Transmittals and MLN Matters articles: CMS implements OIVIT NCD, deletes point of origin codes, and more
Medicare Weekly Update, February 9, 2010
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HCPCS codes subject to CLIA edits
On February 5, CMS issued a transmittal documenting the new HCPCS codes for 2010 subject to Clinical Laboratory Improvement Amendments (CLIA) edits and excluded from CLIA edits.
Effective date: January 1, 2010
Implementation date: April 5, 2010
CMS revises Claims Processing Manual language
On February 5, CMS issued a transmittal updating Chapter 25 of the Claims Processing Manual, changing “FI” to "FI or A/B MAC," as well as other CR updates.
Effective Date: April 14, 2010
Implementation Date: April 14, 2010
CMS introduces new SNF consolidated billing edit
On February 5, CMS issued a transmittal announcing the creation of a new skilled nursing facility (SNF) consolidated billing edit to prevent separate payment for facility costs billed by ambulatory surgical centers for Medicare beneficiaries in Part A SNF stays.
Effective Date: January 1, 2008
Implementation Date: July 6, 2010
CMS changes clotting factor furnishing fee language
On February 5, CMS issued a transmittal detailing the change of all references of “IU” to “units” to more appropriately address the clotting factor furnishing fee.
Effective Date: January 1, 2005
Implementation Date: March 5, 2010
Medicare coverage denied for outpatient intravenous insulin therapy
On February 5, CMS issued two transmittals to implement an NCD for outpatient intravenous insulin therapy (OIVIT). CMS determined that OIVIT does not improve health outcomes in Medicare beneficiaries and is not reasonable and necessary under section 1862(a)(1)(A) of the Social Security Act. Therefore, OIVIT and services comprising an OIVIT regimen are nationally non-covered by Medicare.
Effective date: December 23, 2009
Implementation date: March 8, 2010
View the National Coverage Determinations Manual transmittal.
View the Claims Processing Manual transmittal.
New waived tests
On February 5, CMS issued a transmittal instructing contractors of new waived tests approved by the Food and Drug Administration under Clinical Laboratory Improvement Amendments of 1988.
Effective Date: April 1, 2010
Implementation Date: April 5, 2010
CMS deletes point of origin codes
On February 5, CMS issued a transmittal documenting the deletion of point of origin for admission or visit (formerly source of admission) codes by the National Uniform Billing Committee (NUBC).
Effective Date: July 1, 2010
Implementation Date: July 6, 2010
CMS implements quarterly NCCI updates
On February 5, CMS issued a transmittal with the quarterly updates to National Correct Coding Initiative (NCCI) edits.
Effective Date: April 1, 2010
Implementation Date: April 5, 2010
CMS revises language for model approval letters
On February 5, CMS issued a transmittal which revises existing model provider enrollment language for model approval letters.
Effective Date: March 8, 2010
Implementation Date: March 8, 2010
Change request for ACE demonstrations project
On February 5, CMS issued a transmittal detailing a change request to implement the necessary requirements for the acute care episode (ACE) demonstration project. Under the ACE demonstration, CMS is issuing a single global payment to an institution for both the hospital and physician components of the episode of care.
Effective Date: July 1, 2010
Implementation Date: July 6, 2010
MLN Matters articles
CMS issued several MLN Matters articles related to transmittals previously outlined in Medicare Weekly Update.
- April 2010 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
- MCS Changes Needed to Automate the Annual Update to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
- Correction to Processing of Non-Covered Revenue Codes
- Revision of Definition of Compendia as Authoritative Source for Use in the Determination of a Medically-Accepted Indication of Drugs/Biologicals Used Off-label in Anti-Cancer Chemotherapeutic Regimens
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