09/02/10
08/31/10
- Provider Reminder: Type of Bill (TOB) 13X: Appropriate Medical Record Documentation for Critical Care (CPT 99291)
- Healthcare Integrated General Ledger Accounting System (HIGLAS) Frequently Asked Questions (FAQs)
08/30/10
08/24/10
- Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC), and Medicare Remit Easy Print (MREP) Update (MM7089)
- LCD - J10 MAC A - Radiology: Computed Tomographic Angiography of the Heart and Coronary Vessels (L30047) - Update
08/20/10
- Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2011 (MM7034)
- 5010 Implementation--Processing Additional International Classification of Diseases, 9th Revision-Clinical Modification (ICD-9-CM) Diagnosis and Procedure Codes in Pricer, Grouper, and the Medicare Code Editor (MCE) (MM7004) Revised
- Version 5010 Implementation—Changes to Present on Admission (POA) Indicator ‘1’ and the K3 Segment (MM7024)
- Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for Fiscal Year (FY) 2011 (MM7076)
08/18/10
- Educational Article - J10 MAC A - Pulmonary Rehabilitation (PR) Services (A50031)
- Educational Article - J10 MAC A - Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Services (A50030)
08/17/10
08/16/10
08/12/10
- Common Working File (CWF) Override Edit for Kidney Transplant Donor Claims When the Kidney Recipient is Deceased (MM6978) Revised
- Common Working File (CWF) Unsolicited Response Adjustments for Certain Claims Denied Due to an Open Medicare Secondary Payer (MSP) Group Health Plan (GHP) Record Where the GHP Record was Subsequently Deleted or Terminated (MM6625)
008/11/10
08/05/10
- Common Working File (CWF) Override Edit for Kidney Transplant Donor Claims When the Kidney Recipient is Deceased (MM6978) Revised
- HIGLAS - Healthcare Integrated General Ledger Accounting System
- Revisions and Re-issuance of Audiology Policies (MM6447) Revised
- Common Working File (CWF) Override Edit for Kidney Transplant Donor Claims When the Kidney Recipient is Deceased (MM6978)
- 5010 Implementation--Processing Additional International Classification of Diseases, 9th Revision-Clinical Modification (ICD-9-CM) Diagnosis and Procedure Codes in Pricer, Grouper, and the Medicare Code Editor (MCE) (MM7004)
- Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) (MM7006) Revised
- Revised Instructions for Reporting Assessment Dates under the Inpatient Rehabilitation Facility (IRF), Skilled Nursing Facility (SNF), and Swing Bed (SB) Prospective Payment Systems (PPSs) (MM7019)
- Implementation of the Interrupted Stay Policy under the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) (MM7044)
- Implementation of the Interrupted Stay Policy under the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) (MM7058)
- October Quarterly Update for 2010 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule (MM7070)
- Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for Fiscal Year (FY) 2011 (MM7077)
- Timely Claims Filing: Additional Instructions (MM7080)
08/04/10
08/03/2010
07/27/10
07/23/10
- Updates to the Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, Outpatient Prospective Payment System (OPPS), and Inpatient Rehabilitation Facility (IRF) PPS Changes due to the Affordable Care Act (ACA) (MM7029) Revised
- Magnetic Resonance Angiography (MRA) (MM7040)
- Claim Status Category and Claim Status Code Update (MM7052)
- Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2010 (MM7057)
07/22/10
- LCD - J10 MAC A - Drugs and Biologicals: Gemcitabine Hydrochloride (Gemzar ®) (L29995) - Update
- Article - J10 MAC A: CPT 0171T and 0172T (Insertion of posterior spinous process distraction device) (A50029)
- Widespread Probe Review Results - J10 MAC A-GA & TN- CPT 99212, 99213, 99214 submitted with modifier 25, TOB 13X
07/21/10
- LCD - J10 MAC A - Medicine: Occupational Therapy - Outpatient (L30007) - Update
- LCD - J10 MAC A - Medicine: Physical Therapy - Outpatient (L30009) - Update
- LCD - J10 MAC A - Retired Local Coverage Determinations
07/16/10
07/13/10
- Jurisdiction 10 A/B MAC Merge of the Part B Alabama, Georgia, and Tennessee CICS Production and User Acceptance Test Regions (CR 6765) Revised
- Dermal Injections for Treatment of Facial Lipodystrophy Syndrome (LDS) (MM6953)
- October 2010 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files (MM7007)
- July Update to the 2010 Medicare Physician Fee Schedule Database (MPFSDB) (MM6974)
- July Quarterly Update for 2010 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule (MM6945) Revised
- Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) (MM7006)
07/09/10
07/07/10
06/24/10
06/23/10
- Probe Notification - Review of DRG 312- Syncope and Collapse
- Probe Review Results - CPT 97597 and 97598, TOB 13X
- Probe Review Results - CPT 29580 TOB 13X
06/17/10
- Guidelines to Allow Contractors to Develop and Utilize Procedures for Accepting and Processing Appeals via Facsimile and/or via a Secure Internet Portal/Application (MM6958)
- Enhancements to Home Health (HH) Consolidated Billing Enforcement (MM6911) Revised
- Clarification on Use of the Skilled Nursing Facility (SNF) Advance Beneficiary Notice (ABN) and Denial Letters (CR 6987)
06/09/10
- July 2010 Update of the Hospital Outpatient Prospective Payment System (OPPS) (MM6996) Revised
- Revisions and Re-issuance of Audiology Policies (MM6447)
- Collagen Meniscus Implant (MM6903)
- July 2010 Integrated Outpatient Code Editor (I/OCE) Specifications Version 11.2 (MM6967) Revised
- Additional Instruction for Implementation of Health Insurance Portability and Accountability Act of 1996 (HIPAA) Version 5010 for Transaction 835 - Health Care Claim Payment/Advice and Updated Standard Paper Remit (SPR) (MM6975)
- Update-Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Rate Year 2011 (MM6986)
06/08/10
- Open Local Coverage Determination (LCD) Meeting
- Probe Review Results - CPT 83880 TOB 13X and 14X
- Gastric Restrictive Procedures and Subsequent Visits
- Modifier 50 and Billing For Bilateral Surgeries by Physicians
- LCD - J10 MAC A - Radiology: Computed Tomography of the Head or Brain (L30016)
- LCD - J10 MAC A - Radiology: Magnetic Resonance Imaging of the Brain (L30018)
- LCD - J10 MAC A - Finalized Draft Local Coverage Determinations (LCDs)
06/07/10
06/03/10
- Cardiac Rehabilitation and Intensive Cardiac Rehabilitation (MM6850)
- July 2010 Update of the Hospital Outpatient Prospective Payment System (OPPS) (MM6996)
06/02/10
06/01/10
05/26/10
- Quarterly Healthcare Common Procedure Coding System (HCPCS) Code Changes - July 2010 Update (MM6809)
- Pulmonary Rehabilitation (PR) Services (MM6823)
- Internet Only Manual (IOM) Chapter 25 Revisions (Medicare Claims Processing Manual, Chapter 25 - Completing and Processing the Form CMS-1450 Data Set) (MM6907)
- July 2010 Integrated Outpatient Code Editor (I/OCE) Specifications Version 11.2 (MM6967)
- Extension for the Two Percent and Three Percent Add-On for the Ground Ambulance, Air Ambulance in Rural Areas and "Super Rural" Add-0n through December 31, 2010 (MM6972)
05/25/10
05/21/10
- Screening for the Human Immunodeficiency Virus (HIV) Infection (MM6786)
- July Quarterly Update for 2010 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule (MM6945)
- Ambulance Services - Updating the Medicare Benefit Policy Manual Chapter 10, Section 10.5 to Include Ambulance Transports with Joint Responses (MM6949)
- Clinical Review Judgment (MM6954)
- Revised Payment Files for the 2010 Medicare Physician Fee Schedule Database (MPFSDB) and Retroactive Provisions under the Patient Protection and Affordable Care Act (Pub. L. 111-148) (the Affordable Care Act) (MM6973)
- Providers, Intern and Resident Information System (IROS) Programs- Additonal Codes Added
- LCD Update - J10 MAC A - Transportation Services: Ambulance (L30022)
05/20/10
05/12/10
- Requirements for Hospital Attestation and Billing of Fiscal Year (FY) 2007 and 2008 Informational Only Inpatient Claims for Medicare Advantage Beneficiaries (MM6821)
- FDG PET for Solid Tumors and Myeloma (MM6632) Revised
- Change in the Amount in Controversy (AIC) Requirement for Administrative Law Judge Hearings and Federal District Court Appeals (MM6894)
- Systems Changes Necessary to Implement the Patient Protection and Affordable Care Act (PPACA) Section 6404 - Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months (MM6960)
05/11/10
- LCD - J10 MAC A - Open Local Coverage Determinations (LCD) Meetings - 2010
- Outpatient Propsective Payment System (OPPS) Market Basket Reduction- Affordable Care Act (ACA) Changes
- LCD Update - J10 MAC A - Drugs and Biologicals: Oxaliplatin (Eloxatin®) (L29999)
05/07/10
- Discarded Drugs and Biologicals Updates (MM6711)
- Implementation of Home Health Agency Program Safeguard Provisions (MM6750) Rescinded
- Use of 12X Type of Bill (TOB) for Billing Colorectal Screening Services (MM6760)
- Removal of the Provider Reporting Requirement for Total Number of Therapy Visits using Value Codes 50-53 (MM6899)
- Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC), and Medicare Remit Easy Print (MREP) Update (MM6901)
- New Medicare Summary Notice (MSN) Message for Higher than Expected Prospective Payment System (PPS) Payments (MM6910)
- Enhancements to Home Health (HH) Consolidated Billing Enforcement (MM6911)
- Skilled Nursing Facility (SNF) Health Insurance Prospective Payment System (HIPPS) Coding Updates Effective October 1, 2010 (MM6916)
- Instructions Regarding the Processing of Inpatient Claims for Gender/Procedure Conflict (MM6917)
- Medicare Benefits Policy Manual Update - Determining Self-Administration of Drug or Biological (MM6950)
- Temporary 3 Percent Rural Add-On for the Home Health Prospective Payment System (HH PPS) (MM6955)
- Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2010 (MM6964)
05/05/10
04/27/10
- Probe Notification - Review of DRG 392 Esophagitis, Gastroenteritis, and Miscellaneous Digestive Disorders without MCC
- Inpatient Acute Hospitals (Section 3401(a))
- Inpatient Rehabilitation Facilities (Section 3401(d))
- Long-Term Care Hospitals (Section 3401(c))
04/23/10
04/21/10
- Probe Notification - Review of CMG's A0801-A0806
- Probe Notification - Review of CMG's A2001-A2004, Miscellaneous
04/19/10
- Claims Submitted for Items or Services Furnished to Medicare Beneficiaries in State or Local Custody Under a Penal Authority and Examples of Application of Government Entity Exclusion (MM6880)
- Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Version 005010 Medicare Administrative Contractors Requirements (MM6472)
- Signature Guidelines for Medical Review Purposes (MM6698)
- Reporting of Recoupment for Overpayment on the Remittance Advice (RA) (MM6870)
- Update to the Medicare Claims Processing Manual (Publication 100-04, Chapter 15, Section 40) (MM6896)
- Extension of Reasonable Cost Payment for Clinical Lab Tests Furnished by Hospitals with Fewer Than 50 Beds in Qualified Rural Areas (MM6873)
04/13/10
04/12/10
04/08/10
- Holding Claims for Warfarin Responsiveness Testing
- NCD - Ocular Photodynamic Therapy (OPT) (A49819) - J10 MAC
- LCD - J10 MAC A - Drugs and Biologicals: Rituximab (Rituxan®) (L30002)
- Educational Article: CPT 0193T
04/07/10
- Extension of Ambulance Add-Ons for Ambulance Services
- Probe Notification - Review of CPT 11055-11057, 11719-11721, and G0127
04/05/10
- Change in Provider Enrollment Timeliness Standards for Certain Paper Applications (MM6807)
- Update to List of ICD-9-CM Diagnosis Codes Not Requiring the Q0 Healthcare Common Procedure Coding System (HCPCS) Modifier for Automatic Implantable Cardiac Defibrillator (ICD) Services Provided in a Clinical Study (MM6867)
- Positron Emission Tomography (PET) (NaF-18) to Identify Bone Metastasis of Cancer (MM6861)
- Claim Status Category Code and Claim Status Code Update (MM6859)
- Outpatient Intravenous Insulin Treatment (Therapy) (MM6775)
- Comprehensive Outpatient Rehabilitation Facility Manual (MM6005)
- Dialysis Adequacy, Infection and Vascular Access Reporting (MM6782)
- Timely Filing Requirements for Medicare Fee-For-Service Claims
- Medicare Home Health Rural Add-on
- Commercial Banking Services Contract Award
- Extension of the Outpatient Hold-Harmless Provision
- Extension of Reasonable Cost Payment for Clinical Lab Tests Performed by Hospitals with Fewer than 50 Beds in Qualified Rural Areas
- Extension of Moratorium That Allows Independent Laboratories to Bill for the Technical Component (TC) of Physician Pathology Services Furnished to Hospital Patients
- Extension of Therapy Cap Exceptions Process
04/02/10
03/30/10
03/23/10
- Clinical Laboratory Fee Schedule (CLFS) - Medicare Travel Allowance Fees for Collection of Specimens (MM6864)
- Clinical Laboratory Fee Schedule (CLFS) - Special Instructions for Specific Test Codes (CPT Code 80100, CPT Code 80101, CPT Code 80101QW, G0430, G0430QW, and G0431QW (MM6852)
- Billing and Processing Claims with Unlimited Occurrence Span Codes (OSCs) (MM6777)
03/19/10
03/18/10
03/15/10
03/11/10
- Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting (MM6839)
- Additional ICD-9 Codes Analysis and Processing Direction (Institutional Claims Only) (MM6851)
- Accumulation of Claims with Condition Code 04 on the Provider Statistical and Reimbursement Report (PS and R) (MM6784)
- April 2010 Update of the Hospital Outpatient Prospective Payment System (OPPS) (MM6857)
- July 2010 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files (MM6805)
- Correction to Processing of Non-Covered Revenue Codes (MM6774) Revised
- Billing for Services Related to Voluntary Uses of Advance Beneficiary Notices of Noncoverage (ABNs) (MM6563) Revised
03/09/
03/04/10
03/03/10
02/26/10
02/25/10
- LCD - J10 MAC A - Draft Local Coverage Determinations (LCDs) Comment Period
- Reporting Hospice Services Provided by Physicians Under Part A that Could be Described by Current Procedural Terminology (CPT) Consultation Codes
- Reporting Inpatient Hospital Evaluation and Management (E/M) Services that Could be Described by Current Procedural Terminology (CPT) Consultation Codes
02/24/10
- Probe Review Results - HCPCS A0429 Ambulance BLS Emergency Transport
- Probe Notification - Review of DRG 641 Nutritional and Miscellaneous Metabolic Disorders w/o MCC
- Medicare Inpatient Skilled Nursing Facility No Payment Claim's Processing Issue
02/19/10
- Medicare Mammography Services Claims Process Issue- Reason Code 36440
- Medicare Non-Covered Claims with Professional Component Claims Process Issue- Reason Code 31387
02/17/10
02/15/10
- Point of Origin for Admission or Visit Codes Update to the UB-04 (CMS-1450) Manual Code List (MM6801)
- Medicare Systems Edit Refinements Related to Hospice Services (MM6778)
- Instructions on How to Process Negative Claim Adjustment Reason Code (CARC) Adjustment Amounts when Certain CARCs Appear on Medicare Secondary Payer Claims (MM6736)
02/12/10
02/11/10
02/10/10
- LCD - J10 MAC A - Drugs and Biologicals: Bevacizumab (AVASTIN®) (L29992)
- LCD - J10 MAC A - Medicine: Dysphagia/Swallowing Therapy (L30005)
- LCD - J10 MAC A - Medicine: Occupational Therapy - Outpatient (L30007)
- LCD - J10 MAC A - Medicine: Physical Therapy - Outpatient (L30009)
- LCD - J10 MAC A - Medicine: Speech Language Pathology - Outpatient (L30010)
- LCD - J10 MAC A - Drugs and Biologicals: Gemcitabine Hydrochloride (Gemzar ®) (L29995)
- LCD - J10 MAC A - Medicine: Inpatient Rehabilitation (L30006) - Retired
- Probe Notification - Notice to Providers of Upcoming Review of Diagnosis Code 428.23
20/08/10
- Widespread Probe Review for AL-A Providers for CPTs 99291 and 99292
- Widespread Probe Review for TN-A Providers for DRG 690
- Probe/Targeted Review Results-HCPCS A0428 Ambulance BLS Non-Emergency Transport
02/05/10
- Coverage of Inpatient Rehabilitation Services (MM6699)
- Correction to Processing of Non-Covered Revenue Codes (MM6774)
- Billing and Processing for Healthy Control Group Volunteers in a Qualified Clinical Trial (MM6776)
- Dialysis Adequacy, Infection and Vascular Access Reporting (MM6782)
- April 2010 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files (MM6804)
- Revision of Definition of Compendia as Authoritative Source for Use in the Determination of a Medically-Accepted Indication of Drugs/Biologicals Used Off-label in Anti-Cancer Chemotherapeutic Regimens (MM6806)
- Healthcare Provider Taxonomy Codes (HPTC) Update April 2010 (CR6840)
- The February 2010 Medicare A Newsline is Now Available
02/01/10
01/26/10
- Billing for Services Related to Voluntary Uses of Advance Beneficiary Notices of Noncoverage (ABNs) (MM6563)
- Medicare Outpatient Prospective Payment System Claims Process Issue For Q0139- Ferumoxytol Injection
01/21/10
01/20/10
- Submitting Claims to Medicare When There Is an Accident Medicare Secondary Payer Record on the Common Working File
- Billing and Medicare Secondary Payer- Revised Flow Chart
- Important Notice Regarding Due Date for September 30, 2009 Medicare Cost Reports for Providers Not Yet Registered in IACS
- Calendar Year (CY) 2010 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment (MM6657)
- Implementation of Home Health Agency Program Safeguard Provisions (MM6750)
- Expansion of Medicare Telehealth Services for Calendar Year (CY) 2010 (MM6705)
- Positron Emission Tomography (PET) (FDG) for Cervical Cancer (MM6753)
- Pharmacogenomic Testing for Warfarin Response (MM6715)
01/19/10
01/13/10
01/08/10
- Recent Comprehensive Error Rate Testing (CERT) Findings
- LCD - J10 MAC A - Drugs and Biologicals: Oxaliplatin (Eloxatin®) (L29999)
- Widespread Probe Review Results Notification - J10 MAC A - Notice to Tennessee providers of review results from Widespread Probe Review of CPT 99291, TOB 13X
- Widespread Probe Review Results Notification - J10 MAC A - Notice to providers of review results from Widespread Probe Review of CPT 85025 for Bill Type 13X
01/07/10
- Summary of Policies in the 2010 Medicare Physician Fee Schedule (MPFS) and the Telehealth Originating Site Facility Fee Payment Amount (MM6756)
- 10 A/B MAC Merge of the Part B Alabama, Georgia, and Tennessee CICS Production and User Acceptance Test Regions (CR 6765)
- January 2010 Integrated Outpatient Code Editor (I/OCE) Specifications Version 11.0 (MM6761)
- Coverage of Kidney Disease Patient Education Services (MM6557)
- Pharmacogenomic Testing for Warfarin Response (MM6715)
- Emergency Update to the 2010 Medicare Physician Fee Schedule Database (MPFSDB) (MM6796)
01/05/10