Corporate Compliance

Transmittals and MLN Matters articles: CMS posts drug pricing files, issues special MLN Matters article for IPFs, and more

Medicare Insider, June 22, 2010

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CMS updates list of HCPCS excluded from SNF consolidated billing

On June 18, CMS issued a transmittal posting the October update to the list of codes that are excluded from the SNF consolidated billing provision, and therefore separately payable to non-SNF providers for SNF residents.

Effective date: October 1, 2010
Implementation date: October 4, 2010

View the transmittal.

CMS updates list of codes subject to CLIA edits

On June 18, CMS issued a transmittal with additional laboratory codes subject to editing to ensure the rendering provider has an appropriate CLIA certificate prior to payment.

Effective date: January 1, 2009
Implementation date: July 19, 2010

View the transmittal.

CMS reorganizes Program Integrity Manual

On June 18, CMS reorganized the Program Integrity Manual to consolidate enrollment requirements in Chapter 15 entitled “Medicare Enrollment.” The transmittal also incorporates a limited number of changes to existing manual sections.

Effective date: July 1, 2011
Implementation date: July 5, 2011

View the transmittal.

CMS posts quarterly drug pricing files

On June 18, CMS issued a transmittal to implement the October 2010 quarterly average sales price Medicare Part B drug pricing files and make revisions to prior quarterly pricing files.

Effective date: October 1, 2010
Implementation date: October 4, 2010

View the transmittal.

CMS replaces transmittal

On June 18, CMS issued a transmittal to rescind and replace a previous one-time notification.

Requirement for Submission of Shared Systems Data to the Integrated Data Repository (IDR)

MLN Matters articles

CMS released a special edition MLN Matters article reminding inpatient psychiatric facilities (IPF) to use source of admission code D for patient transfers within the same facility. When there is a transfer within the same inpatient facility, this code D ensures that the hospital-based IPF does not receive an additional payment for the costs of emergency department services that Medicare covers in its payment to the acute-care hospital.

View the special edition MLN Matters article.

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



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