Health Information Management

The week in Medicare updates

APCs Insider, January 23, 2015

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CMS releases January 2015 update of the ASC payment system 
On January 9, CMS released a recurring update notification describing changes to billing instructions for various payment policies implemented in the January 2015 ASC payment system update. It applies to the Medicare Claims Processing Manual, Chapter 14, section 10. As appropriate, this notification also includes HCPCS updates. Transmittal 3158, dated December 24, 2014, is being rescinded and replaced by Transmittal 3163 to correct Attachment A, table 3. Table 3 erroneously included code A9606. The correct payment indicator for this code is S1 and should not have been included in table 3. A field name in table 3 will also be corrected to read "CY2015 PI" rather than "CY2015 SI". All other information remains the same. 
Effective date: January 1, 2015
Implementation date: January 5, 2015 
View Transmittal R3163CP
View MLN Matters MM9021.
CMS did not always correctly make clinic visit payments to hospitals during 2012 
On January 13, the OIG posted a report asserting that CMS made incorrect outpatient payments to hospitals for established patients' clinic visits. On the basis of the OIG’s sample results, it estimated CMS made incorrect payments to hospitals totaling $4.6 million for 2012. 
View the report.
CMS decides no NCD appropriate for microvolt T-wave alternans testing
On January 13, CMS posted a decision memorandum deciding that no National Coverage Determination is appropriate at this time for microvolt T-wave alternans (MTWA) testing using the modified moving average (MMA) method for the evaluation of patients at risk for sudden cardiac death. National non-coverage will be removed. Local contractors will determine Medicare coverage of MTWA using the MMA method. 
View the decision memorandum. 
CMS updates interest rate for Medicare overpayments and underpayments
On January 14, CMS released a recurring update notification to Medicare Regulation 42 CFR Section 405.378, which provides for the charging and payment of interest on overpayments and underpayments to Medicare providers. The Secretary of Treasury certifies an interest rate quarterly. Treasury utilizes the most comprehensive data available on consumer interest rates to determine the certified rate. Interest is assessed on delinquent debts in order to protect the Medicare Trust Funds. This recurring update notification applies to Medicare Financial Management, Chapter 3, section 10. 
Effective date: January 21, 2015
Implementation date: January 21, 2015 
View Transmittal R249FM.

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