Corporate Compliance

Transmittals and MLN Matters articles: CMS expands IPPS transfer policy, issues article on ICD-10 implementation, implements edits, and more

Medicare Insider, November 16, 2010

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CMS expands IPPS transfer policy

On November 12, CMS issued a transmittal to expand the current IPPS transfer policy. Currently, a discharge of an acute hospital inpatient is considered to be a transfer for purposes of payment if the discharge is made from the acute hospital to the care of another inpatient prospective payment system (IPPS) hospital. Effective October 1, discharges to critical access hospitals (CAH) and non-participating hospitals will also fall under the transfer policy.

Effective date: October 1, 2010
Implementation date: April 4, 2011

View the transmittal.

CMS issues special article on code freeze

CMS has posted a special edition MLN Matters article on the partial code freeze prior to ICD-10 implementation.

View the MLN Matters article.

CMS implements waiver of coinsurance/deductible for RHC preventive services

On November 12, CMS issued a transmittal to waive coinsurance and deductible for preventive services with a United States Preventive Services Task Force grade of A or B when provided in rural health clinics (RHC).

Effective date: January 1, 2011
Implementation date: April 4, 2011

View the transmittal.

CMS updates frequency billing requirements

On November 12, CMS issued a transmittal to update to the frequency billing requirements to include pulmonary rehabilitation services, revenue code 0948, to the list of repetitive Part B services.

Effective date: April 1, 2011
Implementation date: April 4, 2011

View the transmittal.

CMS implements edits for IPFs

On November 12, CMS issued a transmittal to implement edits under the inpatient psychiatric facility (IPF) PPS for emergency department adjustments where the costs for the emergency department services are already covered by another Medicare payment.

Effective date: April 1, 2011
Implementation date: April 4, 2011

View the transmittal.

CMS issues guidance on therapy billing for institutional claims

On November 12, CMS issued a transmittal to create new edits in the Medicare claims processing systems to ensure correct billing of therapy-related codes on institutional claims. CMS instructed Medicare contractors to return institutional claims to the provider if any service line on the claim contains more than one occurrence of the modifiers GN, GO or GP.

Effective date: April 1, 2011
Implementation date: April 4, 2011

View the transmittal.

CMS posts waived tests update

On November 5, CMS issued its quarterly update to waived tests.

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

View the transmittal.

MLN Matters article

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



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