Transmittals and MLN Matters articles: CMS instructs on billing for voluntary ABNs, issues RAC transmittal, and more
Medicare Weekly Update, November 3, 2009
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CMS issues RAC transmittal
On October 30, CMS issued a transmittal to the Medicare Financial Management Manual pertaining to the RAC national program.
Effective date: December 15, 2009
Implementation date: December 15, 2009
CMS issues guidance on HCPCS remittance advice
On October 30, CMS issued a transmittal in which it updated the remittance advice to use the payment APC, rather than the HCPCS APC.
Effective date: April 1, 2010
Implementation date: April 5, 2010
CMS issues further instructions on fraud edit reporting
On October 30, CMS issued a transmittal in which it further outlines the requirements of its fraud edit module.
Effective date: April 1, 2010
Implementation date: April 5, 2010
CMS issues billing guidance on voluntary use of ABNs
On October 29, CMS issued revisions to the Claims Processing Manual in which it provides guidance on the use of modifiers when billing services for which an ABN has been provided voluntarily to the patient.
Effective date: April 1, 2010
Implementation date: April 5, 2010
CMS instructs on processing claims rejecting for gender/procedure conflict
On October 28, CMS issued instructions to correct the problem of claims for some beneficiaries being rejected in the MCE, IOCE, and CWF due to gender-specific edits. This is resulting in inappropriate denials for Part A and Part B claims.
Effective date: April 1, 2010
Implementation date: April 5, 2010
View a related MLN Matters article.
CMS issues guidance on non-covered procedures
On October 28, CMS issued a transmittal in which it instructed providers to submit ICD-9 CM codes for non-covered procedures performed in the same inpatient stay with covered procedure(s) on a separate claim.
Effective date: April 1, 2010
Implementation date: April 5, 2010
CMS re-issues HCPCS update reminder
On October 28, CMS re-issued a transmittal to remind its contractors of the annual HCPCS update.
Effective date: January 1, 2010
Implementation date: January 4, 2010
MLN Matters articles
CMS issued two MLN Matters articles related to transmittals previously outlined in Medicare Weekly Update.
- Coverage of Inpatient Rehabilitation Services
- Reasonable Charge Update for 2010 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, and Certain Intraocular Lenses
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