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Regulatory MonitoringFebruary 9-16 transmittals: CMS issues wage index corrections, changes lab NCD edit software, and more
Hospitals to report ZIP codes of outpatient service locations for certain services
On February 13, CMS issued clarifying instructions on the calculation of payment amounts for services paid to hospitals on the basis of the Medicare Physician Fee Schedule (MPFS), such as physical therapy, occupational therapy, speech language pathology, and mammograms. The instruction requires providers to report the ZIP code of outpatient service facility locations for off-site outpatient facilities. The location ZIP code will be used to calculate the appropriate local MPFS payment amount.
Effective date: October 1, 2007
Implementation date: July 6, 2009
CMS accepts National Drug Codes (NDCs) for drugs with no HCPCS assigned
On February 13, CMS issued instructions for submitting NDCs for drugs reported with C9399. HCPCS code C9399 is used for FDA approved drugs that do not yet have a product specific HCPCS code. The instruction also makes clear that contractors must accept decimal quantities for NDCs, although they may round those quantities for payment purposes.
Effective date: July 1, 2009
Implementation date: July 6, 2009
CMS issues corrections to the 2009 IPPS and OPPS wage indices
On February 13, CMS released corrections to the wage index for the fiscal year 2009 IPPS and the calendar year 2009 OPPS for certain hospitals requesting reversals of decisions made on their behalf by CMS and one provider with a typographical error in its reclassified CBSA.
Effective date: October 1, 2008
Implementation date: May 18, 2009
CMS announces changes to laboratory NCD edit software for April
On February 13, CMS released a transmittal communicating the changes it will make in April to the laboratory NCD edit software.
Effective date: April 1, 2009
Implementation date: April 6, 2009
CMS instructs contractors to strengthen safeguards against the abuse of modifier -79
On February 13, CMS released a transmittal instructing its contractors to review their safeguards against the misuse of modifier -79 and make any necessary changes.
Effective date: March 16, 2009
Implementation date: March 16, 2009
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