Author Archive for: Medicare Weekly Update
June 22-29 Issuances: CMS updates FAQs
June 30th, 2009 
Frequently asked questions
CMS issued several new/updated frequently asked questions (FAQ).
View a list of recently updated FAQs.
June 22-29 Transmittals and MLN Matters articles: CMS re-issues OPPS update, released MLN Matters article for never events NCDs, and more
June 30th, 2009
CMS issues contractor instructions for 835 adoption
On June 26, CMS instructed contractors to make system changes required for implementation of the next version of Health Insurance Portability and Accountability Act (HIPAA) standard for transaction 835.
Effective date: October 1, 2009
Implementation date: April 6, 2009 for VMS; July 6, 2009 for MCS, FISS
CMS re-issues OPPS update
On June 23, CMS rescinded and replaced its previous OPPS update to the Claims Processing Manual due to some incorrect information regarding HCPCS code Q4115. All other information remains the same.
Effective date: July 1, 2009
Implementation date: July 6, 2009
View a related MLN Matters article.
MLN Matters articles
CMS released two MLN Matters articles related to transmittals previously outlined in Medicare Weekly Update.
- Wrong Surgical or Other Invasive Procedure Performed on a Patient; Surgical or Other Invasive Procedure Performed on the Wrong Body Part; Surgical or Other Invasive Procedure Performed on the Wrong Patient
- Implementation of the Redesigned Provider Statistical and Reimbursement (PS&R) System
Inpatient Part B benefit - limited services payable under Part B to hospital inpatients
June 30th, 2009
By Judith Kares, JD, CPC, regulatory specialist for HCPro, Inc.
Although there were several transmittals and other CMS issuances published during the past week, they were primarily technical in nature rather than of general interest. Having just completed an MBC-H course in Chicago, I was reminded of a topic that I have wanted to discuss for some time. Although not new--that is, there have been no recent changes—there are several things that participants seem surprised about when we discuss them in class. Under the limited inpatient Part B benefit, hospitals can bill Medicare for certain nonphysician services furnished by a hospital (directly or under arrangements) to an inpatient of the hospital when these services are not covered under Part A.
Go to the MedicareMentor Blog to read the rest of this week's note.
Hospital Open Door Forum rescheduled
June 23rd, 2009
Although the next Hospital Open Door Forum was previously scheduled for June 25, CMS has confirmed that the call will be rescheduled to mid-July.
If you're looking for Hospital Open Door Forum resources, transcripts and audio recordings of past Open Door Forum conference calls are available through MedicareFind.
June 15-22 Issuances: CMS issues HITECH fact sheet, OIG audits oxaliplatin billing
June 23rd, 2009
CMS issues fact sheet on HITECH Act
On June 16, CMS issued a fact sheet containing information and frequently asked questions about the Health Information Technology for Economic and Clinical Health (HITECH) Act.
OIG reviews oxaliplatin billing
Last week, the OIG issued two reports on oxaliplatin billing. The OIG found that University Medical Center of Southern Nevada and Louisiana State University Health Sciences Center both billed for an incorrect number of units for this drug and, as a result, received overpayments.
View the OIG report on University Medical Center.
View the OIG report on Louisiana State University Health Sciences Center.
Never Events - CMS issues surgical error NCDs and related guidance
June 17th, 2009
By Judith Kares, JD, CPC, regulatory specialist for HCPro, Inc
In 2002, the National Quality Forum (NQF) published a list of 27 events identified as “serious, largely preventable and of concern to both the public and health care providers.” These events have become more popularly known as “never events”—events that should never occur in a well-run health care facility with appropriate quality controls.
Go to the MedicareMentor blog to read the rest of this week's note.
June 8-15 Issuances: ICD-9-CM documents available
June 16th, 2009
ICD-9-CM October 2009 update available
The fiscal year 2010 ICD-9-CM index to diseases addenda, tabular addenda, and new code conversion table are now available. These are effective October 1, 2009.
View the ICD-9-CM index to diseases addenda.
View the ICD-9-CM tabular addenda.
View the ICD-9-CM new code conversion table.
Frequently asked questions
CMS issued several new/updated frequently asked questions (FAQ) last week.
View a listing of recently updated FAQs.
June 8-15 Transmittals and MLN Matters articles: CMS implements NCDs for surgical never events, and more
June 16th, 2009
CMS implements NCDs for surgical never events
On June 12, CMS issued updates to the Claims Processing Manual and National Coverage Determinations (NCD) Manual pertaining to its NCDs for wrong surgery on a patient, wrong site surgery, and surgery on the wrong patient.
Effective date: January 15, 2009
Implementation date: July 6, 2009, for B MACs and carriers; October 5, 2009, for A MACs, FIs, and FISS
View the transmittal to the Claims Processing Manual.
View the transmittal to the NCD Manual.
CMS issues RAC update
On June 12, CMS updated the Medicare Financial Management Manual with information pertaining to the RAC national program.
Effective date: July 13, 2009
Implementation date: July 13, 2009
CMS implements redesigned provider statistical and reimbursement system
On June 12, CMS announced that the redesigned provider statistical and reimbursement system (PS&R) system is now available. The new PS&R will be used for all cost reports ending January 31, 2009, and later. Chapter 8 of the Medicare Financial Management Manual has been updated.
Effective date: July 13, 2009
Implementation date: July 13, 2009
CMS implements new CAH requirements
On June 12, CMS implemented new critical access hospital (CAH) requirements Under 42 CFR 485.610(e) related to CAH co-location and CAH provider-based locations.
Effective date: June 12, 2009
Implementation date: June 12, 2009
CMS issues transmittal on CMS-855 enrollment applications
On June 12, CMS issued a transmittal in which it changed the time period during which certain Medicare providers and suppliers can submit Medicare enrollment applications in advance of the effective date listed thereon.
Effective date: July 13, 2009
Implementation date: July 13, 2009
CMS issues MLN Matters articles
CMS issued several MLN Matters articles related to transmittals previously outlined in Medicare Weekly Update.
- Update-Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Rate Year 2010
- New Drug/Biological Health Care Procedure Code System (HCPCS) Codes for July 2009 Update
- New Waived Tests
