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Transmittals/MLN Matters articles: CMS implements timely filing changes, establishes lab payment demonstration, and more

Medicare Update for Physician Services, February 3, 2011

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CMS implements PPACA lab payment demonstration

On January 28, CMS issued two transmittals to put in place a demonstration project for certain complex diagnostic lab tests, as mandated by the Patient Protection and Affordable Care Act. The demonstration will establish a separate payment method for these tests with a date of service that would under standard Medicare rules, be bundled into the payment for an associated hospital inpatient stay.

Effective date: July 1, 2011
Implementation date: July 5, 2011

View the Claims Processing Manual transmittal.

View the Demonstrations Manual transmittal.

CMS implements timely filing changes

On January 21, CMS issued a transmittal to update its manual system with changes to the timely filing requirements, under the Patient Protection and Affordable Care Act (PPACA). PPACA reduces the maximum period for submission of all Medicare fee-for-service claims to no more than 12 months after the date of service.

Effective date: Janaury 1, 2010
Implementation date: February 22, 2011

View the transmittal.

CMS makes system changes in preparation for ICD-10

CMS has posted two one-time notifications to make necessary changes to the multi-carrier system (MCS) to accommodate ICD-10 diagnosis codes.

Effective date: Various, see transmittals
Implementation date: Various, see transmittals

View the one-time notification R837OTN.

View the one-time notification R852OTN.

CMS replaces transmittal

CMS rescinded and replaced the following transmittal previously outlined in Medicare Update for Physician Services.

• Emergency Update to the CY 2011 Medicare Physician Fee Schedule (MPFS) Database

MLN Matters articles

CMS issued several MLN Matters articles related to transmittals previously outlined in Medicare Update for Physician Services.

• Medical Nutrition Therapy (MNT) Manual Correction
• Pharmacy Billing for Drugs Provided “Incident to” a Physician’s Service
• Emergency Update to the CY 2011 Medicare Physician Fee Schedule Database
• Summary of Policies in the CY 2011 Medicare Physician Fee Schedule (MPFS) and the Telehealth Originating Site Facility Fee Payment Amount

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