Corporate Compliance

Transmittals and MLN Matters articles: CMS instructs on timely filing, implements IPF interrupted stay policy, and more

Medicare Insider, August 3, 2010

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CMS makes backend changes for deceased kidney recipients

On July 30, CMS issued a transmittal to make changes to the common working file (CWF) regarding kidney transplants when the recipient is deceased. CMS allows donor expenses incurred after the death of the recipient to be treated as incurred before the death of the recipient. However, when these claims are received in CWF, they are rejecting. This transmittal allows contractors to override this when a donor is receiving services related to the procedure and the kidney transplant recipient has died.

Effective date: January 1, 2011
Implementation date: January 3, 2011

View the transmittal.

CMS provides additional timely filing instructions

On July 30, CMS issued a transmittal to provide additional guidance regarding timely filing requirements. The transmittal establishes standards for determining the date of service for claims billed with line item span dates.

Effective date: January 1, 2011
Implementation date: January 3, 2011

View the transmittal.

CMS implements interrupted stay policy for IPFs

On July 29, CMS issued a transmittal to implement an interrupted stay policy under the inpatient psychiatric facility (IPF) prospective payment system. An interrupted stay is a case in which a patient is discharged from an IPF and is readmitted to the same or another IPF before midnight on the third consecutive day following discharge from the original IPF stay. Interrupted stays are considered to be continuous for the purposes of applying the variable per diem adjustment whether the interrupted stay is to the same IPF or not. For an interrupted stay to the same IPF, interrupted stays are considered to be continuous for determining if the case qualifies for an outlier payment.

Effective date: January 1, 2011
Implementation date: January 3, 2011

View the transmittal.

CWF to accept MSP and non-MSP lines on same claim

On July 29, CMS issued a transmittal to implement changes to the common working file (CWF) that will allow it to accept both Medicare secondary payer (MSP) and non-MSP lines on the same claim and not to send the 5414 error code when MSP and non-MSP lines appear on the same claim.

Effective date: January 1, 2011: MCS Analysis and Design; April 1, 2011: VMS and CWF
Implementation date: April 4, 2011

View the transmittal.



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