Corporate Compliance

Transmittals/MLN Matters articles: CMS instructs on RAC demand letters, updates cardiac/pulmonary rehab edits, and more

Medicare Insider, August 9, 2011

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CMS instructs on quarterly NCCI update

CMS issued a transmittal to instruct contractors regarding the upcoming quarterly update of the NCCI edit files.

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

View the transmittal.

View a related MLN Matters article.

CMS updates drug pricing files

CMS has posted a transmittal to make Part B drug pricing file updates to upcoming and previous quarters.

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

View the transmittal.

View a related MLN Matters article.

CMS revises device credit list

On July 29, CMS issued a transmittal to add MS-DRG 265 to the list of DRGs subject to the final policy for the IPPS reimbursement of replaced devices offered without cost or with a credit.

Effective date: October 1, 2008
Implementation date: January 3, 2012

View the transmittal.

View a related MLN Matters article.

CMS instructs on RAC demand letters

On July 29, CMS issued a transmittal to shift responsibility for issuance of demand letters from the RACs to the MACs. CMS wishes to increase the efficiency of this process.

Effective date: January 1, 2012
Implementation date: January 3, 2012

View the transmittal.

View a related MLN Matters article.

CMS clarifies payment for anesthesiologist services in Method II CAH

On August 1, CMS issued a transmittal to clarify the payment calculation for anesthesia services performed by an anesthesiologist in a Method II critical access hospital (CAH).

Effective date: January 1, 2008
Implementation date: January 3, 2012

View the transmittal.

View a related MLN Matters article.

CMS updates CWF edits for pulmonary rehab, cardiac rehab

On August 5, CMS issued a transmittal to update common working file (CWF) edits regarding pulmonary rehab, cardiac rehab, and intensive cardiac rehab.This will allow institutional and professional providers to bill 36 sessions of cardiac rehabilitation services, without the KX modifier, over a period of 36 weeks. In addition, this transmittal allows institutional and professional providers to bill 72 sessions of intensive cardiac rehabilitation, without the KX modifier over a period of 18 weeks. The transmittal updates CWF editing to allow institutional and professional providers to bill 36 sessions of pulmonary rehabilitation services, without the KX modifier, over a period of 36 weeks.

Effective date: January 1, 2010 for claims with dates of service on or after January 1, 2010 processed on or after January 3, 2012
Implementation date: January 3, 2012

View the transmittal.



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