Health Information Management

The week in Medicare updates

APCs Insider, January 10, 2014

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Update to the Program Integrity Manual
On December 30, CMS issued a transmittal to update a number of sections in chapter 15 of the Program Integrity Manual.
Effective date: January 28, 2104
Implementation date: January 28, 2104
View Transmittal R499PI.
 
Notifying the provider of postpayment review results
On December 30, CMS issued a transmittal instructing contractors to provide review results letters to providers at the conclusion of postpayment reviews, even if no overpayment determination is made.
Effective date: January 28, 2014
Implementation date: January 28, 2014
View Transmittal R498PI.
 
Medicare Claims Processing Update
On December 30, CMS issued a transmittal to publish an update to the Medicare Claims Processing Manual, Chapter 22 to reflect changes to Medicare Fee-For-Service’s Remittance Advice due to implementation of operating rules under the Patient Protection and Affordable Care Act.
Effective date: January 28, 2014
Implementation date: 2014.
View Transmittal R2843CP.
 
Form CMS-1500 Instructions: Revised for Form Version 02/12
On December 27, CMS issued a transmittal to revise the current Form CMS-1500 instructions to reflect the revised 1500 form, version 02/12.
Effective date: January 6, 2014
Implementation date: January 6, 2014
View Transmittal R2842CP.
View MLN Matters article MM8509.
 
Provider Reimbursement Manual Part 1, Chapter 9, Compensation of Owners
On December 27, CMS issued a transmittal to provide for calendar year nflation factors to update previous years’ reasonable compensation ranges.
View Transmittal R460PR1.
 
Expansion of Medicare Telehealth Services for 2014
On December 30, CMS issued a transmittal stating that in the 2014 physician fee schedule final rule with comment period, CMS is finalizing a proposal to add two codes to the list of Medicare telehealth services. Additionally, CMS is finalizing a proposal to modify regulations describing eligible telehealth originating sites to include health professional shortage areas (HPSAs) located in rural census tracts of urban areas as determined by the Office of Rural Health Policy (ORHP), effective January 1, 2014. Finally, CMS is finalizing a proposal to establish geographic eligibility for Medicare telehealth originating sites for each calendar year based upon the status of the area as of December 31 of the prior calendar year.
Effective date: January 1, 2014
Implementation date: January 6, 2014
View Transmittal R2848CP.
View Transmittal R2848BP.
View Transmittal R178BP.
 
Medicare System Project for Electronic Submission of Medical Documentation (esMD)
On December 30, CMS issued a Special Edition MLN Matters® article regarding use of the Electronic Submission of Medical Documentation (esMD) via Medicare’s esMD Gateway to respond to review contractors’ requests for medical documentation.
View special edition article SE1343.
 
Mandatory reporting of an 8-digit clinical trial number on claims
On January 2, CMS issued a Special Edition MLN Matters® article regarding the mandatory reporting of a clinical trial identifier number on claims for items and services provided in clinical trials that are qualified for coverage as specified in the Medicare National Coverage Determination  Manual, Section 310.1.
View special edition article SE1344.
 



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