Health Information Management

This week's Medicare updates

APCs Insider, September 27, 2013

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Common Edits and Enhancements Modules (CEM) Code Set Update

On September 17, CMS issued a transmittal stating that the Medicare Shared System Maintainers of the CEM software shall obtain the most recent external code sets, and use them to update the necessary tables and/or reference files as part of the CEM software utilized by the A/B MACs. This change became a recurring with updates to Pub. 100-04, Chapter 24, Section 50.3

Effective date: January 1, 2014
Implementation date: January 6, 2014
View Transmittal R2785CP.
 

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

On September 17, CMS published a rescind and replace transmittal to correct effective and implementation dates within the manual instruction. All other information remains the same.

Effective date: October 4, 2013
Implementation date: October 4, 2013
View Transmittal R227FM.
 
Claim Status Category and Claim Status Codes Update

On September 20, CMS issued a transmittal updating the Claim Status Codes and stating that the committee has decided to allow the industry six months for implementation of newly added or changed codes. Contractors are to use codes posted at www.wpc-edi.com/codes on or about November 1, 2013, which are listed as current codes on that site. This Recurring Update Notification (RUN) can be found in Chapter 31, Section 20.7.

Effective date: January 1, 2014
Implementation date: January 6, 2014
View Transmittal R2792CP.
View MLN Matters article MM8446.
 
Acceptable Submission Methods for Responses to ADRs

On September 20, CMS issued a transmittal to clarify how responses to additional documentation request can be sent to the contractors.

Effective date: October 21, 2013
Implementation date: October 21, 2013
View Transmittal R488PI.
 
Ambulance Inflation Factor for CY 2014 and Productivity Adjustment

On September 20, CMS issued a transmittal to manualize the ambulance inflation factor so Medicare contractors can accurately determine payment amounts for ambulance services. This Recurring Update Notification (RUN) applies to Chapter 15, Section 20.4

Effective date: January 1, 2014
Implementation date: January 6, 2014
View Transmittal R2788CP 

View MLN Matters article MM8452.  



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