Health Information Management

Medicare updates

APCs Insider, May 17, 2013

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

New HCPCS Codes for customized Durable Medical Equipment

On May 6, CMS issued a transmittal to provide instructions on the addition of three new Healthcare Common Procedure Coding System (HCPCS) codes for customized durable medical equipment.
Effective date: July 1, 2013
Implementation date: July 1, 2013
View transmittal R1232OTN.
View MLN Matters article MM8158
 
CMS issues change request on Operating Rules for code usage in Remittance Advice
On May 9, CMS issued a change request instructing Medicare Administrative Contractors (MACs) and Shared System Maintainers (SSMs) to implement Operating Rules for code usage in Electronic Remittance Advice (ERA) under the Patient Protection and Affordable Care Act. The same rules will apply to Standard Paper Remittance (SPR), and Medicare will report the same standard codes in both electronic and paper formats of remittance advice.
View transmittal R1233OTN
 
CMS issues change request on HIPAA EDI Front End Updates for October 2013
On May 9, CMS issued a change request to provide the October 2013 Common Edits and Enhancements Module (CEM) edits for A/B MACs and the Common Electronic Data Interchange (CEDI) contractor.
Effective date: October 1, 2013
Implementation date: October 7, 2013
View transmittal R1220OTN
 
CMS issues transmittal to update Chapter 41, Form CMS-2540-10
On May 10, CMS issued a transmittal updating Chapter 41, Skilled Nursing Facility and Skilled Nursing Facility Complex Cost Reports, Form CMS-2540-10 to clarify and correct existing instructions, incorporate statutory changes, and comply with an Executive order. Effective dates vary.
View transmittal R5P241
 
CMS issues transmittal on Phase III ERA Enrollment Operating Rules
On May 10, CMS issued a transmittal to bring contractors into compliance with Phase III ERA Enrollment Operating Rule requirements. Effective date: October 1, 2013 Implementation date: October 7, 2013
View transmittal R1235OTN
 
CMS issues transmittal on MSP claims and use of CARC 23- Analysis and Design
On May 10, CMS issued a transmittal saying that the current Claim Adjustment Reason Code (CARC) 23 is not being used correctly and/or consistently.CMS will have a change request after discussion and establishment of the correct way to report and balance the RA and COB claim.
Effective date: October 1, 2013
Implementation date: October 7, 2013
View transmittal R1234OTN.
 
CMS issues transmittal on ambulance payment reduction for non-emergency basic life support transports to and from renal dialysis facilities
On May 10, CMS issued a payment reduction that affects transports to and from both hospital-based and freestanding renal dialysis treatment facilities for dialysis services provided on a non-emergency basis.
Effective date: October 1, 2013
Implementation date: October 7, 2013
View transmittal R2703CP
 
CMS issues quarterly update to CCI edits, version 19.2
On May 10, CMS issued a transmittal to provide the normal update to the Correct Coding Initiative (CCI) procedure edits.
Effective date: July 1, 2013
Implementation date: July 1, 2013
View transmittal R2700CP
 
CMS issues updates to Medicare coverage of Hepatitis B vaccine and AWV PPPS
On May 10, CMS issued a change request serving to make the Medicare Benefit Policy Manual provisions consistent with modified regulatory requirements.
Effective date: January 1, 2012- Medicare coverage of the Annual Wellness Visit (AWV); January 1, 2013- Medicare coverage of Hepatitis B vaccine
Implementation date: June 10, 2013
View transmittal R170BP
 
HHS releases unprecedented hospital data on charge variation
On May 8, The Department of Health and Human Services (HHS) released new data on hospital charges showing significant variation on charges from hospital to hospital for inpatient services to promote transparency.
View the data set
View a press release
View a related fact sheet
 
OIG issues updated Special Advisory Bulletin on effect of exclusion from participation in Federal healthcare programs
On May 8, the Office of Inspector General (OIG) issued an updated Special Advisory bulletin describing the scope and effect of the legal prohibition on payment by Federal healthcare programs for items furnished by an excluded person or at the medical direction or on the prescription of an excluded person.
View the complete update
 
OIG issues findings on dialysis payments adjusted for anemia management drug utilization
On May 9, the Office of Inspector General (OIG) issued a report estimating that Medicare and beneficiaries could have saved $510 million for the ESA Epogen and Aranesp and $19 million for the iron supplements Venofer and Ferrlecit during CY2011 if the ESRD base rate had been adjusted to reflect current utilization of anemia management drugs.
View the complete report
 
CMS issues delayed publication of SRTR PSRs and implications for CMS transplant program oversight
On May 10, CMS issued a memo stating that the release of the January 2013 SRTR PSRs have been delayed.
View the complete memo.

 



Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

    Briefings on APCs
  • 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