31, 2021.
Modified: 1/22/2021
This table of MLN Matters articles includes articles released by CMS (Centers for Medicare & Medicaid Services) October 1-December 31, 2020.
Modified: 12/23/2020
This table of MLN Matters articles includes articles released by CMS (Centers for Medicare & Medicaid Services) July 1-September 30, 2020.
Modified: 9/18/2020
This table of MLN Matters articles includes articles released by CMS (Centers for Medicare & Medicaid Services) March 1-June 30, 2020.
Modified: 9/16/2020
This table of MLN Matters articles includes articles released by CMS (Centers for Medicare & Medicaid Services) January 1-March 31, 2020.
Modified: 4/6/2021
This article describes changes to and billing instructions for various payment policies CMS is making in the April 2021 ambulatory surgical center (ASC) payment system update. CR 12183 also includes updates to HCPCS. [MM12183]
Modified: 4/1/2021
This special edition MLN Matters article is for all Medicare providers and suppliers who requested and received COVID-19 accelerated and advance payments (CAAPs) from CMS due to the COVID-19 public health emergency (PHE). [SE21004]
Modified: 3/31/2021
CR 12226 provides the quarterly update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits. [MM12226]
Modified: 3/25/2021
This article tells you about updates to the lists of HCPCS codes that are subject to the consolidated billing provision of the SNF prospective payment system (PPS). [MM12212]
Modified: 3/25/2021
This article gives you important information about recently issued regulatory authorities. These authorities affect currently enrolled Medicare providers and suppliers, or prospective providers and suppliers. [SE21003]
Modified: 3/25/2021
This article informs you about updates to Chapter 15 of the Medicare Benefit Policy Manual for physician supervision for physician assistant (PA) services and medical record documentation for Part B services. [MM11862]
Modified: 3/25/2021
This article announces the changes in the July 2021 quarterly release of the edit module for clinical diagnostic laboratory services. [MM12171]
Modified: 3/25/2021
This article tells you about Medicare claims processing system changes for ICDs with dates of service on or after February 15, 2018. [MM12104]
Modified: 3/19/2021
This article tells you about the payment limit for RHCs effective April 1. [MM12185]
Modified: 3/19/2021
This article tells you of updates to the remittance advice remark code (RARC) and claims adjustment reason code (CARC) lists and instructs Medicare’s shared system maintainers (SSMs) to update Medicare remit easy print (MREP) and PC print. [MM12102]
Modified: 3/19/2021
This article tells you about the changes to the DMEPOS fee schedules that Medicare updates on a quarterly basis, when necessary, to implement fee schedule amounts for new and existing codes, as applicable, and apply changes in payment policies. [MM12193]
Modified: 3/19/2021
This article informs you of new changes to Medicare claims processing for HIT services. [MM12108]
Modified: 3/19/2021
This article tells you about claims frequency editing changes that Medicare’s common working file (CWF) performs based on relevant policy limitations for subsequent nursing facility care services. [MM12068]
Modified: 3/19/2021
This article tells you of the calendar year 2021 rate updates and policies for the ESRD prospective payment system (PPS) and implements payment for renal dialysis services you furnish to Medicare patients with acute kidney injury (AKI) in ESRD facilities. [MM12188]
Modified: 3/12/2021
This MLN Matters article is for hospitals, providers, and suppliers billing MACs, including home health and hospice (HH&H) MACs, for services provided to Medicare patients. [MM12187]
Modified: 3/12/2021
This article was revised to reflect a revised CR 12131. The CR revision changed the date that HCPCS code 87428 was added. The correct date is November 10, 2020. The CR release date, transmittal number, and the web address of the CR were also revised. All other information remains the same. [MM12131]
Modified: 3/12/2021
This MLN Matters article is for clinical diagnostic laboratories that submit claims to MACs for laboratory services they provide to Medicare patients. [MM12178]
Modified: 3/12/2021
This MLN Matters article is for laboratories and providers billing MACs for specimen collection services provided to Medicare patients. [MM12140]
Modified: 3/12/2021
This MLN Matters article is for rural referral centers (RRCs), Medicare dependent hospitals (MDHs), MDH RRCs, sole community hospital (SCH) RRCs, or essential access community hospital (EACH) RRCs submitting claims to MACs for services provided to Medicare beneficiaries. [MM12062]
Modified: 3/12/2021
This article was revised due to a revised CR 11879, which changed the 25th percentile wage index value from 0.8465 to 0.8649. The CR release date, transmittal number, and the web address of the CR were also changed. All other information is the same. [MM11879]
Modified: 3/12/2021
This MLN Matters article is for physicians, hospitals, and other providers billing MACs for services they provide to Medicare patients that Medicare pays using the Medicare physician fee schedule. [MM12155]
Modified: 3/12/2021
This MLN Matters article is for hospitals billing MACs for hospital outpatient services they provide to Medicare patients. [MM12175]
Modified: 3/3/2021
This article describes changes to and billing instructions for various payment policies implemented in the January 2021 ambulatory surgical center (ASC) payment system update. CR 12129 also includes updates to HCPCS. [MM12129]
Modified: 2/25/2021
This article tells you about the new HCPCS codes for 2021 that are subject to and excluded from clinical laboratory improvement amendments (CLIA) edits. Make sure your billing staffs are aware of these updates. [MM12131]
Modified: 2/25/2021
This article informs you about the average sales price methodology, which is based on quarterly data manufacturers submit to CMS. [MM12133]
Modified: 2/25/2021
Don’t deny treatment, entry to a SNF or hospital, or services based on an open or closed Liability (L), No-Fault (NF) or Workers’ Compensation (WC) Medicare Secondary Payer (MSP) record on the beneficiary’s Medicare file or if a claim was inappropriately denied. You must continue to see or provide services to the beneficiary. [MM12027]
Modified: 2/25/2021
The Office of Inspector General (OIG) has conducted several reviews identifying Medicare overpayments to hospitals that didn’t comply with Medicare’s post-acute care transfer policy. The OIG found that some hospitals transferred inpatients to certain post-acute care settings but coded the patient discharge status as a discharge to home. To assure proper payment under the Medicare Severity-Diagnosis Related Group (MS-DRG) payment system, hospitals must be sure to code the discharge/transfer status of patients accurately to reflect the patient’s level of post-discharge care. [SE21001]
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.