Corporate Compliance

Transmittals/MLN Matters articles: CMS instructs on imaging accreditation, eRx, and more

Medicare Update for Physician Services, August 4, 2011

CMS instructs on advanced diagnostic imaging accreditation

CMS posted a special edition MLN Matters article to provide assistance to providers in meeting the accreditation requirements for advanced diagnostic imaging.

View the special edition article.

CMS posts special article on eRx

CMS has released a special edition MLN Matters article on 2011 updates to the e-prescribing (eRx) program.

View the special edition article.

CMS instructs on chiropractic services

CMS has posted a special edition MLN Matters article on Medicare coverage of chiropractic services.

View the special edition article.

CMS posts NCD for autologous cellular immunotherapy treatment of metastatic prostate cancer

On July 8, CMS issued two transmittals related to coverage of autologous cellular immunotherapy treatment - sipuleucel-T; PROVENGE®. CMS has concluded that sipuleucel-T improves health outcomes for Medicare beneficiaries with asymptomatic or minimally symptomatic metastatic castrate-resistant (hormone refractory) prostate cancer, and thus is reasonable and necessary for this on-label indication.

Effective date: June 30, 2011
Implementation date: August 8, 2011 and January 3, 2012 (CWF frequency edit only)

View the National Coverage Determination Manual transmittal.

View the Claims Processing Manual transmittal.

View a related MLN Matters article.

CMS revises flu vaccine instructions

On July 8, CMS issued two transmittals to make changes to the Claims Processing Manual and the Benefit Policy Manual regarding the timing of the influenza vaccine.

Effective date: August 8, 2011
Implementation date: August 8, 2011

View the Claims Processing Manual transmittal.

View the Benefit Policy Manual transmittal.

CMS instructs on teaching physician services

On June 24, CMS issued a transmittal to provide instructions regarding annual wellness visits (HCPCS codes G0438 and G0439), which are included under the primary care exception. CMS also clarified policies concerning late night admissions and the mix of residents under the primary care exception.

Effective date: June 1, 2011
Implementation date: July 25, 2011

View the transmittal.

CMS replaces transmittals

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