Health Information Management

This week?s Medicare updates

APCs Insider, August 2, 2013

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Type of service corrections 2013

On July 24, CMS issued a transmittal to remove DME MAC responsibility from business requirement 8392.1.

Effective date: January 1, 2013

Implementation date: October 7, 2013

View transmittal R2744CP.
 

HIPAA 5010 and D.0 2013 Annual Recertification

On July 25, CMS issued a transmittal to instruct the A/B Medicare Administrative Contractors (MACs) to prepare their Electronic Data Interchange (EDI) front end systems in order to complete the CMS Annual Recertification Program for the Accredited Standards Committee (ASC) X12 version 5010 transactions and the National Committee for Prescription Drug Programs (NCPDP) D.0 format transactions. Recertification is expected to begin on August 1, 2013.

Effective date: August 26, 2013

Implementation date: August 26, 2013

View transmittal R1259OTN.
 

Coding Changes to Ultrasound Diagnostic Procedures for Transesophageal Doppler Monitoring

On July 25, CMS issued a transmittal stating that effective for claims with dates of service on or after January 1, 2013, contractors shall recognize and accept HCPCS Code G9157 when billed for Esophageal Doppler monitoring.

Effective date: July 1, 2013

Implementation date: August 26, 2013

View transmittal R2743CP.
 

New Claim Adjustment Reason Code (CARC) to Identify a Reduction in Payment Due to Sequestration

On July 25, CMS issued a change request to implement a new CARC to identify claims in which payment is reduced due to sequestration.

Effective date: June 3, 2013

Implementation date: January 6, 2014

View transmittal R2739CP.
 

Demand Billing of Hospice General Inpatient Level Care

Changes have been made to provide instructions for hospice demand bills when general inpatient care (GIP) is denied and the routine home care rate is applicable.

Effective date: January 1, 2014

Implementation date: January 6, 2014

View transmittal R2748CP.
 

Revision to the ViPS Medicare System Diagnosis Code Editing on the CMS-1500

On July 25, CMS issued a transmittal to provides instructions for handling claims submitted on a CMS Form-1500 that have an invalid, header-level, diagnosis code.

Effective date: October 1, 2013

Implementation date: October 7, 2013

View transmittal R2746CP.
 

Additional Data Reporting Requirements for Hospice Claims

This instruction requires additional claim data reporting for hospices to support hospice payment form as authorized by the Affordable Care Act of 2010, section 3132(a). Additional data reporting includes visit reporting for general inpatient care, reporting the facility NPI where the care was provided when not provided at the billing hospice facility, and reporting of infusion pumps and prescription drugs.

Effective date: Voluntary Reporting Effective January 1, 2014; Mandatory Reporting Effective April 1, 2014

Implementation date: January 6, 2014

View transmittal R2747CP.



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