Health Information Management

The week in Medicare updates

APCs Insider, January 31, 2014

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Registration of entities using the Indirect Payment Procedure (IPP)
On January 17, CMS issued a transmittal to remove the “Sensitive/Controversial” label. In addition, as the extract analyses were implemented in the January 2014 release, the analyses are not included in this correction. All other information remains the same.
Effective date: January 1, 2014
Implementation date: January 6, 2014
View Transmittal R2502PI.
View Transmittal R2860CP.
View MLN Matters MM8266.
View SE1406
 
Applying the therapy caps to Critical Access Hospitals (CAH)
On January 17, CMS issued a transmittal to implement a regulation subjecting outpatient therapy services furnished by a CAH to the therapy cap and related policies, which include the exceptions process and the manual medical review of claims in excess of the therapy threshold when required by statute.
Effective date: January 1, 2014
Implementation date: January 31, 2014
View Transmittal R2859CP.
View MLN Matters MM8426.
 
Claim status category and claim status codes update
On January 17, CMS issued a transmittal stating it has decided to allow the industry six months for implementation of newly added or changed codes. This can be found in Chapter 31, Section 20.7 of the Medicare Claims Processing Manual.
Effective date: April 1, 2014
Implementation date: April 7, 2014
View Transmittal R2858CP.
View MLN Matters MM8582.
 
HCPCS codes subject to and excluded from Clinical Laboratory Improvement Amendments (CLIA) edits
On January 17, CMS issued a transmittal that informs contractors about the new HCPCS codes for 2014 that are both subject to and excluded from CLIA edits. This applies to Chapter 16, section 70.9.
Effective date: January 1, 2014
Implementation date: April 7, 2014
View Transmittal R2857CP.
View MLN Matters MM8567.
 
OIG advisory opinion: Contracts for placement agency compensation
On January 21, the OIG issued an advisory opinion regarding contracts under which a placement agency is compensated for referring new residents to senior communities where they may eventually receive services paid for by federal healthcare programs.
View the report



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