Revenue Cycle

Important Medicare updates

Medicare Update for CAHs, May 16, 2012

CMS issues guidance on determining rural location for swing bed and RHC eligibility 

On April 20, CMS issued additional guidance on determining rural location for hospital swing bed and rural health clinic eligibility. Specifically, CMS provides instructions for use of the Census Bureau American FactFinder Database to make rural area location determinations.

View the certification letter.

CMS issues minor edits to ABN instructions form

On April 19, CMS issued an update stating that minor edits have been made in the advance beneficiary notice (ABN) instructions to clarify that the provider/supplier is responsible for inserting wording in all of the blanks labeled “D” on the notice including the “D” blanks that are within the “Options” section.  Please click the link in the list below to download the updated ABN instructions.

View the updated instructions.

CMS issues April 2012 Medicare NCD Coding Policy Manual and Change Report

On April 27, CMS issued the Medicare National Coverage Determinations (NCD) Coding Policy and Manual Change Report for clinical diagnostic laboratory services for April 2012.

View the report.
 
CMS issues Medicaid state plan home and community-based services proposed rule
On May 3, CMS issued in the Federal Register a proposed rule that would revise Medicaid regulations to define and describe state plan home and community-based services (HCBS) under the Social Security Act (the Act) as added by the Deficit Reduction Act of 2005 and amended by the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act 1).

View the proposed rule.

View a correction to the proposed rule.

Submit a comment.

View a related fact sheet.

CMS issues new physician specialty code for sleep medicine and sports medicine

On April 27, CMS issued a transmittal that adds new specialty code C0 for sleep medicine.

Effective date: April 1, 2012

Implementation date: October 1, 2012

View the Claims Processing Manual transmittal.

View the Medicare Financial Management transmittal.

CMS issues transmittal on EHR incentive program

On April 26, CMS issued a transmittal that modifies the existing requirements of the Fiscal Intermediary Shared System (FISS) that are currently responsible for supplying the most up-to-date financial information and payment calculations for each hospital identified by the National Level Repository (NLR) as a meaningful user of electronic health records (EHR.)

Effective date: October 1, 2012
Implementation date: October 1, 2012

View transmittal R1073OTN.

CMS issues transmittal on anesthesiologist services with modifier –GC in a Method II CAH

On April 26, CMS issued a transmittal that implements the payment methodology for anesthesiology claims submitted with a GC modifier for CAH Method II providers.

Effective date: January 1, 2010

Implementation date: October 1, 2012

View transmittal R2452CP.
 
View MLN Matters article MM7764.

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