The week in Medicare updates
APCs Insider, May 22, 2015
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
CMS releases July 2015 quarterly update for DMEPOS competitive bidding program
On May 8, CMS released a transmittal with the quarterly updates for the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program (CBP) files, in order to implement necessary changes to the HCPCS, ZIP code, single payment amount, and supplier files. These requirements provide specific instruction for implementing the DMEPOS CBP files. The recurring update notification applies to Chapter 23 of the Medicare Claims Processing Manual, section 100.
Effective date: July 1, 2015
Implementation date: July 6, 2015
View Transmittal R3256CP.
CMS issues correction to multi-carrier system editing
On May 8, CMS released a change request correcting edit 043H, which was incorrectly coded under Change Request 8806 (Transmittal 3103, issued November 13, 2014). This change applies to the Medicare Claims Processing Manual.
Effective date: October 1, 2015
Implementation date: October 5, 2015
View Transmittal R3255CP.
CMS releases July 2015 quarterly HCPCS drug/biological code changes
On May 8, CMS released a transmittal with the updated HCPCS code set for specific drug/biological HCPCS codes. As of July 2015, claims for compounded drugs shall be submitted using the compounded drug, not otherwise classified HCPCS code. This change request is also updating the Section 20.1.2 – Average Sales Price Payment Methodology in Chapter 17 of the Claims Processing Manual.
Effective date: July 1, 2015
Implementation date: July 6, 2015
View Transmittal R3254CP.
CMS updates provider enrollment instructions
On May 8, CMS released a change request to update existing provider enrollment instructions in Chapter 15 of the Medicare Program Integrity.
Effective date: June 8, 2015
Implementation date: June 8, 2015
View Transmittal R592PI.
CMS releases chronic care management frequently asked questions
On May 8, CMS released a MLN Matters special edition article to clarify Medicare’s requirement for 24/7 access by individuals furnishing chronic care management (CCM) services to the electronic care plan rather than the entire medical record. Also, CMS released a set of FAQs to address requests received from practitioners and providers for additional guidance in specific areas such as claims submission, intersection with transitional care management services, and the provision of CCM services in facility settings.
View special edition MLN Matters article SE1516.
View the new CCM FAQs.
View the updated CCM fact sheet.
Podiatrist admits to defrauding almost $1 million from Medicare
On May 13, the Office of Inspector General posted a video regarding a podiatrist from Missouri who admitted to defrauding almost $1 million from Medicare.
View the video.
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
Related Products
-
Briefings on APCs
Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...
-
HIM Briefings
Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...
-
Briefings on Coding Compliance Strategies
Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...
-
Briefings on HIPAA
How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...
-
APCs Insider
This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- The consequences of an incomplete medical record
- Practice the six rights of medication administration
- Complications from immobility by body system
- Q&A: Primary, principal, and secondary diagnoses
- Skills of effective case managers
- Neurological checks for head injuries
- OB services: Coding inside and outside of the package
- Coding Clinic reiterates guidelines for provider documentation
- E-mailed
-
- What are some ways to effectively communicate research findings to the rest of my facility so I can make needed changes in our clinical practice?
- Tip of the week: Three ways nursing homes solved their staffing problems
- The consequences of an incomplete medical record
- Right- and left-brain learners: Strategies to facilitate hemisphere learning
- Q/A: Billing for DME
- Intake and output monitoring
- HIM, CDI programs require 'TEAM' effort
- Follow 72-hour and 24-hour rules
- Coding Clinic reiterates guidelines for provider documentation
- Clergy rights and HIPAA
- Searched
