Transmittals and MLN Matters articles: CMS revises POA process, updates IRF PPS, issues special article on medical record retention, and more
Medicare Weekly Update, August 17, 2010
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CMS revises POA instructions
On August 13, CMS issued a transmittal to instruct on present-on-admission (POA) reporting. Effective with the implementation of 5010, IPPS hospitals shall no longer report the POA indicator of 1. ICD-9-CM diagnosis codes that are exempt from reporting POA shall be left blank instead of populating a 1.
Effective date: January 1, 2011
Implementation date: January 3, 2011
CMS makes CWF changes to accommodate OSCs greater than 10
On August 13, CMS issued a transmittal to revise the common working file (CWF) to allow occurrence span codes (OSC) beyond the currently billable limit of 10. The long-term care PPS, inpatient rehabilitation facility PPS, and inpatient psychiatric facility PPS require a single claim to be billed for an entire stay. Interim claims may be submitted to continually adjust all prior submitted claims for the stay until the beneficiary is discharged. In some instances, significantly long stays having numerous OSCs may exceed the amount of OSCs allowed to be billed on a claim.
Effective date: October 1, 2002
Implementation date: January 3, 2011
CMS updates IRF PPS pricer
On August 13, CMS issued a transmittal to update the inpatient rehabilitation facility (IRF) prospective payment system (PPS) pricer for fiscal year 2011.
Effective date: October 1, 2010
Implementation date: October 4, 2010
CMS issues special edition article on medical record retention
On August 10, CMS issued a special edition MLN Matters article on medical record retention and appropriate media formats for medical records. Among other topics, the article discusses retention requirements under HIPAA and state law.
View the special edition MLN Matters article.
CMS revises fraud edit module requirements
On August 6, CMS issued a transmittal to make several changes to processes regarding the fraud edit module. Among the changes is a requirement that providers have appeal rights if services are denied under the module edits and that contractors must work individually with providers if the providers contact the contractor regarding denials made without appeal rights.
Effective date: September 6, 2010
Implementation date: September 6, 2010
CMS makes backend changes to better identify dual eligibles
On August 6, CMS issued a transmittal to implement processes for identifying dual eligible beneficiaries. The new processes will assist program safeguard contractors (PSC)/zone program integrity contractors (ZPIC) in detecting fraud across the Medicare/Medicaid programs.
Effective date: January 1, 2011
Implementation date: January 3, 2011
CMS replaces transmittal
On August 13, CMS issued a transmittal to rescind and replace a transmittal previously outlined in Medicare Weekly Update.
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