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Transmittals and MLN Matters articles: CMS revises POS code assignment policy, posts new waived tests, and more

Medicare Weekly Update, February 7, 2012

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CMS revises and clarifies POS code assignment policy

On February 3, CMS issued a transmittal that revises and clarifies its national policy for place of service (POS) code assignment. Instructions are provided regarding the assignment of POS for all services paid under the Medicare Physician Fee Schedule and for certain services provided by independent labs. In addition to establishing a national policy for the correct assignment of POS codes, instructions are provided for the interpretation or professional component (PC) and the technical component (TC) of diagnostic tests.

CMS provides guidance for using ICD-10 codes on 33x TOB

On February 3, CMS issued a transmittal that provides guidance on reporting, claims submissions and date span requirements for 33x Type of Bills (TOB) containing ICD-10 codes with dates of service October 1, 2013 as defined in change request 7492. 

CMS instructs contractors to use OPPS cap for technical component of imaging procedures

On February 3, CMS issued a transmittal that notifies contractors to use the outpatient prospective payments system (OPPS) cap on the technical component (TC) for both TC-only and global services, and to discontinue use of the global cap.

CMS has released its regular update to inform contractors of new waived tests under CLIA.

CMS corrects 2012 payment rate increases for RHCs and FQHCs

On January 30, CMS rescinded Transmittal 2343 and replaced it with Transmittal 2406 to provide the corrected 2012 payment rate increases for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). The Medicare Economic Index (MEI) rate that was previously published did not contain the productivity adjustment that is always used for determining the RHC and FQHC upper payment limit. 

CMS implements immediate recoupment process

On January 27, CMS issued a transmittal that implements a standard immediate recoupment process. Providers can elect this process to avoid making payment by check and/or avoid the assessment of interest if the immediate recoupment pays the debt in full before day 31. 

CMS considers edits to correct common overpayments

On January 27, CMS published a transmittal that names issues that the recovery auditors identified as significant improper payments and require edits to correct improper payments. The issues include claims that have physician place of service codes, evaluation and management services during a global period, untimed codes, and hospital transfers.

View the transmittal   

CMS updates abortion condition codes

On January 26, CMS updated reason code 32809 with the following condition codes: AA, AB, and AD. Previous condition codes A7 and A8 have been discontinued and reserved for national assignment effective October 1, 2002.  

View the transmittal 

CMS continues to update Chapter 15 of the PIM

On January 26, CMS issued a transmittal that moves the remaining sections of Chapter 10 of the Program Integrity Manual (PIM) into Chapter 15.    

View the transmittal 

NUBC approves a new occurrence span code

On January 26, CMS issued a transmittal that announced The National Uniform Billing Committee (NUBC) approved a new occurrence span code on November 16, 2011 with an effective/implementation date of July 1, 2012. Medicare systems shall accept new occurrence span code 81 used to report antepartum days. 

View the transmittal

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