Corporate Compliance

Transmittals and MLN Matters articles: CMS instructs on clinical trials, incorporates "compendia" definition into manual system, and more

Medicare Insider, February 2, 2010

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CMS corrects processing of non-covered revenue codes

On January 29, CMS issued a transmittal to change how Medicare systems process revenue code lines submitted with non-covered charges.

Effective date: July 1, 2010
Implementation date: July 6, 2010

View the transmittal.

CMS instructs on clinical trials billing

On January 29, CMS revised the Claims Processing Manual to allow reporting of ICD-9-CM V70.7 (examination of participant in clinical trial), as the primary diagnosis—instead of the secondary diagnosis—for healthy control group volunteers.

Effective date: September 19, 2000
Implementation date: July 6, 2010

View the transmittal.

CMS revises SOM

On January 29, CMS issued revisions to the State Operations Manual related to critical access hospitals.

Effective date: January 29, 2010
Implementation date: January 29, 2010

View the transmittal.

CMS addresses “compendia” definition

On January 29, CMS issued a transmittal to incorporate into the Benefit Policy Manual the regulatory definition of “compendia” for use in the determination of a medically-accepted indication of drugs and biologicals used off-label in an anti-cancer chemotherapeutic regimen.

Effective date: January 1, 2010
Implementation date: March 1, 2010

View the transmittal.

CMS implements changes for dialysis reporting

On January 29, CMS issued a transmittal to implement new reporting for dialysis adequacy, infection, and vascular access, allowing CMS to implement an accurate quality incentive payment for dialysis providers by January 1, 2012, as required by MIPPA.

Effective date: July 1, 2010
Implementation date: July 6, 2010

View the transmittal.

CMS revises I/OCE rewrite transmittal

CMS rescinded and replaced a previous transmittal regarding the I/OCE rewrite.

MLN Matters article

CMS issued an MLN Matters article related to a transmittal previously outlined in Medicare Weekly Update.



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