Corporate Compliance

Transmittals and MLN Matters articles: CMS instructs on use of claims history, updates underpayment guidance, and more

Medicare Insider, March 1, 2011

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CMS instructs on use of claims history for payment determinations

On February 25, CMS issued a transmittal to instruct its auditing contractors (e.g., RAC, CERT, MAC) on the use of historical claims data when making a payment determination.

Effective date: March 25, 2011
Implementation date: March 25, 2011

View the transmittal.

CMS clarifies Alzheimer’s codes for mental health limitation

On February 25, CMS issued a transmittal to provide guidance on ICD-9 diagnosis codes that are Alzheimer’s related disorders for purposes of the outpatient mental health treatment limitation.

Effective date: March 25, 2011
Implementation date: March 25, 2011

View the transmittal.

CMS updates RAC underpayment instructions

On February 25, CMS issued a transmittal to update instructions related to processing of underpayments identified by the RACs.

Effective date: March 28, 2011
Implementation date: March 28, 2011

View the transmittal.

CMS replaces transmittals



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