The week in Medicare updates
APCs Insider, March 21, 2014
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Include diagnosis codes on the HIPAA Eligibility Transaction System (HETS) 270/271 Transactions
On March 6, CMS issued a change request that instructs the Common Working File to send up to 25 iterations of diagnosis codes associated with Medicare secondary payer no-fault, liability, and workers' compensation records for inclusion on the HETS 271 response transaction.
On March 6, CMS issued a change request that instructs the Common Working File to send up to 25 iterations of diagnosis codes associated with Medicare secondary payer no-fault, liability, and workers' compensation records for inclusion on the HETS 271 response transaction.
Effective date: October 1, 2014
Implementation date: October 6, 2014
Update to Pub. 100-01, Chapter 7 for language-only changes for ICD-10
On March 7, CMS issued a transmittal that updates Chapter 7 of the Medicare General Information, Eligibility, and Entitlement Manual, Pub 100-01 for language-only changes for ICD-10, and deletes an outdated example in section 40.3.10 that uses ICD-9 codes. Example 1 is deleted and Example 2 is renumbered to become Example 1. There are no changes in procedure.
April 2014 update of the ASC Payment System
On March 7, CMS issued a recurring update notification that describes changes to billing instructions for various payment policies implemented in the April 2014 ambulatory surgical center payment system update. The recurring update notification applies to Chapter 14, Section 10. As appropriate, this notification also includes updates to HCPCS.
Effective date: April 1, 2014
Implementation date: April 7, 2014
April 2014 I/OCE specifications Version 15.1
On March 7, CMS issued a notification that provides the I/OCE instructions and specifications that will be used under the OPPS and non-OPPS. The instructions and specification are for hospital outpatient departments, community mental health centers, all non-OPPS providers, and for limited services when provided in a home health agency not under the Home Health Prospective Payment System or to a hospice patient for the treatment of a non-terminal illness.
Effective date: April 1, 2014
Implementation date: April 7, 2014
Pub 100-04, language only update for conversion to ICD-10
On March 7, CMS issued a change request that contains language-only changes for updating ICD-10 and ASC X12 language in Chapters 5 and 6 of the Medicare Claims Processing Manual, Pub. 100-04. There are no new instructions or changes in procedure.
Update to Pub. 100-04, Chapter 13 to provide language-only changes for updating ICD-10 and ASC X12
On March 7, CMS issued a change request that contains language-only changes for updating ICD-10 and ASC X12 language in the Medicare Claims Processing Manual, Pub. 100-04, Chapter 13. There are no new instructions or changes in procedure.
Update to Pub. 100-04, Chapter 10 to provide language-only changes for updating ICD-10 and ASC X12
On March 7, CMS issued a change request that contains language-only changes for updating ICD-10 and ASC X12 language in the Medicare Claims Processing Manual, Pub 100-04, Chapter 10. There are no new instructions or changes in procedure.
Update for payment to entities that provide coverage complementary to Medicare Part B
On March 7, CMS issued a change request to update the manual instructions regarding indirect payment procedure policy (in the Medicare Claims Processing Manual, Pub. 100-04, Chapter 1, Section 30.2.8.3).
Effective date: June 6, 2014
Implementation date: June 6, 2014
Update to Pub. 100-04, Chapter 19 to provide language-only changes for ICD-10 and ASC X12
On March 7, CMS issued a change request that contains language-only changes for updating ICD-10 and ASC X12 language in the Medicare Claims Processing Manual, Pub 100-04, Chapter 19. There are no new instructions or changes in procedure.
ICD-10 testing with providers through the Common Edits and Enhancements
Module (CEM) and Common Electronic Data Interchange (CEDI)
Module (CEM) and Common Electronic Data Interchange (CEDI)
On March 7, CMS issued a change request to instruct Medicare Administrative Contractors to implement an official ICD-10 Testing Week with trading partners using the CEM and CEDI, and to solicit ideas on how else ICD-10 testing could be accomplished.
Effective date: December 3, 2013
Implementation date: March 3, 2014
April 2014 update of the OPPS
On March 11, CMS issued a recurring update notification that describes changes to and billing instruction for various payment policies implemented in the April 2014 OPPS update. The April 2014 I/OCE and OPPS Pricer will reflect the HCPCS, Ambulatory Payment Classification, HCPCS Modifier, and Revenue Code additions, changes, and deletions identified in this change request.
Effective date: April 1, 2014
Implementation date: April 7, 2014
April quarterly update for 2014 DMEPOS Fee Schedule
On March 11, CMS issued a transmittal stating that Transmittal 2893, dated February 28, 2014, is being rescinded and replaced by Transmittal 2902, dated March 11, 2014. The recurring update notification applies to Chapter 23, section 60 of Pub. 100-04 Medicare Claims Processing Manual.
Effective date: April 1, 2014
Implementation date: April 7, 2014
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