Health Information Management

This week's Medicare updates

APCs Insider, June 7, 2013

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

CMS issues transmittal to update Chapter 29, Independent Rural Health Clinic (RHC)/ Freestanding Qualified Health Center (FQHC) cost report

On May 24, CMS issued a transmittal to update Form CMS-222-92 to reflect clarifications and corrections to existing instructions, incorporate statutory changes, and comply with an Executive Order.
View transmittal R11P229.
 
Updates to Chapter 12 and Chapter 16 of the Medicare Claims Processing Manual
On May 24, CMS issued a change request to make revisions to the Physicians/Nonphysician Practitioners and laboratory services chapters of the Medicare Claims Processing Manual so that billing and claims processing instructions are up-to-date with regards to billing for the Technical Component (TC) of physician pathology services furnished to hospital patients.
Effective date: July 1, 2012
Implementation date: June 25, 2013
View transmittal R2714CP.
 
Claim Status Category and Claim Status Codes update
On May 24, CMS issued a transmittal announcing that the Accredited Standards Committee (ASC) has decided to allow the industry six months for implementation of newly added or changed codes that are updated three times per year at the ASC X12 meetings.
Effective date: October 1, 2013
Implementation date: October 7, 2013
View transmittal R2713CP.
View MLN Matters article MM8320
 
Quarterly update for the DMEPOS Competitive Bidding Program (CBP) - October 2013
On May 24, CMS issued a transmittal to notify providers that the DMEPOS CBP files have been updated and applies to Chapter 23, section 100.
Effective date: October 1, 2013
Implementation date: October 7, 2013
View transmittal R2712CP.
View MLN Matters article MM8316.
 
Expedited determinations for provider service terminations
On May 24, CMS issued a transmittal providing new information to the Medicare Claims Processing manual in accordance with CMS-4004-FC to ensure consistency with provisions of the final rule and clarifies operating instructions.
Effective date: August 26, 2013
Implementation date: August 26, 2013
View transmittal R2711CP.
View MLN Matters article MM7903.
 
Internet Only Manual (IOM) update to payment for medical or surgical services furnished by CRNAs
On May 30, CMS issued a change request to rescind and replace CR 8027, and to clarify existing manual language to bring the manual in line with revisions to regulations at 410.69.
Effective date: January 1, 2013
Implementation date: February 12, 2013
View transmittal R2716CP.
 
Change in creation date for CMS standard edit/audit/reason code reports
On May 30, CMS issued a change request to change the execution and delivery time Medicare Administrative Contractors (MACs) and legacy contractors will follow in the creation of the CMS standard edit/audit/reason code report.
Effective date: October 1, 2012
Implementation date: October 15, 2012; June 21, 2013 for revised business requirements
View transmittal R1242OTN.
 
Quarterly average sales price for Medicare Part B drug pricing files and revisions to prior quarterly pricing files
On May 31, CMS issued a transmittal to notify providers of updates to the quarterly average sales price (ASP) and to prior quarterly pricing files.
Effective date: October 1, 2013
Implementation date: October 7, 2013
View transmittal R2715CP.
 
Implementation of CMS ruling 1455-R
On May 31, CMS issued a transmittal to set forth requirements for contractors to implement CMS ruling 1455-R until such time as the operating instructions and necessary system changes in CR 8185 can be fully implemented.
Effective date: March 13, 2013
Implementation date: July 1, 2013
View transmittal R1243OTN.
 
Common Working File (CWF) Informational Unsolicited Response (IUR) or Reject for a new patient visit billed by the same physician/physician group within the past three years
On May 31, CMS issued a transmittal to update the new and established patient CPT codes in BR 8165.1 and 8165.2.
Effective date: October 1, 2013
Implementation date: October 7, 2013
View transmittal R1244OTN.
View MLN Matters article MM8165.
 
Update of the Ambulatory Surgical Center (ASC) payment system
On May 31, CMS issued a transmittal to describe changes to and billing instructions for various payment policies implemented in the July 2013 ASC payment system update, applied to Chapter 14, section 10.
Effective date: July 1, 2013
Implementation date: July 1, 2013
View transmittal R2717CP.
View MLN Matters article MM8328.  
 
Detailed written orders and face-to-face encounters
On May 31, CMS issued a change request to implement changes to Pub. 100-8, Medicare Program Integrity Manual to support 42 CFR 410.38(g).
Effective date: July 1, 2013
Implementation date: July 1, 2013
View transmittal R468PI.
 
Requirements for the closing of complaints after transfer to the PSCs and ZPICs in the OIG hotline complaint database
On May 31, CMS issued a transmittal to clarify the procedures by which the ACs and MACs (hereinafter referred to as contractors) should handle complaints that have been transferred to the PSCs and ZPICs on the OIG hotline database.
Effective date: December 1, 2012
Implementation date: July 1, 2013
View transmittal R467PI.



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