Training Programs
Audits & Assessments
Regulatory MonitoringSeptember 7-14 Transmittals and MLN Matters articles
CMS reminds contractors of annual HCPCS update
On September 4, CMS issued a transmittal to remind contractors of the annual HCPCS update.
Effective date: January 1, 2010
Implementation date: January 4, 2010
CMS instructs on HIPAA 5010 implementation for the 835
On September 4, CMS issued a transmittal instructing contractors on implementation of version 5010 of the 835.
Effective date: January 1, 2010
Implementation date: January 4, 2010 for MACs, FISS, and VMS; July 5, 2010 for MCS
CMS revises Claims Processing Manual, Benefit Policy Manual regarding individuals in custody
On September 4, CMS issued a transmittal to make sections of the Claims Processing Manual and Benefit Policy Manual regarding items or services furnished to individuals in custody consistent with regulations at 41 CFR 411.4(b).
Effective date: December 7, 2009
Implementation date: December 7, 2009
View the Claims Processing Manual transmittal.
View the Benefit Policy Manual transmittal.
View a related MLN Matters article.
CMS issues annual instructions on HCPCS update for SNF consolidated billing
On September 4, CMS issued notification that HCPCS codes and Medicare Physician Fee Schedule designations will be used to revise CWF edits to allow MACs, carriers, and fiscal intermediaries to make appropriate payments in accordance with policy for SNF consolidated billing.
Effective date: January 1, 2010
Implementation date: January 4, 2010
View a related MLN Matters article.
CMS updates IPPS, LTCH PPS, and IPF PPS
On September 9, CMS issued a transmittal updating the IPPS, LTCH PPS, and IPF PPS.
Effective date: Discharges on or after October 1, 2009
Implementation date: October 5, 2009
CMS issues guidance on LCD exceptions
On September 11, CMS issued a transmittal on LCD exceptions. During complex medical review ACs, MACs, RACs, and CERT have to apply LCDs when reviewing claims. The change request provides the authority to apply an exception to the clinical reasonable and necessary requirements of an LCD in rare and unusual circumstances.
Effective date: October 13, 2009
Implementation date: October 13, 2009
MLN Matters articles
CMS released several MLN Matters articles related to a transmittals previously outlined in Medicare Weekly Update.
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