Corporate Compliance

Transmittals and MLN Matters articles: CMS posts MRA coverage changes, implements PPACA changes, and more

Medicare Insider, July 13, 2010

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CMS instructs on MRA coverage

On July 9, CMS issued transmittals to the National Coverage Determinations Manual and the Claims Processing Manual regarding magnetic resonance angiography (MRA). Because MRA is a specific application of magnetic resonance imaging (MRI), CMS is combining their coverage provisions. The effect of this change will maintain existing national coverage for both MRI and MRA, and will eliminate the non-coverage language that currently exists for MRA at Section 220.3 of the National Coverage Determinations Manual, thereby permitting local Medicare contractors to cover all indications of MRA (and MRI) that are not specifically nationally covered or nationally non-covered.

Effective date: June 3, 2010
Implementation date: August 9, 2010

View the National Coverage Determinations Manual transmittal.

View the Claims Processing Manual transmittal.

CMS implements IPPS, OPPS, LTC, IRF updates

On July 8, CMS issued a transmittal to outline changes for IPPS hospitals for FY 2010, LTCHs for RY 2010, IRFs for FY 2010, and OPPS for CY 2010 as a result of the Patient Protection and Affordable Care Act (PPACA). These changes have various retroactive effective dates; CMS will soon post instructions regarding how to handle past claims paid under pre-PPACA requirements.

Effective date: Various
Implementation date: August 9, 2010

View the transmittal.

CMS posts ICD-9-CM update reminder

On July 2, CMS issued a transmittal to notify Medicare contractors of the ICD-9-CM update that is effective for dates of service on and after October 1, 2010.

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

View the transmittal.

View a related MLN Matters article.

CMS adds defibrillator verbiage to Claims Processing Manual

On July 2, CMS issued a transmittal to incorporate information previously omitted from the Medicare Claims Processing Manual regarding automatic implantable cardiac defibrillator services. There is no change to current policy.

Effective date: August 31, 2010
Implementation date: August 31, 2010

View the transmittal.

CMS posts special MLN Matters article on alcohol/substance abuse services

On July 7, CMS issued a special edition MLN Matters article regarding Medicare reporting and payment of services for alcohol and/or substance (other than tobacco) abuse structured assessment and brief intervention (SBIRT) services. SBIRT is an early intervention approach that targets those with nondependent substance use to provide effective strategies for intervention prior to the need for more extensive or specialized treatment.

View the special edition article.



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