Corporate Compliance

Transmittals and MLN Matters articles: CMS replaces transmittal on manual medical review of therapy services and more

Medicare Insider, October 2, 2012

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CMS replaces transmittal on manual medical review of therapy services

On September 24, CMS replaced transmittal R1117OTN, containing a notice which stated that all requests for physical therapy/speech-language pathology or occupational therapy services above $3,700 provided under Medicare Part B shall be approved in advance.

View transmittal R1124OTN.

CMS replaces transmittal on NCD for transcatheter aortic valve replacement

On September 24, CMS replaced transmittal R2512CP, containing information on CMS’ covering of TAVR under coverage with evidence development (CED).

View the Claims Processing Manual transmittal.

View the National Coverage Determination transmittal

CMS replaces transmittal on extracorporeal photopheresis (ICD-10)

On September 24, CMS replaced transmittal R2543CP, containing information on the coverage of extracorporeal photopheresis for the treatment of bronchiolitis obliterans syndrome (BOS) following lung allograft transplantation only when extracorporeal photopheresis is provided under a clinical research study that meets specific requirements to assess the effect of extracorporeal photopheresis for the treatment of BOS following lung allograft transplantation.

View transmittal R2551CP.

CMS issues transmittal on physician fee schedule database 2013 file layout manual

On September 21, CMS issued a transmittal that provides the annual file layout for 2013 Medicare Carriers/A/B MACs. This recurring Update Notification applies to Chapter 23, Addendum.

Effective date: January 1, 2013

Implementation date: January 7, 2013
View transmittal R2549CP.

CMS issues common edits and enhancements modules (CEM) code set update

On September 21, CMS issued a transmittal that instructs shared system maintainers of the CEM software to obtain the most recent external code sets, and use them to update the necessary tables and/or reference files as part of the CEM software utilized by the A/B MACs.

Effective date: January 1, 2013

Implementation date: January 7, 2013

View transmittal R2548CP.



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