Important Medicare updates
Medicare Update for CAHs, May 2, 2012
CMS continues updates to Program Integrity Manual
CMS issued two transmittals this past week that continue its process of updating chapter 15 of the Program Integrity Manual.
On April 6, CMS issued two transmittals that update the CLIA waived test list. CMS issued a second transmittal on the same date to include a test that was not included in the original transmittal (86386QW Nuclear Matrix Protein 22 (NMP22), qualitative).
Effective Date: January 1, 2012
Implementation Date: July 2, 2012
CMS offers guidance for correct claims submission when secondary payers are involved
On April 11, CMS issued a special edition MLN Matters article that explains how providers should bill services for Medicare beneficiaries with secondary insurance.
View the special edition MLN Matters article
OIG issues report on claim modifier –KX
On April 20, the OIG issued a report on the –KX modifier, which indicates that a claim meets Medicare coverage criteria and the supplier has the required documentation on file. The report found that the modifier is not effective in ensuring that suppliers of DMEPOS that submitted Medicare claims had the required supporting documentation on file. The OIG estimates that contractors paid approximately $316.4 million to suppliers that did not have the required documentation on file to support the DMEPOS items with 2007 dates of service.
HHS issues administrative simplification proposed rule
On April 17, HHS issued a proposed rule in the Federal Register that would implement section 1104 of the Affordable Care Act by establishing new requirements for administrative transactions that would improve the utility of the existing HIPAA transactions and reduce administrative burden and costs. This rule also proposes to change the official compliance date for ICD-10 from October 1, 2013 to October 1, 2014.
View an HCPro article on the ICD-10 delay.
CMS issues technical corrections to EHR Incentive Program—Stage 2 proposed rule
On April 18, CMS issued technical and typographical errors to the proposed rule entitled ‘‘Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 2’’ which appeared in the March 7, 2012.
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