Revenue Cycle

Important Medicare updates

Medicare Update for CAHs, June 13, 2012

CMS instructs record requests related to the claim being reviewed

On May 25, CMS issued a transmittal that clarifies that contractors shall request records related to the claim and should request documentation related to the beneficiary’s condition before and after a service.

Effective date: June 26, 2012

Implementation date: June 26, 2012

View transmittal R422PI.

CMS modifies timely filing exceptions for certain situations

On May 25, CMS issued a transmittal that revises sections 70.7, 70.7.2, and 70.7.3, in chapter 1 of Pub. 100-04, to specify that if a provider, supplier, or beneficiary is unable to provide the contractor with an official SSA letter, the contractor shall check the Common Working File (CWF) database in order to verify a beneficiary’s retroactive Medicare entitlement date.

Effective date: August 27, 2012

Implementation date: August 27, 2012

View transmittal R2477CP.

View MLN Matters article MM7834.

CMS issues certification letter for approval of the AAAASF RHC accreditation program

On May 30, CMS issued a certification letter which recognizes the American Association for Accreditation of Ambulatory Surgery Facilitiies’ as a national accrediting organization with an approved accreditation program for RHCs seeking to participate in the Medicare or Medicaid programs.

View the certification letter.

CMS replaces transmittal on screening for STIs and HIBC to prevent STIs (ICD-10)

On May 23, CMS replaced transmittal R2402CP, containing a notice which says that CMS will cover screening for chlamydia, gonorrhea, syphilis, and hepatitis B with the appropriate FDA-approved lab tests used consistent with FDA-approved labeling and in compliance with CLIA regulations when ordered by a primary care provider and performed by an eligible Medicare provider for these services.

View transmittal R2476CP.

CMS replaces transmittal on automated tracking and reporting of Recovery Audit-associated reopenings and appeals

On May 23, CMS replaced transmittal R1050OTN, containing guidance on the implementation of the automated tracking/reporting solutions developed as a result of the conference calls held under CR 7469 (Conference Calls and Research Hours to Identify an Automated Solution for Tracking and Reporting Recovery Auditor Reopenings and Appeals throughout the Medicare Appeals Process, Transmittal 944).

View transmittal R1093OTN.

CMS instructs on use of insulin pens in healthcare facilities

On May 18, CMS cited reports of use of insulin pens for more than one patient, with at least one 2011 episode resulting in the need for post-exposure patient notification. This release provides guidance on the use of insulin pens in healthcare facilities.

View the certification letter.

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