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New CMS publications offer plain-English HIPAA guidance

Case Management Weekly, March 17, 2004

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New CMS publications offer plain-English HIPAA guidance

Five brief instructional texts published in February by the Centers for Medicare and Medicaid Services (CMS) cover recent changes in HIPAA regulations that could affect the way your claims are processed. The new publications are part of a larger series on a variety of Medicare issues called Medlearn Matters (MM). The publications cover many of the same topics addressed in the agency's program transmittals, but in a conversational, more direct tone. To see the difference, compare transmittal MM2981 to its counterpart, R114CP.

The five MM publications cover the following policy changes (each of the first four policy changes take effect on July 1, 2004):

·      Covered entities will have to wait 13 extra days to receive payment for noncompliant claims (MM2981)

·      All claims must include certain information not needed for claims processing, but required by HIPAA (MM3031)

·      Covered entities must stop submitting electronic claims with diagnosis codes, zip codes, or telephone numbers that are not HIPAA compliant (MM3050)

·      Medicare durable medical equipment regional carriers will change their systems to allow segments to be transmitted in any order (MM3095)

·      Effective January 1, 2005, Medicare providers will no longer have a 90-day grace period to use discontinued HCPCS codes (MM3093)

You can download Medlearn Matters releases at http://www.cms.hhs.gov/medlearn/matters/

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