Health Information Management

This week?s Medicare updates

APCs Insider, September 13, 2013

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Update the Common Working File (CWF) to not allow certain diagnosis codes on No-Fault Medicare Secondary Payer (MSP) records

On August 23, CMS issued a transmittal to provide a Common Working File (CWF) in the change request of those diagnosis codes that are currently the greatest offenders and are not related to a No-Fault accident or injury. Although this list is not inclusive it will assist in processing thousands of claims systematically and lessen chances of inappropriate claim denial pertaining to No-Fault records.

Effective date: January 1, 2014
Implementation date: January 6, 2014
View Transmittal R95MSP.
 

MCS Prepayment Review Report attachment included

On August 23, CMS issued a transmittal to include the Claims Upload File Format attachment—a report in MCS that lists all claims chosen for prepayment review by system edits implemented by the contractors and/or CMS—that was previously omitted.

Effective date: October 1, 2013
Implementation date: October 7, 2013
View Transmittal R1290OTN.
 

ECRS batch file layout changes for ICD-10 codes

On August 30, CMS issued a transmittal directing its contractors to fully implement all ICD-10 related system changes no later than October 1, 2013, to allow for end-to-end testing. The COB&R contractors have already made a number of system changes to accommodate the transition to ICD-10 codes, and are now preparing to make the last set of changes to meet this required time frame.

Effective: October 1, 2013
Implementation date: January 6, 2014
View Transmittal R96MSP.
 

Operating rules for code usage in Remittance Advice

On August 30, CMS issued a rescind and replace transmittal to remove contractor responsibilities from BRs 8182.1–8182.4, to add a note to several business requirements stating that all business requirements marked with VMS responsibility are to be implemented by January 6, 2014, by VMS. Also, BR 8182.8 has been added to the CR. All other information remains the same.

View Transmittal R1291OTN.
 

Remittance Advice Remark, Claims Adjustment Reason Code, and Medicare Remit Easy Print and PC Print update

On August 30, CMS updated the Claim Adjustment Reason Code (CARC) and Remittance Advice Remark Code (RARC) lists and also instructed VIPs and FISS to update Medicare Remit Easy Print (MREP) and PC Print. This Recurring Update Notification applies to chapter 22, sections 40.5, 60.1, and 60.2.

Effective date: October 1, 2013
Implementation date: October 7, 2013
View Transmittal R2776CP

View MLN Matters article MM8422

 

Revisions to State Operations Manual

One August 30, CMS issued a series of transmittals to make updates to the State Operations Manual and to release CAH distance criteria.

View Transmittal R88SOMA.
View Transmittal R89SOMA.
View Transmittal R90SOMA
 

FY 2014 IPPS and Long Term Care Hospital PPS changes

On August 30, CMS issued a transmittal to provide the FY 2014 update to the Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) Prospective Payment System (PPS).

Effective date: October 1, 2013
Implementation date: October 7, 2013
View Transmittal R2778CP

View MLN Matters article MM8421

 

Removal of POR and PSOR instructions and the Glossary of Acronyms from the Internet-Only Manual, Publication 100.06, Chapter 3

On September 4, CMS issued a rescind and replace transmittal to reorganize the bankruptcy checklists, referral checklists, and accelerated payment information to sections 140.1 and 150.3 respectively of Pub 100-06 Medicare Financial Management. Additionally, section 180 will be reserved and section 180.2.3 will be deleted. The forms and checklists were deleted incorrectly. Also, the effective and implementation dates will be changed to October 4, 2013, to allow the contractors sufficient time to update their files and procedures. All other information remains the same.

Effective date: October 4, 2013
Implementation date: October 4, 2013
View Transmittal R225FM
 

Display of ICD-10 Local Coverage Determinations (LCDs) on the Medicare Coverage Database (MCD)

On September 6, CMS issued a change request to ensure that ICD-10 LCDs and Articles display on the MCD in a timely manner to allow providers sufficient time to make provider-specific billing system changes.

Effective date: October 7, 2013
Implementation date: April 10, 2014

View Transmittal R1293OTN

View MLN Matters article MM8348.



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