Health Information Management

This week?s Medicare updates

APCs Insider, August 16, 2013

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Revision to the ViPS Medicare system diagnosis code editing on the CMS-1500

On August 5, CMS issued a transmittal to provide instructions for handling claims submitted on a CMS Form 1500 that have an invalid, header-level, diagnosis code.

Effective date: January 1, 2014
Implementation date: January 6, 2014

View transmittal R2756CP.

View MLN Matters article MM8279.

 

Medicare Physician Fee Schedule Database (MPFSDB) field revisions for the new Purchased Diagnostic Test (PDT) indicator and new effective date field

On August 9, CMS issued a transmittal to revise the 2014 MPFS layout to accommodate a new field for a PDT indicator and add a new effective date field by renaming and/or renumbering several existing fields.

Effective date: January 1, 2014
Implementation date: January 6, 2014

View transmittal R1277OTN.

 

Revision to the CWF edit for technical component (TC) of pathology services occurring on the same day as an outpatient hospital visit

On August 9, CMS issued a transmittal to refine the CWF edit implemented under CR 5347 to reduce the number of "false positives" that improperly deny claims for the technical component (TC) of physician pathology services furnished to a hospital outpatient when the date of service on the TC of pathology claim is the same as the DOS on an outpatient hospital claim.

Effective date: January 1, 2014
Implementation date: January 6, 2014

View transmittal R1276OTN.

View MLN Matters article MM8399.

 

October 2013 Integrated Outpatient Code Editor (I/OCE) specifications version 14.3

On August 9, CMS issued a transmittal providing the Integrated OCE (I/OCE) instructions and specifications for the I/OCE that will be utilized under the OPPS and Non-OPPS for hospital outpatient departments, community mental health centers, all non-OPPS providers, and for limited services when provided in a home health agency not under the Home Health Prospective Payment System or to a hospice patient for the treatment of a non-terminal illness. The Recurring Updated Notification applies to 100-04, Chapter 4, section 40.1.

Effective date: October 1, 2013
Implementation date: October 7, 2013

View transmittal R2763CP.

 

Mandatory reporting of an 8-digit clinical trial number on claims

On August 9, CMS issued a transmittal to inform providers and suppliers that effective January 1, 2014, it will be mandatory to report a clinical trial number on claims for items/services provided in clinical trials that are qualified for coverage as specified in the Medicare National Coverage Determination (NCD) Manual, Publication 100-03, section310.1. The clinical trial number that CMS is making mandatory is the same number that has been reported voluntarily since the implementation of CR5790, TR310, dated January 18, 2008—the number assigned by the National Library of Medicine (NLM) ClinicalTrials.gov website when a new study appears in the NLM Clinical Trials data base.

Effective date: January 1, 2014
Implementation date: January 6, 2014

View transmittal R2758CP.

 

Healthcare Provider Taxonomy Codes (HPTC) update, October 2013

On August 9, CMS issued a transmittal stating that affected Medicare contractors shall obtain the most recent Healthcare Provider Taxonomy Codes (HPTC) set and use it to update their internal HPTC tables and/or reference files. The attached Recurring Update Notification applies to the appropriate section in Chapter 24.

Effective date: October 1, 2013—Effective date established by the NUCC for the HPTC code set.

Implementation date: January 6, 2014—Date by which Medicare contractors must implement the HPTC code set; those contractors with capabilities of implementing earlier than January 6, 2014, shall do so; those with capabilities of implementing on October 1, 2013, shall do so.

View transmittal R2762CP

 

Update of the Ambulatory Surgery Center (ASC) Payment System, January 2013

On August 9, CMS issued a transmittal describing changes to and billing instructions for various payment policies implemented in the January 2013 Ambulatory Surgery Center (ASC) payment system update. This Recurring Update Notification applies to chapter 14, section 10. As appropriate, this notification also includes updates to the Healthcare Common Procedure Coding System (HCPCS).

Effective date: January 1, 2013
Implementation date: January 7, 2013

View transmittal R2626CP.

View MLN Matters article MM8148



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