Corporate Compliance

CMS Transmittals and MLN Matters articles

Medicare Insider, January 22, 2008

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CMS issues clarification of coverage and billing requirements for bone mass measurement tests

On January 18, CMS issued a transmittal clarifying coverage and billing requirements for bone mass measurement tests.

Effective date: January 1, 2007
Implementation date: February 20, 2008

View the transmittal.

CMS issues changes to modifiers used in billing for clinical research studies

On January 18, CMS issued a transmittal changing the HCPCS modifiers used to differentiate between routine and investigational patient care services furnished in connection with clinical research studies.

Effective date: January 1, 2008
Implementation date: April 7, 2008

View the transmittal.

CMS issues January 2008 Update of the Hospital Outpatient Prospective Payment System

On January 18, CMS issued a transmittal announcing the release of the January 2008 Update of the Hospital Outpatient Prospective Payment System.

Effective date: January 1, 2008
Implementation date: January 7, 2008

View the transmittal.

CMS re-issues January 2008 Integrated Outpatient Code Editor specifications

On January 18, CMS re-issued the January 2008 Integrated Outpatient Code Editor specifications (version 9.0). The new transmittal replaces Transmittal 1403 to the Medicare Claims Processing Manual, issued on December 28, 2007. According to CMS, the revised transmittal changes the status indicators for brachytherapy and radiopharmaceutical codes. 

Effective date: January 1, 2008
Implementation date: January 7, 2008

View the transmittal.

CMS issues notice of new interest rate for Medicare overpayments and underpayments

On January 11, CMS issued a transmittal announcing the quarterly update of the interest rate for Medicare overpayments and underpayments. The new interest rate is 12.125%.

Effective date: January 18, 2008
Implementation date: January 18, 2008

View the transmittal.

CMS issues corrected transmittal revising manual instruction on orders for diagnostic tests

On January 11, CMS issued a transmittal correcting a previous revision to its manual instructions relating to orders for diagnostic tests. According to CMS, most of the information added to the manual is not applicable in a hospital setting. See the "Note from Hugh" in the December 18, 2007 Medicare Weekly Update for a discussion of the potential applicability of these manual instructions to hospitals.

Effective date: January 1, 2003
Implementation date: November 19, 2007

View the transmittal.

CMS issues three transmittals related to the coverage and billing requirements applicable to claims for Erythropoiesis Stimulating Agents (ESAs)

Last week, CMS issued three transmittals related to coverage and billing for ESAs (see "Note from Hugh," above). The transmittals include:

  • Transmittal 1412 to the Medicare Claims Processing Manual

Effective date: January 1, 2008
Implementation date: April 7, 2008

View the transmittal.

  • Transmittal 1413 to the Medicare Claims Processing Manual

Effective date: July 30, 2007
Implementation date: April 7, 2008

View the transmittal.

  • Transmittal 80 to the Medicare National Coverage Determinations

Effective date: July 30, 2007
Implementation date: April 7, 2008

View the transmittal.

View a related MLN Matters article.

CMS issues April 2008 update to the Medicare Code Editor and Grouper

On January 11, CMS issued a transmittal announcing that patient status code 70 will be implemented in the April 2008 update to the Medicare Code Editor and Grouper.  Patient status code 70 is defined as "Discharges or Transfers to Other Types of Health Care Institutions not defined elsewhere in the UB-04 (CMS-1450) Manual Code List."

Effective date: April 1, 2008
Implementation date: April 7, 2008

View the transmittal.

View a related MLN Matters article.



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