What's New From CMS

Date CMS CR/JSM Number News Item
December 2008
12/19/07 MM5577 Mammography Change Certification Based Action (MM5577) Globe to indicate www link.
12/10/07 MM5834 Pulmonary Rehabilitation Services (MM5834) Globe to indicate www link.
12/10/07 MM5803 2008 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Update (MM5803) Globe to indicate www link.
12/05/07 MM5824 Correct Coding Initiative (CCI) Edits- Version 14.0 (MM5824) Globe to indicate www link.
12/05/07 MM5810 2008 Therapy Code List (MM5810) Globe to indicate www link.
12/05/07 MM5801 2008 Ambulance Inflation Factor (MM5801) Globe to indicate www link.
12/05/07 MM5800 Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update (MM5800) Globe to indicate www link.
12/05/07 MM5795 Update to Requirement to Submit National Provider Identifier (NPI) Notification (MM5795) Globe to indicate www link.
12/05/07 MM5777 Place of Service (POS) New Code for Temporary Lodging (MM5777) Globe to indicate www link.
12/05/07 MM5628 Medicare Telehealth Services (MM5628) Globe to indicate www link.
November 2008
11/16/07 SE0730 Key Medicare News for 2008 (SE0730) Globe to indicate www link.
11/16/07 MM5680 2008 Ambulatory Surgical Center (ASC) Payment System Changes (MM5680) Globe to indicate www link.
11/08/07   2008 Healthcare Common Procedure Coding System (HCPCS) Updates Globe to indicate www link.
11/08/07 MM5780 Crossover of Assignment of Benefits Indicator (CLM08) From Paper Claim Input (MM5780) Globe to indicate www link.
11/08/07 MM5757 Additional Common Working File (CWF) Editing for Skilled Nursing Facility (SNF) Consolidated Billing (CB) - Part II (MM5757) Globe to indicate www link.
11/08/07 MM5756 Low Vision Rehabilitation Demonstration (MM5756) Globe to indicate www link.
11/08/07 MM5726 Rejection of Electronic Claim Status Requests that Lack National Provider Identifiers (NPIs) (MM5726) Globe to indicate www link.
11/08/07 SE0744 Important NPI and Enrollment Information for Physicians and Non-Physician Practitioners (SE0744) Globe to indicate www link.
October 2008
10/31/07 MM5744 Payment Allowances for the Influenza Virus and the Pneumococcal Vaccines (MM5744) Globe to indicate www link.
10/31/07 MM5674 How to Handle the National Provider Identifier (NPI) Claims (MM5674) Globe to indicate www link.
10/31/07 MM5606 Application of Administrative Simplification Compliance Act (ASCA) Enforcement (MM5606) Globe to indicate www link.
10/31/07 SE0730 Key Medicare News for 2008 (SE0730) Globe to indicate www link.
10/23/07 MM5722 Medicare Summary Notice (MSN) Message- Revised 38.13 (MM5722) Globe to indicate www link.
10/12/07 MM5728 Medicare Fee-For-Service (FFS) National Provider Identifier (NPI) Final Implementation (MM5728) Globe to indicate www link.
10/05/07 MM5740 Reasonable Charge Update for 2008 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, and Certain Intraocular Lenses (MM5740) Globe to indicate www link.
10/05/07 MM5721 Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update (MM5721) Globe to indicate www link.
10/05/07 MM5715 New Waived Tests (MM5715) Globe to indicate www link.
10/02/07 MM5730 Revisions to 9-Digit ZIP Code List Provided in Change Request (CR) 5208 (MM5730) Globe to indicate www link.
10/02/07 MM5729 Unlabeled Use for Anti-Cancer Drugs: Medical Literature used to Determine Medically Accepted Indications for Drugs and Biologicals used in Anti-Cancer Treatment (MM5729) Globe to indicate www link.
10/020/07 MM5724 New Website for Approved Transplant Centers (MM5724) Globe to indicate www link.
10/02/07 MM5698 2008 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payment (MM5698) Globe to indicate www link.
10/02/07 MM5677 Magnetic Resonance Imaging (MRI) Procedures (MM5677) Globe to indicate www link.
10/020/07 MM5452 Stage # NPI Changes for Transaction 835 & Standard Paper Remittance Advice (MM5452) Globe to indicate www link.
September 2008
09/21/07 MM5727 Lumbar Artificial Disc Replacement (LADR) (MM5727) Globe to indicate www link.
09/21/07 SE0742 Revised Payment System for Ambulatory Surgical Centers (ASC) in Calendar Year (CY) 2008 (SE0742) Globe to indicate www link.
09/20/07 MM5660 Percutaneous Transluminal Angioplasty (PTA) (MM5660) Globe to indicate www link.
09/18/07 MM5719 Medicare Clinical Trial Policy (CTP) (MM5719) Globe to indicate www link.
09/18/07 MM5584 Discontinuance of the Unique Physician Identification Number (UPIN) Registry-Revised (MM5584) Globe to indicate www link.
09/17/07 MM5711 Sunset of the Physician Scarcity Area (PSA) Bonus Payment (MM5711) Globe to indicate www link.
09/17/07 MM5710 Quarterly October 2007 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files (MM5710) Globe to indicate www link.
09/17/07 MM5608 Ultrasound Diagnostic Procedures (MM5608) Globe to indicate www link.
09/13/07 MM5659 New Remark Code for Denying Separately Billed Services (MM5659) Globe to indicate www link.
09/07/07 MM5714 October Update to the 2007 Medicare Physician Fee Schedule Database (MM5714) Globe to indicate www link.
09/07/07 MM5703 Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 13.3, Effective October 1, 2007 (MM5703) Globe to indicate www link.
09/07/07 MM5667 Clarification of Percutaneous Transluminal Angioplasty (PTA) Billing Requirements Issued in CR 3811-Revised (MM5667) Globe to indicate www link.
09/07/07 MM5678 Delete References to Required Reporting of the National Provider Identifier (NPI) on or after May 23, 2007 and Revise to a 'When Effective' Date (MM5678) Globe to indicate www link.
09/07/07 MM5618 Anesthesia Services Furnished by the Same Physician Providing the Medical and Surgical Service-Revised (MM5618) Globe to indicate www link.
09/07/07 MM5601 Transitioning the Mandatory Medigap ('Claim-Based') Crossover Process to the Coordination of Benefits Contractor (COBC)-Revised (MM5601) Globe to indicate www link.
August 2008
08/29/08 MM5667 Clarification of Percutaneous Transluminal Angioplasty (PTA) Billing Requirements Issued in CR 3811 MM5667 Globe to indicate www link.
08/24/08 MM5618 Anesthesia Services Furnished by the Same Physician Providing the Medical and Surgical Service MM5618 Globe to indicate www link.
08/22/08 MM5696 Skilled Nursing Facility (SNF) Consolidated Billing- 2008 HCPCS Annual Update MM5696 Globe to indicate www link.
08/22/08 MM5684 Revision to Certification for Hospital Services Covered by the Supplementary Medical Insurance Program as it Pertains to Ambulance Services MM5684 Globe to indicate www link.
08/22/08 MM5659 Ambulance- New Remark Code for Denying Separately Billed Services MM5659 Globe to indicate www link.
08/22/08 MM5639 Nurse Practitioner (NP) Services and Clinical Nurse Specialist (CNS) Services MM5639 Globe to indicate www link.
08/22/08 MM5573 Date of Service for Laboratory Specimens MM5573 Globe to indicate www link.
08/13/08 MM5658 Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals MM5658 Globe to indicate www link.
08/07/08 MM5687 Claim Status Category Code and Claim Status Code Update MM5687 Globe to indicate www link.
08/07/08 MM5675 Laboratory and Radiology Technical Component Provided to Hospital Patients MM5675 Globe to indicate www link.
08/02/08 MM5665 Positron Emission Tomography (PET) Scan Coding Revision MM5665 Globe to indicate www link.
08/02/08 MM5586 Electronic Funds Transfer (EFT) Standardization MM5586 Globe to indicate www link.
July 2008
07/18/08 MM5511 Influenza Billing for Part B (MM5511) Globe to indicate www link.
07/18//08 MM5624 Skilled Nursing Facility (SNF) Consolidated Billing (CB) Editing (MM5624) Globe to indicate www link.
07/13/08 MM5637 >National Provider Identifier (NPI) Required to Enroll in Electronic Data Interchange (EDI), and Update of Telecommunication and Transmission Protocols for EDI (MM5637) Globe to indicate www link.
07/13/08 MM5660 Percutaneous Transluminal Angioplasty (PTA) (MM5660) Globe to indicate www link.
07/13/08 MM5597 Provider Customer Service Program Updates (MM5597) Globe to indicate www link.
07/05/08 MM5460 Appeals Claim Decisions (MM5460) Globe to indicate www link.
07/05/08 MM5629 HPSA Claims Processing Modifiers QB & QU (MM5629) Globe to indicate www link.
07/05/08 MM5625 Health Professional Shortage Area (HPSA) - Billing and Payment (MM5625) Globe to indicate www link.
07/05/08 MM5613 Missed Appointments (MM5613) Globe to indicate www link.
07//08 MM
07//08 MM
07//08 MM
June 2008
06/27/08 MM5662 Notifying Affected Parties Regarding Changes to the Mandatory Medigap ("Claim-Based") Crossover Process (MM5662) Globe to indicate www link.
06/27/08 MM5634 Update of Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) and Enhancement of Medicare Remit Easy Print (MREP) (MM5634) Globe to indicate www link.
06/27/08 MM5612 Vagus Nerve Stimulation (VNS) for Resistant Depression (MM5612) Globe to indicate www link.
06/22/08 MM5564 NPI Reporting Requirements for Ambulance Service Claims (MM5564) Globe to indicate www link.
06/22/08 MM5614 Update to the 2007 Medicare Physician Fee Schedule Database (MPFSDB) (MM5614) Globe to indicate www link.
06/22/08 MM5636 October Quarterly Update to 2007 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement (MM5636) Globe to indicate www link.
06/22/08 MM5643 Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) (MM5643) Globe to indicate www link.
06/22/08 MM5646 July 2007 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective July 1, 2007, and Revisions to January 2007, April 2007, and October 2006 Quarterly ASP Medicare Part B Drug Pricing Files (MM5646) Globe to indicate www link.
06/14/08 MM5536 Scope of Portable X-ray Benefit (MM5536) Globe to indicate www link.
06/07/08 MM5641 July, 2007 Quarterly Update to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule (MM5641) Globe to indicate www link.
06/07/08 SE0724 Medicare Payment for Ambulance Transports (SE0724) Globe to indicate www link.
06/07/08 MM5645 July, 2007 Quarterly Update to the HCPCS Codes for Albuterol, Levalbuterol, and Reclast® (MM5645) Globe to indicate www link.
06/07/08 MM5635 Immune Globulin- Revised HCPCS Codes (MM5635) Globe to indicate www link.
06/04/08 MM5616 CMS-1500 Claim Form (8/05) New Submission Deadline (MM5616) Globe to indicate www link.
06/04/08 MM5584 Unique Physician Identification Number Discontinuance (MM5584) Globe to indicate www link.
06/04/08 MM5452 Stage 3 NPI Changes for Transaction 835 and Standard Paper Remittance Advice (MM5452) Globe to indicate www link.
May 2008
05/30/08 SE00707 Overview of Medicare Podiatry Services (SE0707) Globe to indicate www link.
05/30/08 MM5640 Physician Quality Reporting Initiative (PQRI) Coding and Reporting Principles (MM5640) Globe to indicate www link.
05/30/08 MM5607 Correct Coding Initiative (CCI) Edits- Version 13.2 (MM5604) Globe to indicate www link.
05/30/08 MM5603 Medically Unlikely Edits (MUEs) Version 1.2 (MM5603) Globe to indicate www link.
05/30/08 MM5601 Mandatory Medigap Cross-Over Process to the COB Contractor (MM5601 Globe to indicate www link.
05/30/08 MM5543 Jurisdictional Pricing Rules for All Purchased Diagnostic Service Claims (MM5543) Globe to indicate www link.
05/30/08 MM5520 Discarded Drugs & Biologicals- Modifier JW (MM5520) Globe to indicate www link.
05/22/08 MM5521 Bone Mass Measurements (MM5521) Globe to indicate www link.
05/14/08 SE0721 Provider Authentication Requirements for Telephone and Written Inquires during the Medicare FFS National Provider Identifier (NPI) Contingency Plan (SE0721) Globe to indicate www link.
05/11/08 MM5554 Medicare Redetermination Notice (MM5554) Globe to indicate www link.
05/11/08 MM5530 Blood Brain Barrier Osmotic Disruption for Treatment of Brain Tumors (MM5530 Globe to indicate www link.
05/02/08 MM5587 Invalid Skilled Nursing Facility (SNF) Informational Unsolicited Responses (IURs) from CWF (MM5587) Globe to indicate www link.
05/02/08 MM5527 Instructions for Implementation of CMS 1536-R; Astigmatism-Correcting Intraocular Lens (A-C IOLs) (MM5527) Globe to indicate www link.
05/02/08 MM5477 Clarification of Bariatric Surgery Billing Requirements (MM5477) Globe to indicate www link.
April 2008
04/26/07 MM05480 Requirements for Providing Route of Administration Codes for Erythropoiesis Stimulating Agents (ESAs) (MM5480) Globe to indicate www link.
04/25/07 MM5595 Medicare Fee-For-Service (FFS) National Provider Identifier (NPI) Implementation Contingency Plan (MM5595) Globe to indicate www link.
04/25/07 MM5347 Common Working File (CWF) Duplicate Claim Edit for the Technical Component (TC) of Radiology and Pathology Laboratory Services Provided to Hospital Patients (MM5347) Globe to indicate www link.
04/20/07 MM5538 Part C and D Plan Type Display on the Common Working File (CWF)- This CR rescinds and fully replaces CR 5349 (MM5538) Globe to indicate www link.
04/20/07 MM5516 Ventricular Assist Devices (VADs) (MM5516 Globe to indicate www link.
04/12/07 MM5508 Provider Education for Handling NPI Issues Related to Deceased Providers (MM5508) Globe to indicate www link.
04/02/07 MM5541 Update to Medicare Claims Processing Manual, Publication 100-04, Chapter 18, Section 60.1 Regarding Colorectal Screening Services (MM5541) Globe to indicate www link.
04/02/07 MM5533 Ambulance Fee Schedule-Ground Ambulance Services- Revision to the Specialty Care Transport (SCT) Definition (MM5533) Globe to indicate www link.
04/02/07 MM5518 Change in the Amount in Controversy Requirement for Federal District Court Appeals (MM5518 Globe to indicate www link.
04/02/07 MM5489 CMS-1500 Claim Form Revisions (MM5489) Globe to indicate www link.
March 2008
03/22/07 MM5568 Extension for Acceptance of Form CMS-1500 (12/90) (MM5568) Globe to indicate www link.
03/22/07 MM5517 Average Sales Price (ASP)- April 2007 Update (MM5517) Globe to indicate www link.
03/22/07 MM5488 Administrative Simplification Compliance Act (ASCA)- Exception List for MSP Claims, Temporary Edition (MM5488) Globe to indicate www link.
03/22/07 MM5464 Extracorporeal Photopheresis (MM5464) Globe to indicate www link.
03/14/07 MM5558 2007 Physician Quality Reporting Initiative (PQRI) Program Overview (MM5558) Globe to indicate www link.
03/14/07 MM5537 April Quarterly Update for 2007 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule (MM5537) Globe to indicate www link.
03/14/07 MM5514 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2007 (MM5514) Globe to indicate www link.
03/14/07 MM5495 Medically Unlikely Edits (MUEs) (MM5495) Globe to indicate www link.
03/14/07 MM5492 Quarterly Update to Correct Coding Initiative (CCI) Edits,Version 13.1, Effective April 1, 2007 (MM5492) Globe to indicate www link.
03/14/07 MM5484 New Waived Tests (MM5484) Globe to indicate www link.
03/14/07 MM5482 New Waived Tests- Correction to CR5404 (MM5482) Globe to indicate www link.
03/14/07 MM5208 (Revised) Use of Nine-Digit ZIP codes for Determining the Correct Payment Locality for Services Paid Under the Medicare Physician Fee Schedule (MPFS) and Anesthesia Services (MM5208) Globe to indicate www link.
03/12/07 SE0712 Common Billing Errors To Avoid When Billing Medicare Carriers (SE0712) Globe to indicate www link.
03/08/07 MM5442 Ambulance Fee Schedule- Medical Conditions List-Manualization Revisions (MM5442) Globe to indicate www link.
03/08/07 MM5528 2007 Medicare Physician Fee Schedule Database - April Update (MM5428) Globe to indicate www link.
03/08/07 MM5427 Services Not Provided Within the United States (MM5427) Globe to indicate www link.
03/08/07 MM5391 Revisions to Incomplete or Invalid Claims Instructions Necessary to Implement the Revised Health Insurance Form CMS-1500 (08/05) (MM5391) Globe to indicate www link.
03/08/07 SE0709 Medicare Provides Coverage of Prostate Cancer Screening for Eligible Medicare Beneficiaries (SE0709) Globe to indicate www link.
February 2008
02/23/07 MM5472 Differentiating Mass Adjustments from Other Types of Adjustments and Claims for Crossover Purposes and Revising the Detailed Error Report Special Provider Notification Letters (MM5472) Globe to indicate www link.
02/19/07   Physician Quality Reporting Initiative (PQRI) (JSM-07226)
02/09/07 MM5221 Direct Billing and Payment for Non-Physician Practitioner (NPP) Services Furnished to Hospital Inpatients and Outpatients (MM5221) Globe to indicate www link.
02/09/07 MM5349 Part C Plan Type Display on Medicare's Common Working File (CWF) (MM5349) Globe to indicate www link.
02/09/07 MM5421 Infrared Therapy Services. (MM5421) Globe to indicate www link. Transmittal 1127, Change Request 5421, dated December 15, 2006 is rescinded and replaced by Transmittal 1183, dated February 9, 2007. An incorrect code was listed in the Business Requirements in 5421.2, and in the manual section 20.4. The correct code should be 880.00-887.7. All other material remains the same.
02/09/07 MM5457 Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits (MM5457) Globe to indicate www link.
02/06/07 MM5355 Timeliness Standards for Processing Other-Than-Clean Claims (MM5355) Globe to indicate www link.
0206//07 MM5253 Competitive Acquisition Program (CAP) - Claim Processing for Not Otherwise Classified (“NOC”) Drugs (MM5259) Globe to indicate www link.
02/06/07 MM5208 Use of Nine-Digit ZIP codes for Determining the Correct Payment Locality for Services Paid Under the Medicare Physician Fee Schedule (MPFS) and Anesthesia Services (MM5208) Globe to indicate www link.
January 2008
01/31/07 MM5507 Update on CMS Actions to Reverse Invalid Overpayments Generated by Managed Care Informational Unsolicited Responses (MCIURs) - (Invalid MCIURs from the Common Working File (CWF)) (MM5507) Globe to indicate www link.
01/31/07 MM5498 Additional Changes to the 2007 Medicare Physician Fee Schedule Database (MPFSDB) (MM5498 Globe to indicate www link.
01/31/07 MM5462 Coding Change for Lumbar Artificial Disc Replacement (LADR) (MM5462) Globe to indicate www link.
01/31/07 MM5456 Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update (MM5456) Globe to indicate www link.
01/25/07 MM5441 Processing All Diagnosis Codes Reported on Claims Submitted to Carriers (MM5441 Globe to indicate www link.
01/25/07 MM5387 Colorectal Cancer Screening Flexible Sigmoidoscopy and Colonoscopy Coinsurance Payment Change (MM5387) Globe to indicate www link.
04//07 MM5253 Outpatient Therapy-Additional Deficit Reduction Act Mandated Service Edits (MM5253) Globe to indicate www link.
04//07 MM5131 Correction to CR4136: New Waived Tests (MM5131) Globe to indicate www link.
01/18/07 MM5424 Enhance the Multi-Carrier System (MCS) to Avoid Duplicate Payments When a Full Claim Adjustment is Performed (MM5424) Globe to indicate www link.
  • Application of All Diagnosis Codes Reported in Processing Carrier Claims (MM5390) Globe to indicate www link.
    		•
    01/16/07 SE0703 Assignment of Dedicated Medicare Secondary Payer Modifier Introduced in Change Request (CR) 5332 (Transmittal 1088) (SE0703) Globe to indicate www link.
    01/16/07 MM5468 Tax Relief and Health Care Act of 2006 (MM5468) Globe to indicate www link.
    01/16/07 MM5432 Intracranial Percutaneous Transluminal Angioplasty (PTA) with Stenting (MM5432) Globe to indicate www link.
    01/16/07 MM5396 Chiropractic Demonstration 2007 Rate Change (MM5396) Globe to indicate www link.
    01/10/07 MM4321 Healthcare Common Procedure Coding System (HCPCS) Codes Subject to, and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits (MM4321) Globe to indicate www link.
    01/09/07 SE0680 The New HHS National Clearinghouse for Long-Term Care Information Website SE0680 Globe to indicate www link.
    01/09/07 MM5478 Outpatient Therapy Cap Exception Process for 2007 (MM5478 Globe to indicate www link.
    01/09/07 MM5332 Instructions for the Coordination of Medicare Secondary Payer (MSP) claims for the Competitive Acquisition Program (CAP) (MM5332 Globe to indicate www link.
    01/04/07 SE0679 Medicare Fee for Service (FFS) Implementation of the National Provider Identifier (NPI) (SE0679) Globe to indicate www link.
    01/04/07 SE0681 Medicare Fee-for-Service (FFS) and Medicare Advantage (MA) Eligibility System Issues (SE0681) Globe to indicate www link.
    01/02/07 MM5365 Payment Allowances for the Influenza Virus Vaccine (CPT Codes 90655, 90656, 90657, and 90658) and the Pneumoccocal Vaccine (CPT 90732) When Payment is Based on 95 Percent of the Average Wholesale Price (AWP) (MM5365) Globe to indicate www link.
    01/02/07 MM5386 Revisions to Procedures to Establish Good Cause and Qualified Independent Contractor (QIC) Jurisdictions (MM5386) Globe to indicate www link.
    01/02/07 MM5426 Private Contracting- Definition of Physician/Practitioner (MM5426) Globe to indicate www link.
    01/02/07 MM5428 Medicare Payment for Pre-administration-Related Services Associated with IVIG Administration (MM5428) Globe to indicate www link.
    01/02/07 MM5443 Physician Fee Schedule Payment Policies (MM5443) Globe to indicate www link.
    01/02/07 MM5459 Emergency Update to the 2007 Medicare Physician Fee Schedule Database (MPFSDB) (MM5459) Globe to indicate www link.

     

    Curved image to close content area