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Transmittals and MLN Matters articles: CMS replaces ICD-9-CM transmittal, modifies pricers, and more

Medicare Weekly Update, August 10, 2010

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CMS rescinds and replaces ICD-9-CM update

On August 4, CMS issued a transmittal to replace its previous instruction regarding implementation of updated ICD-9-CM codes. CMS has revised the table attachments for that change request; all other information remains the same.

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

View the transmittal.

View the related MLN Matters article.

CMS implements automated MSP process for certain situations

On July 30, CMS issued instructions to the common working file (CWF) to implement an automated process to reopen certain Medicare secondary payer (MSP) claims when MSP group health plan (GHP) records were deleted or, under some circumstances, certain MSP GHP records were terminated and claims were denied due to MSP or Medicare made a secondary payment before the termination date was accreted.

Effective date: January 1, 2011 Analysis and Design; April 1, 2011 Coding and Implementation
Implementation date: January 3, 2011 Analysis and Design; April 4, 2011 Coding and Implementation

View the transmittal.

View a related MLN Matters article.

CMS makes pricer changes to accommodate increased code processing

On July 30, CMS issued a transmittal to make changes to the pricers for the IPPS, IPF PPS, and SNF PPS. With the implementation of the 5010 837I transaction in January 2011, the number of ICD-9-CM diagnosis and procedure codes are being expanded from 9 and 6 to 25 and 25. For example, CMS is modifying grouper and Medicare code editor to process more ICD-9-CM codes to determine the appropriate MS-DRG.

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

View the transmittal.

View a related MLN Matters article.

MLN Matters articles

CMS released the following MLN Matters articles related to transmittals previously outlined in Medicare Weekly Update.

• Common Working File (CWF) Override Edit for Kidney Transplant Donor Claims When the Kidney Recipient is Deceased
• Timely Claims Filing: Additional Instructions
• Revised Instructions for Reporting Assessment Dates under the Inpatient Rehabilitation Facility (IRF), Skilled Nursing Facility (SNF), and Swing Bed (SB) Prospective Payment Systems (PPS)
• Implementation of the Interrupted Stay Policy under the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)

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