Corporate Compliance

Transmittals and MLN Matters articles: CMS implements kidney disease education coverage, replaces transmittals, and more

Medicare Insider, December 22, 2009

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CMS instructs on appeals timelines

On December 18, CMS issued a transmittal to make changes related to the timeframe for contractors to process and forward misfiled appeal requests.

Effective date: January 19, 2010
Implementation date: January 19, 2010

View the transmittal.

CMS replaces Managed Care Manual chapter

On December 18, CMS issued a transmittal to completely replace Chapter 4 of the Managed Care Manual, “Benefits and Beneficiary Protections.”

Effective date: December 18, 2009
Implementation date: December 18, 2009

View the transmittal.

CMS implements CED for pharmacogenomic testing for warfarin responsiveness

On December 18, CMS issued two transmittals to implement coverage with evidence development (CED) for pharmacogenomic testing for warfarin responsiveness.

Effective date: August 3, 2009
Implementation date: April 5, 2010

View the NCD Manual transmittal.

View the Claims Processing Manual transmittal.

CMS implements coverage of kidney disease patient education

On December 18, CMS issued two transmittals to implement coverage of kidney disease education services for Medicare beneficiaries diagnosed with Stage IV chronic kidney disease, under Section 152(b) of the Medicare Improvements for Patients and Providers Act (MIPPA).

Effective date: January 1, 2010
Implementation date: April 5, 2010

View the Benefit Policy Manual transmittal.

View the Claims Processing Manual transmittal.

CMS instructs on consultation coding

On December 14, CMS issued a transmittal regarding consultation codes, which it will stop using effective January 1, 2010.  For hospital providers, this transmittal affects only Method II Critical Access Hospitals. Consultation codes were discontinued effective January 1, 2008 for hospitals paid under the OPPS.

Effective date: January 1, 2010
Implementation date: January 4, 2010

View the transmittal.

View a related MLN Matters article.

CMS replaces transmittals

CMS issued several transmittals to rescind and replace previously issued transmittals for various reasons.

MLN Matters article

CMS issued one MLN Matters article related to the OPPS 2010 update transmittal previously outlined in Medicare Weekly Update.



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