2004 Job Aids

HIPAA Privacy Act

Thu, 10 Nov 2005 09:51:00 EST

Transmittal #: R7GI
Subject: HIPAA Privacy Act
CR #: 2484
Job Aid #: N/A

Additional Instructions Related to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments

Thu, 10 Nov 2005 09:53:00 EST

Transmittal #: R92OTN
Subject: Additional Instructions Related to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments
CR #: 3353
Job Aid #: N/A

PET Scans and Related Claims Processing

Thu, 10 Nov 2005 09:54:00 EST

Transmittal #: R223CP
Subject: PET Scans and Related Claims Processing
CR #: 3304
Job Aid #: N/A

SNF CB Requirements for DMEPOS

Thu, 10 Nov 2005 09:56:00 EST

Transmittal #: R222CP
Subject: SNF CB Requirements for DMEPOS
CR #: 2453
Job Aid #: N/A

Chapter 11

Thu, 10 Nov 2005 09:58:00 EST

Transmittal #: R56MCM
Subject: Chapter 11
CR #: N/A
Job Aid #: N/A

Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision

Thu, 10 Nov 2005 09:59:00 EST

Transmittal #: R79PI
Subject: Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision
CR #: 3222
Job Aid #: N/A

This transmittal is rescinded and replaced with Transmittal 50, dated July 30, 2004.

Thu, 10 Nov 2005 10:00:00 EST

Transmittal #: R48FM
Subject: This transmittal is rescinded and replaced with Transmittal 50, dated July 30, 2004.
CR #: 3274
Job Aid #: N/A

Correction to January 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement

Thu, 10 Nov 2005 10:33:00 EST

Transmittal #: R421CP
Subject: Correction to January 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
CR #: 3613
Job Aid #: N/A

Update to FY 2005 Wage Index for Inpatient Prospective Payment System (IPPS) and Outpatient Prospective Payment System (OPPS) Hospitals

Thu, 10 Nov 2005 10:34:00 EST

Transmittal #: R422CP
Subject: Update to FY 2005 Wage Index for Inpatient Prospective Payment System (IPPS) and Outpatient Prospective Payment System (OPPS) Hospitals
CR #: 3672
Job Aid #: N/A

January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes

Thu, 10 Nov 2005 10:35:00 EST

Transmittal #: R419CP
Subject: January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes
CR #: 3632
Job Aid #: N/A

January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes

Thu, 10 Nov 2005 10:36:00 EST

Transmittal #: R423CP
Subject: January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes
CR #: 3632
Job Aid #: N/A

Elimination of Regulations for Written Statement of Intent (SOI)

Thu, 10 Nov 2005 10:40:00 EST

Transmittal #: R211CP
Subject: Elimination of Regulations for Written Statement of Intent (SOI)
CR #: 3310
Job Aid #: JA3310

Reporting Medicare Secondary Payer (MSP) Information on the Health Insurance Portability and Accountability Act of 1996 (HIPAA) X12N 837 Created Via Free Billing Software

Thu, 10 Nov 2005 11:06:00 EST

Transmittal #: R84OTN
Subject: Reporting Medicare Secondary Payer (MSP) Information on the Health Insurance Portability and Accountability Act of 1996 (HIPAA) X12N 837 Created Via Free Billing Software
CR #: 3284
Job Aid #: JA3284

Initial Preventive Physical Examination (IPPE)-(Note: This is a full replacement of CR 3413, transmittal 294, dated September 3, 2004. CR 3413 is rescinded.)

Thu, 10 Nov 2005 11:08:00 EST

Transmittal #: R417CP
Subject: Initial Preventive Physical Examination (IPPE)-(Note: This is a full replacement of CR 3413, transmittal 294, dated September 3, 2004. CR 3413 is rescinded.)
CR #: 3638
Job Aid #: N/A

Interest Payment on Clean Non-PIP Claims Not Paid Timely

Thu, 10 Nov 2005 11:09:00 EST

Transmittal #: R416CP
Subject: Interest Payment on Clean Non-PIP Claims Not Paid Timely
CR #: 3557
Job Aid #: N/A

Chemotherapy Demonstration Project

Thu, 10 Nov 2005 11:09:00 EST

Transmittal #: R14DEMO
Subject: Chemotherapy Demonstration Project
CR #: 3670
Job Aid #: JA3670

Temporary Change in Carrier Jurisdictional Pricing Rules for Purchased Diagnostic Services

Thu, 10 Nov 2005 11:10:00 EST

Transmittal #: R415CP
Subject: Temporary Change in Carrier Jurisdictional Pricing Rules for Purchased Diagnostic Services
CR #: 3630
Job Aid #: N/A

Business Partners Systems Security Manual

Thu, 10 Nov 2005 11:43:00 EST

Transmittal #: R5SSS
Subject: Business Partners Systems Security Manual
CR #: 3605
Job Aid #: N/A

January Update to the Medicare Outpatient Code Editor (OCE) Version 20.1 for Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System (Non-OPPS)

Thu, 10 Nov 2005 11:45:00 EST

Transmittal #: R402CP
Subject: January Update to the Medicare Outpatient Code Editor (OCE) Version 20.1 for Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System (Non-OPPS)
CR #: 3621
Job Aid #: N/A

January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS):Changes to Coding and Payment for Drug Administration

Thu, 10 Nov 2005 11:46:00 EST

Transmittal #: R404CP
Subject: January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS):Changes to Coding and Payment for Drug Administration
CR #: 3610
Job Aid #: N/A

January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Billing for Devices that do not have Transitional Pass-Through Status, and that are not Classified as New Technology Ambulatory Payment Classification (APC) Groups

Thu, 10 Nov 2005 11:47:00 EST

Transmittal #: R403CP
Subject: January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Billing for Devices that do not have Transitional Pass-Through Status, and that are not Classified as New Technology Ambulatory Payment Classification (APC) Groups
CR #: 3606
Job Aid #: N/A

New Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Ant-Emetic, Immunosuppressive, and Inhalation Drugs

Thu, 10 Nov 2005 11:47:00 EST

Transmittal #: R396CP
Subject: New Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Ant-Emetic, Immunosuppressive, and Inhalation Drugs
CR #: 3620
Job Aid #: N/A

DMERC/Local Carriers/SADMERC - Drug Pricing Limits as of January 1, 2005

Thu, 10 Nov 2005 11:49:00 EST

Transmittal #: R397CP
Subject: DMERC/Local Carriers/SADMERC - Drug Pricing Limits as of January 1, 2005
CR #: 3232
Job Aid #: N/A

Diabetes Screening Tests

Thu, 10 Nov 2005 11:51:00 EST

Transmittal #: R409CP
Subject: Diabetes Screening Tests
CR #: 3637
Job Aid #: N/A

Update to Health Care Claims Status Category Codes and Health Care Claim Status Codes for Use with the Health Care Claim Status Request and Response ASC X12N 276/277

Thu, 10 Nov 2005 11:52:00 EST

Transmittal #: R406CP
Subject: Update to Health Care Claims Status Category Codes and Health Care Claim Status Codes for Use with the Health Care Claim Status Request and Response ASC X12N 276/277
CR #: 3566
Job Aid #: N/A

Shared System Maintainer Hours for Resolution of Problems Detected as a Result of Implementation of Change Request 2525 and Change Request 2527

Thu, 10 Nov 2005 11:54:00 EST

Transmittal #: R133OTN
Subject: Shared System Maintainer Hours for Resolution of Problems Detected as a Result of Implementation of Change Request 2525 and Change Request 2527
CR #: 3603
Job Aid #: N/A

Scheduled Release for January Updates to Software Programs and Pricing/Coding Files

Thu, 10 Nov 2005 11:56:00 EST

Transmittal #: R14GI
Subject: Scheduled Release for January Updates to Software Programs and Pricing/Coding Files
CR #: 3550
Job Aid #: N/A

Medicare Coordinated Care Demonstration (MCCD)-Override of Certain Medicare Secondary Payer Edit Codes

Thu, 10 Nov 2005 11:57:00 EST

Transmittal #: R11DEMO
Subject: Medicare Coordinated Care Demonstration (MCCD)-Override of Certain Medicare Secondary Payer Edit Codes
CR #: 3594
Job Aid #: N/A

Incorrect Reporting of MTUS Indicator When Drugs are Billed Using an NDC Code

Thu, 10 Nov 2005 11:58:00 EST

Transmittal #: R400CP
Subject: Incorrect Reporting of MTUS Indicator When Drugs are Billed Using an NDC Code
CR #: 3435
Job Aid #: N/A

Section 2231, Regional Medicare Swing-Bed Rates

Thu, 10 Nov 2005 11:59:00 EST

Transmittal #: R427PR1
Subject: Section 2231, Regional Medicare Swing-Bed Rates
CR #: N/A
Job Aid #: N/A

Development of a Coordination of Benefits Agreement (COBA) Auxiliary File and Modification of the Health Insurance Portability and Accountability Act (HIPAA) 837 Coordination of Benefits (COB) Flat File and National Council for Prescription Drug Programs (NCPDP) File

Thu, 10 Nov 2005 12:01:00 EST

Transmittal #: R130OTN
Subject: Development of a Coordination of Benefits Agreement (COBA) Auxiliary File and Modification of the Health Insurance Portability and Accountability Act (HIPAA) 837 Coordination of Benefits (COB) Flat File and National Council for Prescription Drug Programs (NCPDP) File
CR #: 3614
Job Aid #: N/A

Cardiovascular Disease Screening

Thu, 10 Nov 2005 12:02:00 EST

Transmittal #: R408CP
Subject: Cardiovascular Disease Screening
CR #: 3411
Job Aid #: N/A

Hospital Billing for Repetitive Services

Thu, 10 Nov 2005 12:03:00 EST

Transmittal #: R407CP
Subject: Hospital Billing for Repetitive Services
CR #: 3633
Job Aid #: N/A

Emergency Change to Carrier Instructions for the End Stage Renal Disease (ESRD) 50/50 Rule Implementation

Thu, 10 Nov 2005 12:05:00 EST

Transmittal #: R405CP
Subject: Emergency Change to Carrier Instructions for the End Stage Renal Disease (ESRD) 50/50 Rule Implementation
CR #: 3609
Job Aid #: N/A

New Location Code ICC, Status Code AR and Modified Intent Letter for Unfiled Cost Reports Only

Thu, 10 Nov 2005 12:12:00 EST

Transmittal #: R61FM
Subject: New Location Code ICC, Status Code AR and Modified Intent Letter for Unfiled Cost Reports Only
CR #: 3563
Job Aid #: N/A

Medicare Secondary Payer (MSP) Debt Referral Instructions and Debt Collection Improvement Act of 1996 (DCIA) Activities

Thu, 10 Nov 2005 13:54:00 EST

Transmittal #: R22MSP
Subject: Medicare Secondary Payer (MSP) Debt Referral Instructions and Debt Collection Improvement Act of 1996 (DCIA) Activities
CR #: 3293
Job Aid #: N/A

Hospice Pre-Election Evaluation and Counseling Services

Thu, 10 Nov 2005 13:56:00 EST

Transmittal #: R386CP
Subject: Hospice Pre-Election Evaluation and Counseling Services
CR #: 3585
Job Aid #: JA3585

Surveys, Contracting Strategy, Grievances and Appeals

Thu, 10 Nov 2005 13:56:00 EST

Transmittal #: R64MCM
Subject: Surveys, Contracting Strategy, Grievances and Appeals
CR #: N/A
Job Aid #: N/A

January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of OPPS Outpatient Code Editor (OCE) Data Changes and OPPS PRICER Logic Changes; Changes to Payment for Diagnostic Mammography

Thu, 10 Nov 2005 13:58:00 EST

Transmittal #: R385CP
Subject: January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of OPPS Outpatient Code Editor (OCE) Data Changes and OPPS PRICER Logic Changes; Changes to Payment for Diagnostic Mammography
CR #: 3586
Job Aid #: N/A

This instruction is to inform the fiscal intermediaries that the January 2005 Outpatient Prospective Payment System Outpatient Code Editor (OPPS OCE) Specifications have been updated with new additions, changes, and deletions

Thu, 10 Nov 2005 13:58:00 EST

Transmittal #: R387CP
Subject: This instruction is to inform the fiscal intermediaries that the January 2005 Outpatient Prospective Payment System Outpatient Code Editor (OPPS OCE) Specifications have been updated with new additions, changes, and deletions
CR #: 3583
Job Aid #: N/A

2005 Part B Deductible Update to the Back Page of Medicare Summary Notices

Thu, 10 Nov 2005 14:00:00 EST

Transmittal #: R401CP
Subject: 2005 Part B Deductible Update to the Back Page of Medicare Summary Notices
CR #: 3600
Job Aid #: N/A

Expansion of the Existing Interrupted Stay Policy Under Long Term Care Hospital (LTCH) Prospective Payment System

Thu, 10 Nov 2005 14:00:00 EST

Transmittal #: R399CP
Subject: Expansion of the Existing Interrupted Stay Policy Under Long Term Care Hospital (LTCH) Prospective Payment System
CR #: 3279
Job Aid #: JA3279

Ambulance Fee Schedule - Medical Conditions List

Thu, 10 Nov 2005 14:01:00 EST

Transmittal #: R395CP
Subject: Ambulance Fee Schedule - Medical Conditions List
CR #: 3619
Job Aid #: N/A

New Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Ant-Emetic, Immunosuppressive, and Inhalation Drugs

Thu, 10 Nov 2005 14:02:00 EST

Transmittal #: R394CP
Subject: New Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Ant-Emetic, Immunosuppressive, and Inhalation Drugs
CR #: 3620
Job Aid #: N/A

2005 Part B Deductible Update to the Back Page of Medicare Summary Notices

Thu, 10 Nov 2005 14:03:00 EST

Transmittal #: R393CP
Subject: 2005 Part B Deductible Update to the Back Page of Medicare Summary Notices
CR #: 3600
Job Aid #: N/A

Chemotherapy Demonstration Project

Thu, 10 Nov 2005 14:07:00 EST

Transmittal #: R12DEMO
Subject: Chemotherapy Demonstration Project
CR #: 3634
Job Aid #: N/A

Revision of Program Integrity Manual (PIM), Section 3.11.1.4

Thu, 10 Nov 2005 14:08:00 EST

Transmittal #: R91PI
Subject: Revision of Program Integrity Manual (PIM), Section 3.11.1.4
CR #: 3560
Job Aid #: N/A

Prepayment Review of Claims for MR Purposes

Thu, 10 Nov 2005 14:12:00 EST

Transmittal #: R90PI
Subject: Prepayment Review of Claims for MR Purposes
CR #: 3569
Job Aid #: N/A

Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)

Thu, 10 Nov 2005 14:17:00 EST

Transmittal #: R384CP
Subject: Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)
CR #: 3541
Job Aid #: JA3541

Instructions Applicable to the Audit of Hospitals that are Part of an Affiliated Group in Relation to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments

Thu, 10 Nov 2005 14:18:00 EST

Transmittal #: R127OTN
Subject: Instructions Applicable to the Audit of Hospitals that are Part of an Affiliated Group in Relation to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments
CR #: 3558
Job Aid #: N/A

Annual Update of HCPCS Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB)

Thu, 10 Nov 2005 14:20:00 EST

Transmittal #: R360CP
Subject: Annual Update of HCPCS Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB)
CR #: 3542
Job Aid #: N/A

Hospice Pre-Election Evaluation and Counseling Services

Thu, 10 Nov 2005 14:21:00 EST

Transmittal #: R28BP
Subject: Hospice Pre-Election Evaluation and Counseling Services
CR #: 3585
Job Aid #: JA3585

2005 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

Thu, 10 Nov 2005 14:22:00 EST

Transmittal #: R363CP
Subject: 2005 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment
CR #: 3526
Job Aid #: N/A

2005 Drug Administration Coding Revisions

Thu, 10 Nov 2005 14:22:00 EST

Transmittal #: R129OTN
Subject: 2005 Drug Administration Coding Revisions
CR #: 3631
Job Aid #: JA3631

Promoting Medicare's Preventive Benefits and Services on an Annual Basis

Thu, 10 Nov 2005 14:23:00 EST

Transmittal #: R128OTN
Subject: Promoting Medicare's Preventive Benefits and Services on an Annual Basis
CR #: 3527
Job Aid #: N/A

Update to the Prospective Payment System (PPS) for Home Health Agencies for Calendar Year (CY) 2005

Thu, 10 Nov 2005 14:25:00 EST

Transmittal #: R362CP
Subject: Update to the Prospective Payment System (PPS) for Home Health Agencies for Calendar Year (CY) 2005
CR #: 3556
Job Aid #: N/A

Payment for Referred Laboratory Automated Multi-Channel Chemistry (AMCC) Tests

Thu, 10 Nov 2005 14:25:00 EST

Transmittal #: R372CP
Subject: Payment for Referred Laboratory Automated Multi-Channel Chemistry (AMCC) Tests
CR #: 3483
Job Aid #: JA3483

Fee Schedule Update for 2005 for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)

Thu, 10 Nov 2005 14:26:00 EST

Transmittal #: R369CP
Subject: Fee Schedule Update for 2005 for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
CR #: 3574
Job Aid #: N/A

Updated Billing Instructions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)

Thu, 10 Nov 2005 14:27:00 EST

Transmittal #: R371CP
Subject: Updated Billing Instructions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
CR #: 3487
Job Aid #: N/A

Clarification to IOM Chapter 17, Section 80.4 regarding claims for Blood Clotting Factors

Thu, 10 Nov 2005 14:28:00 EST

Transmittal #: R374CP
Subject: Clarification to IOM Chapter 17, Section 80.4 regarding claims for Blood Clotting Factors
CR #: 3370
Job Aid #: N/A

New ESRD Composite Payment Rates Effective January 1, 2005

Thu, 10 Nov 2005 14:30:00 EST

Transmittal #: R27BP
Subject: New ESRD Composite Payment Rates Effective January 1, 2005
CR #: 3554
Job Aid #: N/A

Updating Financial Reporting Requirements for Medical Review and Local Provider Education and Training

Thu, 10 Nov 2005 14:30:00 EST

Transmittal #: R89PI
Subject: Updating Financial Reporting Requirements for Medical Review and Local Provider Education and Training
CR #: 3446
Job Aid #: N/A

Timeframes for Processing 855 Enrollment Applications

Thu, 10 Nov 2005 14:32:00 EST

Transmittal #: R88PI
Subject: Timeframes for Processing 855 Enrollment Applications
CR #: 3528
Job Aid #: N/A

Revised instructions on contractor procedures for provider audit and the Provider Statistical & Reimbursement Report (PSRR)

Thu, 10 Nov 2005 14:32:00 EST

Transmittal #: R60FM
Subject: Revised instructions on contractor procedures for provider audit and the Provider Statistical & Reimbursement Report (PSRR)
CR #: 3492
Job Aid #: N/A

Independent Laboratory Billing for the Technical Component (TC) of Physician Pathology Services to Hospital Patients

Thu, 10 Nov 2005 14:33:00 EST

Transmittal #: R382CP
Subject: Independent Laboratory Billing for the Technical Component (TC) of Physician Pathology Services to Hospital Patients
CR #: 3467
Job Aid #: JA3467

MMA Drug Pricing Update - Payment Limit for J0207 (Amifostine)

Thu, 10 Nov 2005 14:35:00 EST

Transmittal #: R361CP
Subject: MMA Drug Pricing Update - Payment Limit for J0207 (Amifostine)
CR #: 3552
Job Aid #: N/A

Implementation of Coverage of Religious Nonmedical Health Care Institution Items and Services Furnished in the Home, MMA section 706.

Thu, 10 Nov 2005 14:36:00 EST

Transmittal #: R357CP
Subject: Implementation of Coverage of Religious Nonmedical Health Care Institution Items and Services Furnished in the Home, MMA section 706.
CR #: 3529
Job Aid #: N/A

Implementation of Coverage of Religious Nonmedical Health Care Institution (RNHCI) Items and Services Furnished in the Home, MMA section 706.

Thu, 10 Nov 2005 14:37:00 EST

Transmittal #: R25BP
Subject: Implementation of Coverage of Religious Nonmedical Health Care Institution (RNHCI) Items and Services Furnished in the Home, MMA section 706.
CR #: 3529
Job Aid #: N/A

Chapter 5 and Chapter 17B

Thu, 10 Nov 2005 14:38:00 EST

Transmittal #: R63MCM
Subject: Chapter 5 and Chapter 17B
CR #: N/A
Job Aid #: N/A

Instructions for Completion of Form CMS-1450

Thu, 10 Nov 2005 14:40:00 EST

Transmittal #: R368CP
Subject: Instructions for Completion of Form CMS-1450
CR #: 3543
Job Aid #: N/A

Guidance to Surveyors for Long Term Care Facilities

Thu, 10 Nov 2005 14:40:00 EST

Transmittal #: R4SOM
Subject: Guidance to Surveyors for Long Term Care Facilities
CR #: N/A
Job Aid #: N/A

Revisions to Appendix P (Survey Protocols for Long Term Care Facilities) and Appendix PP (Guidance to Surveyors for Long Term Care Facilities)

Thu, 10 Nov 2005 14:42:00 EST

Transmittal #: R5SOM
Subject: Revisions to Appendix P (Survey Protocols for Long Term Care Facilities) and Appendix PP (Guidance to Surveyors for Long Term Care Facilities)
CR #: N/A
Job Aid #: N/A

Section 630 of the Medicare Modernization Act (MMA) allows for the reimbursement for ambulance services provided by IHS/Tribal Hospitals, including CAHs, which manage and operate hospital-based ambulances.

Thu, 10 Nov 2005 14:42:00 EST

Transmittal #: R367CP
Subject: Section 630 of the Medicare Modernization Act (MMA) allows for the reimbursement for ambulance services provided by IHS/Tribal Hospitals, including CAHs, which manage and operate hospital-based ambulances.
CR #: 3521
Job Aid #: N/A

New Case-Mix Adjusted End Stage Renal Disease (ESRD) Composite Payment Rates and New Composite Rates and New Composite Rate Exceptions Window for Pediatric ESRD Facilities

Thu, 10 Nov 2005 14:44:00 EST

Transmittal #: R370CP
Subject: New Case-Mix Adjusted End Stage Renal Disease (ESRD) Composite Payment Rates and New Composite Rates and New Composite Rate Exceptions Window for Pediatric ESRD Facilities
CR #: 3572
Job Aid #: N/A

New ESRD Composite Payment Rates Effective January 1, 2005

Thu, 10 Nov 2005 14:44:00 EST

Transmittal #: R373CP
Subject: New ESRD Composite Payment Rates Effective January 1, 2005
CR #: 3554
Job Aid #: N/A

Long Act Implant, Bcg Live Intravesical Vac, and Gallium ga 67; Adjustments Due to Misclassification

Thu, 10 Nov 2005 14:45:00 EST

Transmittal #: R377CP
Subject: Long Act Implant, Bcg Live Intravesical Vac, and Gallium ga 67; Adjustments Due to Misclassification
CR #: 3540
Job Aid #: N/A

Changes to the Laboratory National Coverage Determination (NCD) edit Software for January 2005

Thu, 10 Nov 2005 14:48:00 EST

Transmittal #: R380CP
Subject: Changes to the Laboratory National Coverage Determination (NCD) edit Software for January 2005
CR #: 3429
Job Aid #: N/A

Low Osmolar Contrast Material/Laboratory Tests/Payment for Inpatient Services Furnished by a Critical Access Hospital (CAH)

Thu, 10 Nov 2005 14:49:00 EST

Transmittal #: R379CP
Subject: Low Osmolar Contrast Material/Laboratory Tests/Payment for Inpatient Services Furnished by a Critical Access Hospital (CAH)
CR #: 3439
Job Aid #: N/A

Revisions and Corrections, Chapter 29 of the IOM, Claims Processing Manual - Appeals

Thu, 10 Nov 2005 14:50:00 EST

Transmittal #: R381CP
Subject: Revisions and Corrections, Chapter 29 of the IOM, Claims Processing Manual - Appeals
CR #: 3127
Job Aid #: N/A

Payment for Emergency Medical Treatment and Labor Act (EMTALA) - Mandated Screening and Stabilization Services

Thu, 10 Nov 2005 14:51:00 EST

Transmittal #: R86PI
Subject: Payment for Emergency Medical Treatment and Labor Act (EMTALA) - Mandated Screening and Stabilization Services
CR #: 3437
Job Aid #: N/A

DMERC - Revision to CR 2631 Requirements for DMERC claims

Thu, 10 Nov 2005 15:15:00 EST

Transmittal #: R353CP
Subject: DMERC - Revision to CR 2631 Requirements for DMERC claims
CR #: 3261
Job Aid #: N/A

Three Places after the Decimal Point for ASP drug file

Thu, 10 Nov 2005 15:16:00 EST

Transmittal #: R352CP
Subject: Three Places after the Decimal Point for ASP drug file
CR #: 3436
Job Aid #: N/A

Notice of New Interest Rate for Medicare Overpayments and Underpayments.

Thu, 10 Nov 2005 15:18:00 EST

Transmittal #: R59FM
Subject: Notice of New Interest Rate for Medicare Overpayments and Underpayments.
CR #: 3453
Job Aid #: N/A

Inclusion of Forteo as a Covered Osteoporosis Drug and Clarification of Manual Instructions Regarding Osteoporosis Drugs

Thu, 10 Nov 2005 15:19:00 EST

Transmittal #: R358CP
Subject: Inclusion of Forteo as a Covered Osteoporosis Drug and Clarification of Manual Instructions Regarding Osteoporosis Drugs
CR #: 3524
Job Aid #: N/A

Annual Type of Service (TOS)

Thu, 10 Nov 2005 15:21:00 EST

Transmittal #: R349CP
Subject: Annual Type of Service (TOS)
CR #: 3519
Job Aid #: N/A

Three Places after the Decimal Point for ASP drug file

Thu, 10 Nov 2005 15:22:00 EST

Transmittal #: R346CP
Subject: Three Places after the Decimal Point for ASP drug file
CR #: 3436
Job Aid #: N/A

Inclusion of Forteo as a Covered Osteoporosis Drug and Clarification of Manual Instructions Regarding Osteoporosis Drugs

Thu, 10 Nov 2005 15:27:00 EST

Transmittal #: R26BP
Subject: Inclusion of Forteo as a Covered Osteoporosis Drug and Clarification of Manual Instructions Regarding Osteoporosis Drugs
CR #: 3524
Job Aid #: N/A

Instructions Applicable to the Audit of Hospitals that are Part of an Affiliated Group in Relation to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments

Thu, 10 Nov 2005 15:28:00 EST

Transmittal #: R125OTN
Subject: Instructions Applicable to the Audit of Hospitals that are Part of an Affiliated Group in Relation to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments
CR #: 3558
Job Aid #: N/A

Implementation of the Medicare Physician Fee Schedule (MPFS) National Abstract File for Purchased Diagnostic Tests and Interpretations

Thu, 10 Nov 2005 15:30:00 EST

Transmittal #: R341CP
Subject: Implementation of the Medicare Physician Fee Schedule (MPFS) National Abstract File for Purchased Diagnostic Tests and Interpretations
CR #: 3481
Job Aid #: JA3481

Manualization NCD: Acupuncture for Fibromyalgia/Osteoarthritis

Thu, 10 Nov 2005 15:31:00 EST

Transmittal #: R11NCD
Subject: Manualization NCD: Acupuncture for Fibromyalgia/Osteoarthritis
CR #: 3250
Job Aid #: N/A

Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement

Thu, 10 Nov 2005 15:31:00 EST

Transmittal #: R340CP
Subject: Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement
CR #: 3525
Job Aid #: N/A

Remonal of the Skilled Nursing Facility (SNF) No Pay File

Thu, 10 Nov 2005 15:32:00 EST

Transmittal #: R338CP
Subject: Remonal of the Skilled Nursing Facility (SNF) No Pay File
CR #: 3534
Job Aid #: N/A

Change in Hospital Type of Bill for Billing Diagnostic and Screening Mammographics

Thu, 10 Nov 2005 15:33:00 EST

Transmittal #: R337CP
Subject: Change in Hospital Type of Bill for Billing Diagnostic and Screening Mammographics
CR #: 3469
Job Aid #: N/A

DMERC - Revision to CR 2631 Requirements for DMERC claims

Thu, 10 Nov 2005 15:34:00 EST

Transmittal #: R345CP
Subject: DMERC - Revision to CR 2631 Requirements for DMERC claims
CR #: 3261
Job Aid #: N/A

Indian Health Service (IHS) or Tribal Hospitals including Critical Access Hospitals (CAH) Payment Methodology for Inpatient Social Admissions and Outpatient Services Occurring During Concurrent Stays

Thu, 10 Nov 2005 15:35:00 EST

Transmittal #: R336CP
Subject: Indian Health Service (IHS) or Tribal Hospitals including Critical Access Hospitals (CAH) Payment Methodology for Inpatient Social Admissions and Outpatient Services Occurring During Concurrent Stays
CR #: 3452
Job Aid #: N/A

Incorrect Reporting of Miles, Times, Units, Services (MTUS) Indicator When a Drug is Billed in the NCPDP Format Using an NDC Code

Thu, 10 Nov 2005 15:36:00 EST

Transmittal #: R335CP
Subject: Incorrect Reporting of Miles, Times, Units, Services (MTUS) Indicator When a Drug is Billed in the NCPDP Format Using an NDC Code
CR #: 3435
Job Aid #: N/A

Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site

Thu, 10 Nov 2005 15:37:00 EST

Transmittal #: R342CP
Subject: Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site
CR #: 3427
Job Aid #: N/A

Editing of Hospitals and Skilled Nursing Facilities Part B Inpatient Services (Full Replacement of Change Request 3366)

Thu, 10 Nov 2005 15:38:00 EST

Transmittal #: R351CP
Subject: Editing of Hospitals and Skilled Nursing Facilities Part B Inpatient Services (Full Replacement of Change Request 3366)
CR #: 3531
Job Aid #: JA3531

Inpatient Rehabilitation Facility (IRF) Classification Requirements

Thu, 10 Nov 2005 15:39:00 EST

Transmittal #: R347CP
Subject: Inpatient Rehabilitation Facility (IRF) Classification Requirements
CR #: 3503
Job Aid #: N/A

January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective January 1, 2005

Thu, 10 Nov 2005 15:40:00 EST

Transmittal #: R348CP
Subject: January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective January 1, 2005
CR #: 3539
Job Aid #: N/A

Clarification: Modifiers for Transportation of Portable X-rays (R0075)

Thu, 10 Nov 2005 15:41:00 EST

Transmittal #: R343CP
Subject: Clarification: Modifiers for Transportation of Portable X-rays (R0075)
CR #: 3280
Job Aid #: N/A

Editing for Part B Carriers and Durable Medical Equipment Regional Carriers (DMERCs) for Duplicate Claims in Process at the Same Time

Thu, 10 Nov 2005 15:41:00 EST

Transmittal #: R350CP
Subject: Editing for Part B Carriers and Durable Medical Equipment Regional Carriers (DMERCs) for Duplicate Claims in Process at the Same Time
CR #: 3347
Job Aid #: N/A

Revision of Section 300.5.1, Chapter 15 of the Medicare Benefit Policy Manual to include 22x TOB as an applicable TOB for Diabetes Self-Management Training.

Thu, 10 Nov 2005 15:42:00 EST

Transmittal #: R24BP
Subject: Revision of Section 300.5.1, Chapter 15 of the Medicare Benefit Policy Manual to include 22x TOB as an applicable TOB for Diabetes Self-Management Training.
CR #: 3531
Job Aid #: N/A

Medicare Termination of Beneficiaries With End Stage Renal Disease (ESRD)

Thu, 10 Nov 2005 15:43:00 EST

Transmittal #: R13GI
Subject: Medicare Termination of Beneficiaries With End Stage Renal Disease (ESRD)
CR #: 2923
Job Aid #: N/A

Medicare Secondary Payer (MSP) Savings Report Redesign

Thu, 10 Nov 2005 15:44:00 EST

Transmittal #: R21MSP
Subject: Medicare Secondary Payer (MSP) Savings Report Redesign
CR #: 3407
Job Aid #: N/A

Medicare Secondary Payer (MSP) Savings Report Redesign

Thu, 10 Nov 2005 15:46:00 EST

Transmittal #: R20MSP
Subject: Medicare Secondary Payer (MSP) Savings Report Redesign
CR #: 3181
Job Aid #: N/A

Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 5 and 6

Thu, 10 Nov 2005 16:45:00 EST

Transmittal #: R71PI2
Subject: Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 5 and 6
CR #: 3030
Job Aid #: N/A

New Requirements for Self-Administered Drug (SAD) Exclusion List Articles in the Medicare Coverage Database (MCD)

Thu, 10 Nov 2005 16:46:00 EST

Transmittal #: R70PI
Subject: New Requirements for Self-Administered Drug (SAD) Exclusion List Articles in the Medicare Coverage Database (MCD)
CR #: 3136
Job Aid #: N/A

Rewrite of the Program Integrity Manual (except Chapter 10), Transmittal Page, Business Requirements, Table of Contents, Chapters 1 and 2.

Thu, 10 Nov 2005 16:46:00 EST

Transmittal #: R71PI
Subject: Rewrite of the Program Integrity Manual (except Chapter 10), Transmittal Page, Business Requirements, Table of Contents, Chapters 1 and 2.
CR #: 3030
Job Aid #: N/A

Electrical Stimulation and Electromagnetic Therapy for the Treatment of Woundsq

Thu, 10 Nov 2005 16:48:00 EST

Transmittal #: R7NCD
Subject: Electrical Stimulation and Electromagnetic Therapy for the Treatment of Woundsq
CR #: 3149
Job Aid #: N/A

New Requirements for payment of drugs furnished in independent dialysis facilities and paid outside of the composite rate for dates of service (DOS) starting on January 1, 2004. Drugs furnished in this setting will be paid at the lower of billed charges or 95 percent Average Wholesale Price (AWP) for the calendar year 2004. These changes have been established with the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, PL 108-173.

Thu, 10 Nov 2005 16:48:00 EST

Transmittal #: R110CP
Subject: New Requirements for payment of drugs furnished in independent dialysis facilities and paid outside of the composite rate for dates of service (DOS) starting on January 1, 2004. Drugs furnished in this setting will be paid at the lower of billed charges or 95 percent Average Wholesale Price (AWP) for the calendar year 2004. These changes have been established with the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, PL 108-173.
CR #: 3078
Job Aid #: N/A

Type of Service (TOS) Corrections

Thu, 10 Nov 2005 16:49:00 EST

Transmittal #: R108CP
Subject: Type of Service (TOS) Corrections
CR #: 3018
Job Aid #: N/A

Medicare Business Partners Systems Security (a.k.a. CMS Business Partners Systems Security Manual)

Thu, 10 Nov 2005 16:50:00 EST

Transmittal #: R4SSM
Subject: Medicare Business Partners Systems Security (a.k.a. CMS Business Partners Systems Security Manual)
CR #: 3106
Job Aid #: N/A

Provider/Supplier Communications - Revisions and Additions to Existing Contractor Requirements

Thu, 10 Nov 2005 16:51:00 EST

Transmittal #: R4COM
Subject: Provider/Supplier Communications - Revisions and Additions to Existing Contractor Requirements
CR #: 3118
Job Aid #: N/A

Implementation of Section 508(f) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173)

Thu, 10 Nov 2005 16:51:00 EST

Transmittal #: R65OTN
Subject: Implementation of Section 508(f) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173)
CR #: 3084
Job Aid #: N/A

Implementation of Sections 401, 402, 504 and 508(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173

Thu, 10 Nov 2005 16:52:00 EST

Transmittal #: R64OTN
Subject: Implementation of Sections 401, 402, 504 and 508(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173
CR #: 3158
Job Aid #: N/A

Durable Medical Equipment Regional Carriers (DMERCs) - DeWall Posture Protector Orthotic Body Jacket (L0430): Continuation of CMS' Policy Stated in CR 2711 (B-03-025) dated April 11, 2003.

Thu, 10 Nov 2005 16:53:00 EST

Transmittal #: R63OTN
Subject: Durable Medical Equipment Regional Carriers (DMERCs) - DeWall Posture Protector Orthotic Body Jacket (L0430): Continuation of CMS' Policy Stated in CR 2711 (B-03-025) dated April 11, 2003.
CR #: 3224
Job Aid #: N/A

Interim Non-Systems Solution: Converting Health Insurance Portability and Accountability Act (HIPAA) Individual Relationship Codes to Common Working File (CWF) Patient Relationship Codes

Thu, 10 Nov 2005 16:53:00 EST

Transmittal #: R12MSP
Subject: Interim Non-Systems Solution: Converting Health Insurance Portability and Accountability Act (HIPAA) Individual Relationship Codes to Common Working File (CWF) Patient Relationship Codes
CR #: 3117
Job Aid #: N/A

Streamlining Enrollment Requirements

Thu, 10 Nov 2005 16:54:00 EST

Transmittal #: R69PI
Subject: Streamlining Enrollment Requirements
CR #: 3159
Job Aid #: N/A

New Payment Allowance Percentages for DMERC Drugs

Thu, 10 Nov 2005 16:55:00 EST

Transmittal #: R131CP
Subject: New Payment Allowance Percentages for DMERC Drugs
CR #: 3153
Job Aid #: N/A

Frequency Limitations for Darbepoetin Alfa (trade name Aranesp) For Treatment Of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis.

Thu, 10 Nov 2005 16:56:00 EST

Transmittal #: R118CP
Subject: Frequency Limitations for Darbepoetin Alfa (trade name Aranesp) For Treatment Of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis.
CR #: 2984
Job Aid #: N/A

Chapter 32, Billing Instructions for Special Services

Thu, 10 Nov 2005 16:57:00 EST

Transmittal #: R130CP
Subject: Chapter 32, Billing Instructions for Special Services
CR #: 2323
Job Aid #: N/A

Instructions for downloading the Medicare zip code file.

Thu, 10 Nov 2005 16:58:00 EST

Transmittal #: R117CP
Subject: Instructions for downloading the Medicare zip code file.
CR #: 3160
Job Aid #: N/A

Additional Information and Corrections to Previous Transmittals Regarding Healthcare Common Procedure Coding System (HCPCS) Codes and Modifiers for Low Osmolar Contrast Material, Orthotics, and Durable Medical Equipment

Thu, 10 Nov 2005 16:58:00 EST

Transmittal #: R129CP
Subject: Additional Information and Corrections to Previous Transmittals Regarding Healthcare Common Procedure Coding System (HCPCS) Codes and Modifiers for Low Osmolar Contrast Material, Orthotics, and Durable Medical Equipment
CR #: 3143
Job Aid #: N/A

Manualization of Deep Brain Stimulation

Thu, 10 Nov 2005 17:00:00 EST

Transmittal #: R128CP
Subject: Manualization of Deep Brain Stimulation
CR #: 2553
Job Aid #: N/A

2004 Jurisdiction List

Thu, 10 Nov 2005 17:01:00 EST

Transmittal #: R127CP
Subject: 2004 Jurisdiction List
CR #: 3139
Job Aid #: N/A

Manualization Clarification of ICD-9 Coding

Thu, 10 Nov 2005 17:02:00 EST

Transmittal #: R126CP
Subject: Manualization Clarification of ICD-9 Coding
CR #: 2857
Job Aid #: N/A

Manualization of the Sacral Nerve Stimulation

Thu, 10 Nov 2005 17:03:00 EST

Transmittal #: R125CP
Subject: Manualization of the Sacral Nerve Stimulation
CR #: 2532
Job Aid #: N/A

ESRD- Miscellaneous Code Processing Clarification

Thu, 10 Nov 2005 17:04:00 EST

Transmittal #: R116CP
Subject: ESRD- Miscellaneous Code Processing Clarification
CR #: 3019
Job Aid #: N/A

Manual Revision Regarding Waiver of Annual Deductible and Coinsurance for Both ASC Facility, and ASC/Hospital Outpatient Department Physician Services

Thu, 10 Nov 2005 17:05:00 EST

Transmittal #: R11GI
Subject: Manual Revision Regarding Waiver of Annual Deductible and Coinsurance for Both ASC Facility, and ASC/Hospital Outpatient Department Physician Services
CR #: 3471
Job Aid #: N/A

DMERCs and VIPS, Processing NDC Numbers - Clarification to CR 3141

Thu, 10 Nov 2005 17:05:00 EST

Transmittal #: R115CP
Subject: DMERCs and VIPS, Processing NDC Numbers - Clarification to CR 3141
CR #: 3148
Job Aid #: N/A

Changes to the FY 2004 Graduate Medical Education (GME) Payments as Required by the Medicare Modernization Act of 2003 (MMA), P.L. 108-173

Thu, 10 Nov 2005 17:06:00 EST

Transmittal #: R61OTN
Subject: Changes to the FY 2004 Graduate Medical Education (GME) Payments as Required by the Medicare Modernization Act of 2003 (MMA), P.L. 108-173
CR #: 3071
Job Aid #: N/A

Policy Changes to Reflect Billing for Darbepoetin Alfa and Epoetin

Thu, 10 Nov 2005 17:06:00 EST

Transmittal #: R8BP
Subject: Policy Changes to Reflect Billing for Darbepoetin Alfa and Epoetin
CR #: 2984
Job Aid #: N/A

Payment of Beneficiary Submitted Flu Claims and Flu Claims Submitted by Non-Enrolled Providers

Thu, 10 Nov 2005 17:08:00 EST

Transmittal #: R334CP
Subject: Payment of Beneficiary Submitted Flu Claims and Flu Claims Submitted by Non-Enrolled Providers
CR #: 3555
Job Aid #: N/A

Chapter 7, Sanctions and ESRD Complaints and Grievances

Thu, 10 Nov 2005 17:09:00 EST

Transmittal #: R7ESRD
Subject: Chapter 7, Sanctions and ESRD Complaints and Grievances
CR #: N/A
Job Aid #: N/A

Chapter 6, Community Information and Resources

Thu, 10 Nov 2005 17:10:00 EST

Transmittal #: R6ESRD
Subject: Chapter 6, Community Information and Resources
CR #: N/A
Job Aid #: N/A

Calendar Year (CY) 2005 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures

Thu, 10 Nov 2005 17:10:00 EST

Transmittal #: R339CP
Subject: Calendar Year (CY) 2005 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures
CR #: 3442
Job Aid #: N/A

Chapter 4, Information Management

Thu, 10 Nov 2005 17:11:00 EST

Transmittal #: R5ESRD
Subject: Chapter 4, Information Management
CR #: N/A
Job Aid #: N/A

Common Working File (CWF) Duplicate Claim Edit for Referred Clinical Diagnostic and Purchased Diagnostic Services

Thu, 10 Nov 2005 17:13:00 EST

Transmittal #: R124OTN
Subject: Common Working File (CWF) Duplicate Claim Edit for Referred Clinical Diagnostic and Purchased Diagnostic Services
CR #: 3551
Job Aid #: N/A

Contractor Reporting of Operations and Workload Data (CROWD) for EDI

Thu, 10 Nov 2005 17:13:00 EST

Transmittal #: R36FM
Subject: Contractor Reporting of Operations and Workload Data (CROWD) for EDI
CR #: 2249
Job Aid #: N/A

New Part B Annual Deductible

Thu, 10 Nov 2005 17:14:00 EST

Transmittal #: R3GI
Subject: New Part B Annual Deductible
CR #: 3121
Job Aid #: N/A

Instructions For Pricing Trepostinil (Q4077)

Thu, 10 Nov 2005 17:15:00 EST

Transmittal #: R123OTN
Subject: Instructions For Pricing Trepostinil (Q4077)
CR #: 3533
Job Aid #: N/A

Electronic Reporting Specifications for Form CMS-1984-99

Thu, 10 Nov 2005 17:15:00 EST

Transmittal #: R5P238
Subject: Electronic Reporting Specifications for Form CMS-1984-99
CR #: N/A
Job Aid #: N/A

MMA Drug Pricing Update-Drug Exceptions

Thu, 10 Nov 2005 17:15:00 EST

Transmittal #: R119CP
Subject: MMA Drug Pricing Update-Drug Exceptions
CR #: 3161
Job Aid #: N/A

Home Health Agency Cost Report

Thu, 10 Nov 2005 17:16:00 EST

Transmittal #: R12P232
Subject: Home Health Agency Cost Report
CR #: N/A
Job Aid #: N/A

Shared System and CWF Renovation of Override Code Process and Recognition of Four 2-byte Modifier Fields on the Part B Query Record - For MCS Phased Implementation Approach Only

Thu, 10 Nov 2005 17:16:00 EST

Transmittal #: R122OTN
Subject: Shared System and CWF Renovation of Override Code Process and Recognition of Four 2-byte Modifier Fields on the Part B Query Record - For MCS Phased Implementation Approach Only
CR #: 3494
Job Aid #: N/A

Physician Self-Referral Prohibition; 18-Month Moratorium on Physician Investment in Specialty Hospitals

Thu, 10 Nov 2005 17:17:00 EST

Transmittal #: R62OTN
Subject: Physician Self-Referral Prohibition; 18-Month Moratorium on Physician Investment in Specialty Hospitals
CR #: 3036
Job Aid #: N/A

Installation of Version 33 of the Provider Statistical and Reimbursement (PS&R) Reporting System.

Thu, 10 Nov 2005 17:17:00 EST

Transmittal #: R37FM
Subject: Installation of Version 33 of the Provider Statistical and Reimbursement (PS&R) Reporting System.
CR #: 3131
Job Aid #: N/A

Modification to Fiscal Intermediary Standard System (FISS) Regarding Common Working File Initiated Adjustments

Thu, 10 Nov 2005 17:17:00 EST

Transmittal #: R121OTN
Subject: Modification to Fiscal Intermediary Standard System (FISS) Regarding Common Working File Initiated Adjustments
CR #: 3330
Job Aid #: N/A

Updates to the Electronic Correspondence Referral System (ECRS) User Guide v7.0 and Quick Reference Card v7.0

Thu, 10 Nov 2005 17:18:00 EST

Transmittal #: R13MSP
Subject: Updates to the Electronic Correspondence Referral System (ECRS) User Guide v7.0 and Quick Reference Card v7.0
CR #: 3174
Job Aid #: N/A

Electrical Stimulation and Electromagnetic Therapy for the Treatment of Wounds

Thu, 10 Nov 2005 17:19:00 EST

Transmittal #: R124CP
Subject: Electrical Stimulation and Electromagnetic Therapy for the Treatment of Wounds
CR #: 3149
Job Aid #: N/A

April Outpatient Code Editor (OCE) Specifications Version 5.1

Thu, 10 Nov 2005 17:20:00 EST

Transmittal #: R123CP
Subject: April Outpatient Code Editor (OCE) Specifications Version 5.1
CR #: 3170
Job Aid #: N/A

Revision to Required Messages in Change Request (CR) 2944, Implementation of Skilled Nursing Facility (SNF) Consolidated Billing Edit for Therapy Codes Considered Separately Payable Physician Services

Thu, 10 Nov 2005 17:21:00 EST

Transmittal #: R122CP
Subject: Revision to Required Messages in Change Request (CR) 2944, Implementation of Skilled Nursing Facility (SNF) Consolidated Billing Edit for Therapy Codes Considered Separately Payable Physician Services
CR #: 3156
Job Aid #: N/A

Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT)

Thu, 10 Nov 2005 17:22:00 EST

Transmittal #: R8NCD
Subject: Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT)
CR #: 2988
Job Aid #: N/A

Optional Method for Outpatient Services: Cost-Based Facility Services Plus 115 percent Fee Schedule Payment for Professional Services

Thu, 10 Nov 2005 17:23:00 EST

Transmittal #: R103CP
Subject: Optional Method for Outpatient Services: Cost-Based Facility Services Plus 115 percent Fee Schedule Payment for Professional Services
CR #: 3114
Job Aid #: N/A

New Waived Tests--April 1, 2004

Thu, 10 Nov 2005 17:24:00 EST

Transmittal #: R102P
Subject: New Waived Tests--April 1, 2004
CR #: 3061
Job Aid #: JA3571

Restoring Composite Rate Exceptions for Pediatric Facilities Under the ESRD Composite Rate System

Thu, 10 Nov 2005 17:26:00 EST

Transmittal #: R101CP
Subject: Restoring Composite Rate Exceptions for Pediatric Facilities Under the ESRD Composite Rate System
CR #: 3119
Job Aid #: N/A

Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction

Thu, 10 Nov 2005 17:27:00 EST

Transmittal #: R107CP
Subject: Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction
CR #: 3031
Job Aid #: JA3031

Restoring Composite Rate Exceptions for Pediatric Facilities Under the ESRD Composite Rate System

Thu, 10 Nov 2005 17:27:00 EST

Transmittal #: R7BP
Subject: Restoring Composite Rate Exceptions for Pediatric Facilities Under the ESRD Composite Rate System
CR #: 3119
Job Aid #: N/A

April 2004 Changes to the Hospital Outpatient Prospective Payment System (OPPS): Payment for Drugs, Biologicals and Radiopharmaceuticals, Generic Versus Brand Name

Thu, 10 Nov 2005 17:28:00 EST

Transmittal #: R112CP
Subject: April 2004 Changes to the Hospital Outpatient Prospective Payment System (OPPS): Payment for Drugs, Biologicals and Radiopharmaceuticals, Generic Versus Brand Name
CR #: 3144
Job Aid #: N/A

The Medicare Coverage Database

Thu, 10 Nov 2005 17:29:00 EST

Transmittal #: R67PI
Subject: The Medicare Coverage Database
CR #: 2976
Job Aid #: JA2976

General Policy

Thu, 10 Nov 2005 17:30:00 EST

Transmittal #: R11MSP
Subject: General Policy
CR #: 3064
Job Aid #: N/A

Claims Requiring Adjustment As a Result of April 2004 Changes to the Outpatient Prospective Payment System (OPPS)

Thu, 10 Nov 2005 17:31:00 EST

Transmittal #: R113CP
Subject: Claims Requiring Adjustment As a Result of April 2004 Changes to the Outpatient Prospective Payment System (OPPS)
CR #: 3145
Job Aid #: N/A

Modification of CMS' Medicare Contingency Plan for HIPPA Implementation

Thu, 10 Nov 2005 17:31:00 EST

Transmittal #: R114CP
Subject: Modification of CMS' Medicare Contingency Plan for HIPPA Implementation
CR #: 2981
Job Aid #: N/A

Payment For Services Provided Under a Contractual Agreement

Thu, 10 Nov 2005 17:32:00 EST

Transmittal #: R111CP
Subject: Payment For Services Provided Under a Contractual Agreement
CR #: 3083
Job Aid #: N/A

April 2004 Update of the Hospital Outpatient Prospective Payment System

Thu, 10 Nov 2005 17:32:00 EST

Transmittal #: R132CP
Subject: April 2004 Update of the Hospital Outpatient Prospective Payment System
CR #: 3154
Job Aid #: N/A

NCD - Ocular Photodynamic Therapy (OPT) With Verteporfin for Age-Related Macular Degeneration (AMD)

Thu, 10 Nov 2005 17:33:00 EST

Transmittal #: R9NCD
Subject: NCD - Ocular Photodynamic Therapy (OPT) With Verteporfin for Age-Related Macular Degeneration (AMD)
CR #: 3191
Job Aid #: N/A

Requirement for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), Fiscal Intermediaries (FIs), and Full Program Safeguard Contractors (PSCs) to Encourage Providers to Submit Medical Records to the Comprehensive Error Rate Testing (CERT) Contractor for Use in the November 2004 Improper Medicare Fee-For-Service (FFS) Payments Report

Thu, 10 Nov 2005 17:34:00 EST

Transmittal #: R67OTN
Subject: Requirement for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), Fiscal Intermediaries (FIs), and Full Program Safeguard Contractors (PSCs) to Encourage Providers to Submit Medical Records to the Comprehensive Error Rate Testing (CERT) Contractor for Use in the November 2004 Improper Medicare Fee-For-Service (FFS) Payments Report
CR #: 3157
Job Aid #: N/A

Transmittal 49 Implementation Date Extension

Thu, 10 Nov 2005 17:34:00 EST

Transmittal #: R68OTN
Subject: Transmittal 49 Implementation Date Extension
CR #: 3197
Job Aid #: N/A

Grievances, Organization Determinations, and Appeals

Thu, 10 Nov 2005 17:35:00 EST

Transmittal #: R48MCM
Subject: Grievances, Organization Determinations, and Appeals
CR #: N/A
Job Aid #: N/A

Purchased Diagnostic Test - Carriers

Thu, 10 Nov 2005 17:36:00 EST

Transmittal #: R135CP
Subject: Purchased Diagnostic Test - Carriers
CR #: 1658
Job Aid #: N/A

Instructions for Downloading the Medicare Zip Code File.

Thu, 10 Nov 2005 17:37:00 EST

Transmittal #: R134CP
Subject: Instructions for Downloading the Medicare Zip Code File.
CR #: 3198
Job Aid #: N/A

Billing NonCovered Charges to Fiscal Intermediaries - Summary and New Instructions - Clarification

Thu, 10 Nov 2005 17:37:00 EST

Transmittal #: R133CP
Subject: Billing NonCovered Charges to Fiscal Intermediaries - Summary and New Instructions - Clarification
CR #: 3115
Job Aid #: N/A

How Fiscal Intermediary's are to Record Coinsurance Amounts from The Provider Statistical and Reimbursement (PS&R) Report for Providers Who Elected to Accept Reduced Coinsurance for Outpatient Prospective Payment System (OPPS) Services

Thu, 10 Nov 2005 17:38:00 EST

Transmittal #: R70OTN
Subject: How Fiscal Intermediary's are to Record Coinsurance Amounts from The Provider Statistical and Reimbursement (PS&R) Report for Providers Who Elected to Accept Reduced Coinsurance for Outpatient Prospective Payment System (OPPS) Services
CR #: 3166
Job Aid #: N/A

NCD is being released

Thu, 10 Nov 2005 17:38:00 EST

Transmittal #: R10NCD
Subject: NCD is being released
CR #: N/A
Job Aid #: N/A

Carrier Only* Shared System Maintainer Hours for Resolution of Problems Detected As A Result of Implementation of CR 2525 and CR 2527

Thu, 10 Nov 2005 17:39:00 EST

Transmittal #: R69OTN
Subject: Carrier Only* Shared System Maintainer Hours for Resolution of Problems Detected As A Result of Implementation of CR 2525 and CR 2527
CR #: 3146
Job Aid #: N/A

Chapter 20, Managed Care and M+C Systems Business Requirements

Thu, 10 Nov 2005 17:40:00 EST

Transmittal #: R50MCM
Subject: Chapter 20, Managed Care and M+C Systems Business Requirements
CR #: N/A
Job Aid #: N/A

Rewrite of the Program Integrity Manual (except Chapter 10), Exhibits

Thu, 10 Nov 2005 17:42:00 EST

Transmittal #: R71PI5
Subject: Rewrite of the Program Integrity Manual (except Chapter 10), Exhibits
CR #: 3030
Job Aid #: N/A

Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 13 and 11

Thu, 10 Nov 2005 17:42:00 EST

Transmittal #: R71PI4
Subject: Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 13 and 11
CR #: 3030
Job Aid #: N/A

Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 7, 8, 9 and 12

Thu, 10 Nov 2005 17:43:00 EST

Transmittal #: R71PI3
Subject: Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 7, 8, 9 and 12
CR #: 3030
Job Aid #: N/A

Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 3 and 4

Thu, 10 Nov 2005 17:44:00 EST

Transmittal #: R71PI1
Subject: Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 3 and 4
CR #: 3030
Job Aid #: N/A

April Update to the January Medicare Outpatient Code Editor (OCE) Specifications Version 19.1 R1 For Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System

Thu, 10 Nov 2005 17:45:00 EST

Transmittal #: R120CP
Subject: April Update to the January Medicare Outpatient Code Editor (OCE) Specifications Version 19.1 R1 For Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System
CR #: 3155
Job Aid #: N/A

Manualization of Place of Service (POS) Code Set Program Memorandum; Revision to Group Home Code Description

Thu, 10 Nov 2005 17:45:00 EST

Transmittal #: R121CP
Subject: Manualization of Place of Service (POS) Code Set Program Memorandum; Revision to Group Home Code Description
CR #: 3087
Job Aid #: N/A

Processing of Claims for Referred Services for a Independent Clinical Diagnostic Laboratory

Thu, 10 Nov 2005 17:46:00 EST

Transmittal #: R85P
Subject: Processing of Claims for Referred Services for a Independent Clinical Diagnostic Laboratory
CR #: 3090
Job Aid #: N/A

Additional Guidelines for Implementing the National Council for Prescription Drug Program

Thu, 10 Nov 2005 17:47:00 EST

Transmittal #: R84CP
Subject: Additional Guidelines for Implementing the National Council for Prescription Drug Program
CR #: 3095
Job Aid #: N/A

Expansion of Transfer Policy Under Inpatient Payment Prospective System

Thu, 10 Nov 2005 17:47:00 EST

Transmittal #: R87CP
Subject: Expansion of Transfer Policy Under Inpatient Payment Prospective System
CR #: 2934
Job Aid #: N/A

X12N 837 Professional Implementation Guide (IG) Edits

Thu, 10 Nov 2005 17:48:00 EST

Transmittal #: R86CP
Subject: X12N 837 Professional Implementation Guide (IG) Edits
CR #: 3050
Job Aid #: N/A

Unsolicited/Voluntary Refunds

Thu, 10 Nov 2005 17:49:00 EST

Transmittal #: R35FM
Subject: Unsolicited/Voluntary Refunds
CR #: 1444
Job Aid #: N/A

Scheduled Release for April Updates to Software Programs and Pricing/Coding Files

Thu, 10 Nov 2005 17:49:00 EST

Transmittal #: R2GI
Subject: Scheduled Release for April Updates to Software Programs and Pricing/Coding Files
CR #: 3123
Job Aid #: N/A

Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Coordination of Benefits (COB) Gap Fill Additional Instruction

Thu, 10 Nov 2005 17:50:00 EST

Transmittal #: R99CP
Subject: Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Coordination of Benefits (COB) Gap Fill Additional Instruction
CR #: 3100
Job Aid #: N/A

DMERC-Beneficiary Submitted Claims, Process First Claim

Fri, 11 Nov 2005 09:58:00 EST

Transmittal #: R330CP
Subject: DMERC-Beneficiary Submitted Claims, Process First Claim
CR #: 3233
Job Aid #: N/A

New Policy and Refinements on Billing Noncovered Charges to Fiscal Intermediaries (FIs)

Fri, 11 Nov 2005 10:00:00 EST

Transmittal #: R332CP
Subject: New Policy and Refinements on Billing Noncovered Charges to Fiscal Intermediaries (FIs)
CR #: 3416
Job Aid #: N/A

DMERC Only - Payment to Providers/Suppliers Qualified to Bill Medicare for Prosthetics and Certain Custom-Fabricated Orthotics

Fri, 11 Nov 2005 10:01:00 EST

Transmittal #: R329CP
Subject: DMERC Only - Payment to Providers/Suppliers Qualified to Bill Medicare for Prosthetics and Certain Custom-Fabricated Orthotics
CR #: 3373
Job Aid #: N/A

2005 Annual Update for Skilled Nursing Facility (SNF) Consolidated Billing for the Common Working File (CWF) and Medicare Carriers

Fri, 11 Nov 2005 10:02:00 EST

Transmittal #: R328CP
Subject: 2005 Annual Update for Skilled Nursing Facility (SNF) Consolidated Billing for the Common Working File (CWF) and Medicare Carriers
CR #: 3535
Job Aid #: N/A

This transmittal rescinded and replaced by R374CP

Fri, 11 Nov 2005 10:03:00 EST

Transmittal #: R327CP
Subject: This transmittal rescinded and replaced by R374CP
CR #: 3370
Job Aid #: N/A

New Waived Tests-January 1, 2005

Fri, 11 Nov 2005 10:03:00 EST

Transmittal #: R325CP
Subject: New Waived Tests-January 1, 2005
CR #: 3484
Job Aid #: N/A

Instructions for Downloading the Medicare Zip Code File

Fri, 11 Nov 2005 10:04:00 EST

Transmittal #: R321CP
Subject: Instructions for Downloading the Medicare Zip Code File
CR #: 3482
Job Aid #: N/A

Reminder Notice of the Implementation of the Ambulance Transition Schedule

Fri, 11 Nov 2005 10:06:00 EST

Transmittal #: R320CP
Subject: Reminder Notice of the Implementation of the Ambulance Transition Schedule
CR #: 3473
Job Aid #: N/A

CORF/OPT Edit for Billing Inappropriate Supplies

Fri, 11 Nov 2005 10:17:00 EST

Transmittal #: R319CP
Subject: CORF/OPT Edit for Billing Inappropriate Supplies
CR #: 3468
Job Aid #: N/A

Clarification of Messgaes in Chapter 1, Section 10.1.1.1 to Match Official Listing on the WPC-EDI Web Site

Fri, 11 Nov 2005 10:18:00 EST

Transmittal #: R316CP
Subject: Clarification of Messgaes in Chapter 1, Section 10.1.1.1 to Match Official Listing on the WPC-EDI Web Site
CR #: 3462
Job Aid #: N/A

Clarification of CR 3176 - Payment amounts for ESRD drug administration supplies: HCPCS A4657 and A4913

Fri, 11 Nov 2005 10:23:00 EST

Transmittal #: R318CP
Subject: Clarification of CR 3176 - Payment amounts for ESRD drug administration supplies: HCPCS A4657 and A4913
CR #: 3451
Job Aid #: N/A

Clarification to Chapter 26 of the Internet Only Manual (IOM)

Fri, 11 Nov 2005 10:27:00 EST

Transmittal #: R317CP
Subject: Clarification to Chapter 26 of the Internet Only Manual (IOM)
CR #: 3431
Job Aid #: N/A

Temporary Change in Carrier Jurisdictional Pricing Rules for Purchased Diagnostic Services

Fri, 11 Nov 2005 10:28:00 EST

Transmittal #: R315CP
Subject: Temporary Change in Carrier Jurisdictional Pricing Rules for Purchased Diagnostic Services
CR #: 3464
Job Aid #: N/A

Invalid Diagnosis Code Editing - Second Phase

Fri, 11 Nov 2005 10:30:00 EST

Transmittal #: R326CP
Subject: Invalid Diagnosis Code Editing - Second Phase
CR #: 3260
Job Aid #: N/A

New Policy and Refinements on Billing Noncovered Charges to Fiscal Intermediaries (FIs)

Fri, 11 Nov 2005 10:30:00 EST

Transmittal #: R12GI
Subject: New Policy and Refinements on Billing Noncovered Charges to Fiscal Intermediaries (FIs)
CR #: 3416
Job Aid #: N/A

Quarterly Update to Correct Coding Initiative (CCI) edits, Version 11.0, Effective January 1, 2005

Fri, 11 Nov 2005 10:32:00 EST

Transmittal #: R324CP
Subject: Quarterly Update to Correct Coding Initiative (CCI) edits, Version 11.0, Effective January 1, 2005
CR #: 3491
Job Aid #: N/A

Update Regarding the Use of American Dental Association's (ADA) Current Dental Terminology (CDT) Codes on Medicare Contractors' Web Sites and Other Electronic Media

Fri, 11 Nov 2005 10:32:00 EST

Transmittal #: R323CP
Subject: Update Regarding the Use of American Dental Association's (ADA) Current Dental Terminology (CDT) Codes on Medicare Contractors' Web Sites and Other Electronic Media
CR #: 3499
Job Aid #: N/A

Release Medlearn Article for Change Request (CR) 2813 (End Stage Renal Disease Reimbursement for Automated Multi-channel Chemistry Test(s)).

Fri, 11 Nov 2005 10:33:00 EST

Transmittal #: R322CP
Subject: Release Medlearn Article for Change Request (CR) 2813 (End Stage Renal Disease Reimbursement for Automated Multi-channel Chemistry Test(s)).
CR #: 3501
Job Aid #: N/A

Revised Reporting Requirements for Contractor Reporting of Operational Workload Data (CROWD) Health Professional Shortage Area (HPSA) Quarterly Report (CMS Form 1565E, CROWD Form S)

Fri, 11 Nov 2005 10:34:00 EST

Transmittal #: R57FM
Subject: Revised Reporting Requirements for Contractor Reporting of Operational Workload Data (CROWD) Health Professional Shortage Area (HPSA) Quarterly Report (CMS Form 1565E, CROWD Form S)
CR #: 3472
Job Aid #: N/A

Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial

Fri, 11 Nov 2005 10:35:00 EST

Transmittal #: R85PI
Subject: Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial
CR #: 3363
Job Aid #: N/A

Revision to Balancing Requirement on Form 5, Line 10, of the Contractor Reporting of Operational and Workload Data (Crowd)

Fri, 11 Nov 2005 10:37:00 EST

Transmittal #: R56FM
Subject: Revision to Balancing Requirement on Form 5, Line 10, of the Contractor Reporting of Operational and Workload Data (Crowd)
CR #: 3486
Job Aid #: N/A

Two New Medicare Summary Notice (MSN) Messages for Parental Pumps - DMERC only

Fri, 11 Nov 2005 13:09:00 EST

Transmittal #: R308CP
Subject: Two New Medicare Summary Notice (MSN) Messages for Parental Pumps - DMERC only
CR #: 3506
Job Aid #: N/A

Disabling the CWF 57x3 Consistency Error Code

Fri, 11 Nov 2005 13:10:00 EST

Transmittal #: R305CP
Subject: Disabling the CWF 57x3 Consistency Error Code
CR #: 3470
Job Aid #: N/A

Payment Allowances for the Influenza Virus Vaccine (CPT 90658) and the Pneumoccocal Vaccine (CPT 90732)

Fri, 11 Nov 2005 13:12:00 EST

Transmittal #: R114OTN
Subject: Payment Allowances for the Influenza Virus Vaccine (CPT 90658) and the Pneumoccocal Vaccine (CPT 90732)
CR #: 3490
Job Aid #: N/A

Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit

Fri, 11 Nov 2005 13:14:00 EST

Transmittal #: R304CP
Subject: Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit
CR #: 3226
Job Aid #: JA3226

Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit

Fri, 11 Nov 2005 13:15:00 EST

Transmittal #: R22BP
Subject: Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit
CR #: 3226
Job Aid #: N/A

Medicare Comprehensive Outpatient Rehabilitation Facility Coverage

Fri, 11 Nov 2005 13:15:00 EST

Transmittal #: R21BP
Subject: Medicare Comprehensive Outpatient Rehabilitation Facility Coverage
CR #: 3315
Job Aid #: JA3315

New Remark Code Message for Use with Claims for Parenteral Pumps - (DMERC) Only

Fri, 11 Nov 2005 13:16:00 EST

Transmittal #: R117OTN
Subject: New Remark Code Message for Use with Claims for Parenteral Pumps - (DMERC) Only
CR #: 3405
Job Aid #: N/A

Billing Requirements for Positron Emission Tomography (PET) Scans for Dementia and Neurodegenerative Diseases

Fri, 11 Nov 2005 13:17:00 EST

Transmittal #: R310CP
Subject: Billing Requirements for Positron Emission Tomography (PET) Scans for Dementia and Neurodegenerative Diseases
CR #: 3426
Job Aid #: N/A

For Assets Acquired On or After May 1, 2004

Fri, 11 Nov 2005 13:18:00 EST

Transmittal #: R426PR1
Subject: For Assets Acquired On or After May 1, 2004
CR #: N/A
Job Aid #: N/A

Reporting Appeals Redetermination Information On Forms CMS-2591 and 2590

Fri, 11 Nov 2005 13:19:00 EST

Transmittal #: R55FM
Subject: Reporting Appeals Redetermination Information On Forms CMS-2591 and 2590
CR #: 3448
Job Aid #: N/A

Revised Requirements for Chiropractic Billing of Active/Corrective Treatment and Maintenance Therapy. Full Replacement of CR 3063

Fri, 11 Nov 2005 13:21:00 EST

Transmittal #: R23BP
Subject: Revised Requirements for Chiropractic Billing of Active/Corrective Treatment and Maintenance Therapy. Full Replacement of CR 3063
CR #: 3449
Job Aid #: N/A

Instructions for Completion of Form CMS-1450

Fri, 11 Nov 2005 13:22:00 EST

Transmittal #: R311CP
Subject: Instructions for Completion of Form CMS-1450
CR #: 3417
Job Aid #: JA3417

Shared Systems Maintainers Hours for Resolution of Problems Detected as a Result of Implementation of Change Request 2525 and Change Request 2527

Fri, 11 Nov 2005 13:23:00 EST

Transmittal #: R118OTN
Subject: Shared Systems Maintainers Hours for Resolution of Problems Detected as a Result of Implementation of Change Request 2525 and Change Request 2527
CR #: 3536
Job Aid #: N/A

Percutaneous Transluminal Angioplasty (PTA)

Fri, 11 Nov 2005 13:24:00 EST

Transmittal #: R314CP
Subject: Percutaneous Transluminal Angioplasty (PTA)
CR #: 3489
Job Aid #: JA3489

Percutaneous Transluminal Angioplasty (PTA)

Fri, 11 Nov 2005 13:26:00 EST

Transmittal #: R25NCD
Subject: Percutaneous Transluminal Angioplasty (PTA)
CR #: 3489
Job Aid #: JA3489

Override of Common Working File (CWF) Edit for Observation Services Exceeding 48 Hours

Fri, 11 Nov 2005 13:27:00 EST

Transmittal #: R120OTN
Subject: Override of Common Working File (CWF) Edit for Observation Services Exceeding 48 Hours
CR #: 3311
Job Aid #: N/A

Nursing Facility Visits (Codes 99301 -99313)

Fri, 11 Nov 2005 13:28:00 EST

Transmittal #: R302CP
Subject: Nursing Facility Visits (Codes 99301 -99313)
CR #: 3096
Job Aid #: N/A

Instructions for Completion of Form CMS-1450

Fri, 11 Nov 2005 13:29:00 EST

Transmittal #: R303CP
Subject: Instructions for Completion of Form CMS-1450
CR #: 3417
Job Aid #: N/A

Fiscal Year (FY) 2005 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) and Other Bill Processing Changes Related to the IPPS Final Rule

Fri, 11 Nov 2005 13:30:00 EST

Transmittal #: R309CP
Subject: Fiscal Year (FY) 2005 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) and Other Bill Processing Changes Related to the IPPS Final Rule
CR #: 3459
Job Aid #: JA3459

Full Replacement of CR 3415, 3rd Update to the 2004 Medicare Physician Fee Schedule Database.

Fri, 11 Nov 2005 13:31:00 EST

Transmittal #: R306CP
Subject: Full Replacement of CR 3415, 3rd Update to the 2004 Medicare Physician Fee Schedule Database.
CR #: 3505
Job Aid #: N/A

Revisions to Chapter 13 - Medicare+Choice Beneficiary Grievances, Organization Determinations and Appeals

Fri, 11 Nov 2005 13:32:00 EST

Transmittal #: R62MCM
Subject: Revisions to Chapter 13 - Medicare+Choice Beneficiary Grievances, Organization Determinations and Appeals
CR #: N/A
Job Aid #: N/A

Use of Condition Code 44, "Inpatient Admission Changed to Outpatient"

Fri, 11 Nov 2005 13:33:00 EST

Transmittal #: R299CP
Subject: Use of Condition Code 44, "Inpatient Admission Changed to Outpatient"
CR #: 3444
Job Aid #: N/A

Reasonable Charge Update for 2005 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, Therapeutic Shoes, and Certain Intraocular Lenses

Fri, 11 Nov 2005 13:34:00 EST

Transmittal #: R297CP
Subject: Reasonable Charge Update for 2005 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, Therapeutic Shoes, and Certain Intraocular Lenses
CR #: 3430
Job Aid #: N/A

MSN and ANSI Messages for Mammography Claims

Fri, 11 Nov 2005 13:35:00 EST

Transmittal #: R298CP
Subject: MSN and ANSI Messages for Mammography Claims
CR #: 2617
Job Aid #: N/A

Magnetic Resonance Spectroscopy for Diagnosing Brain Tumors

Fri, 11 Nov 2005 13:36:00 EST

Transmittal #: R21NCD
Subject: Magnetic Resonance Spectroscopy for Diagnosing Brain Tumors
CR #: 3425
Job Aid #: N/A

Hospital Services Covered Under Part B

Fri, 11 Nov 2005 13:37:00 EST

Transmittal #: R19BP
Subject: Hospital Services Covered Under Part B
CR #: 3444
Job Aid #: N/A

Crossover Patients in New Long Term Care Hospitals (LTCH)

Fri, 11 Nov 2005 13:38:00 EST

Transmittal #: R267CP
Subject: Crossover Patients in New Long Term Care Hospitals (LTCH)
CR #: 3391
Job Aid #: JA3391

Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year 2005

Fri, 11 Nov 2005 13:38:00 EST

Transmittal #: R10GI
Subject: Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year 2005
CR #: 3463
Job Aid #: N/A

Editing Of Hospital And Skilled Nursing Facility Part B Inpatient Services

Fri, 11 Nov 2005 13:40:00 EST

Transmittal #: R301CP
Subject: Editing Of Hospital And Skilled Nursing Facility Part B Inpatient Services
CR #: 3366
Job Aid #: N/A

Notification of Medlearn Matters (MM) Article for Confidential Change Request (CR) 3301

Fri, 11 Nov 2005 13:41:00 EST

Transmittal #: R116OTN
Subject: Notification of Medlearn Matters (MM) Article for Confidential Change Request (CR) 3301
CR #: 3465
Job Aid #: N/A

Notification to Providers of Intent to Complete a Post-Payment Audit

Fri, 11 Nov 2005 13:42:00 EST

Transmittal #: R54FM
Subject: Notification to Providers of Intent to Complete a Post-Payment Audit
CR #: 3441
Job Aid #: N/A

Clarification of MSP Rules in Relation to a Temporary Leave of Absence

Fri, 11 Nov 2005 13:43:00 EST

Transmittal #: R19MSP
Subject: Clarification of MSP Rules in Relation to a Temporary Leave of Absence
CR #: 3447
Job Aid #: N/A

Fiscal Year (FY) 2005 Payment for Services Furnished in Ambulatory Surgical Centers (ASCs)

Fri, 11 Nov 2005 13:45:00 EST

Transmittal #: R288CP
Subject: Fiscal Year (FY) 2005 Payment for Services Furnished in Ambulatory Surgical Centers (ASCs)
CR #: 3394
Job Aid #: N/A

2005 Healthcare Common Procedure Coding System (HCPCS) Annual Update reminder

Fri, 11 Nov 2005 13:45:00 EST

Transmittal #: R283CP
Subject: 2005 Healthcare Common Procedure Coding System (HCPCS) Annual Update reminder
CR #: 3422
Job Aid #: N/A

Addition of Physician Assistants, Nurse Practitioners and Clinical Nurse Specialists as Emergency On-Call Providers for Critical Access Hospitals (CAHs)

Fri, 11 Nov 2005 13:46:00 EST

Transmittal #: R285CP
Subject: Addition of Physician Assistants, Nurse Practitioners and Clinical Nurse Specialists as Emergency On-Call Providers for Critical Access Hospitals (CAHs)
CR #: 3228
Job Aid #: JA3228

For Cost Reporting Periods End On or After March 31, 2002

Fri, 11 Nov 2005 13:47:00 EST

Transmittal #: R6P229
Subject: For Cost Reporting Periods End On or After March 31, 2002
CR #: N/A
Job Aid #: N/A

Emergency and Urgently Needed Services

Fri, 11 Nov 2005 13:48:00 EST

Transmittal #: R61MCM
Subject: Emergency and Urgently Needed Services
CR #: N/A
Job Aid #: N/A

Payment Denial for Medicare Services Furnished to Alien Beneficiaries Who Are Not Lawfully Present in the United States

Fri, 11 Nov 2005 13:49:00 EST

Transmittal #: R296CP
Subject: Payment Denial for Medicare Services Furnished to Alien Beneficiaries Who Are Not Lawfully Present in the United States
CR #: 2825
Job Aid #: N/A

MSN Messages and Reason Codes for Mammography

Fri, 11 Nov 2005 13:50:00 EST

Transmittal #: R295CP
Subject: MSN Messages and Reason Codes for Mammography
CR #: 2617
Job Aid #: N/A

Billing Instructions for ADVATE rAHF-PFM on Medicare Claims

Fri, 11 Nov 2005 13:51:00 EST

Transmittal #: R112OTN
Subject: Billing Instructions for ADVATE rAHF-PFM on Medicare Claims
CR #: 3331
Job Aid #: JA3331

Implementation of Section 921 of the Medicare Modernization Act (MMA) - Provider Customer Service Program

Fri, 11 Nov 2005 13:51:00 EST

Transmittal #: R113OTN
Subject: Implementation of Section 921 of the Medicare Modernization Act (MMA) - Provider Customer Service Program
CR #: 3376
Job Aid #: N/A

Medicare Physician Fee Schedule Database (MPFSDB) 2005 File Layout

Fri, 11 Nov 2005 13:52:00 EST

Transmittal #: R286CP
Subject: Medicare Physician Fee Schedule Database (MPFSDB) 2005 File Layout
CR #: 3421
Job Aid #: N/A

Schedule for Completing the Calendar Year (CY) 2005 Fee Schedule Updates and the Participating Physician Enrollment Procedures

Fri, 11 Nov 2005 13:53:00 EST

Transmittal #: R287CP
Subject: Schedule for Completing the Calendar Year (CY) 2005 Fee Schedule Updates and the Participating Physician Enrollment Procedures
CR #: 3409
Job Aid #: N/A

DMERCs Only-Appeals of Duplicate claims

Fri, 11 Nov 2005 13:55:00 EST

Transmittal #: R284CP
Subject: DMERCs Only-Appeals of Duplicate claims
CR #: 3371
Job Aid #: N/A

Program Integrity Management Reporting (PIMR) System Program Integrity Management Reporting System (PIMR) FY 2004 F and T Codes

Mon, 14 Nov 2005 10:16:00 EST

Transmittal #: R58OTN
Subject: Program Integrity Management Reporting (PIMR) System Program Integrity Management Reporting System (PIMR) FY 2004 F and T Codes
CR #: 3110
Job Aid #: N/A

Chapter 19, Managed Care and M+C Systems Requirements

Mon, 14 Nov 2005 10:17:00 EST

Transmittal #: R46MCM
Subject: Chapter 19, Managed Care and M+C Systems Requirements
CR #: N/A
Job Aid #: N/A

Chapter 13, Grievances Organization Determinations and Appeals

Mon, 14 Nov 2005 10:18:00 EST

Transmittal #: R45MCM
Subject: Chapter 13, Grievances Organization Determinations and Appeals
CR #: N/A
Job Aid #: N/A

Update the Part B Shared Systems to Send the Appropriate Medicare Fee Schedule Amounts to the Medicare Secondary Payer Payment (MSPPAY) Software for Psychiatric MSP Claims

Mon, 14 Nov 2005 10:18:00 EST

Transmittal #: R10MSP
Subject: Update the Part B Shared Systems to Send the Appropriate Medicare Fee Schedule Amounts to the Medicare Secondary Payer Payment (MSPPAY) Software for Psychiatric MSP Claims
CR #: 2955
Job Aid #: N/A

Outpatient Clinical Laboratory Tests Furnished by Hospitals With Fewer Than 50 beds in Qualified Rural Areas

Mon, 14 Nov 2005 10:19:00 EST

Transmittal #: R100CP
Subject: Outpatient Clinical Laboratory Tests Furnished by Hospitals With Fewer Than 50 beds in Qualified Rural Areas
CR #: 3130
Job Aid #: N/A

Appendix C-Survey Procedures and Interpretive Guidelines for Laboratories and Laboratory Services

Mon, 14 Nov 2005 10:20:00 EST

Transmittal #: R32SOM
Subject: Appendix C-Survey Procedures and Interpretive Guidelines for Laboratories and Laboratory Services
CR #: N/A
Job Aid #: N/A

Temporary 5 Percent Payment Increase for Home Health Services Furnished in a Rural Area for One Year Under the Home Health Prospective Payment System (HH PPS), Change of HH PPS Annual Update from a Fiscal Year Update to a Calendar Year Update, and Adjustment of HH PPS Annual Update to the Home Health Market Basket Percentage Increase Minus 0.8 Percent

Mon, 14 Nov 2005 10:21:00 EST

Transmittal #: R59OTN
Subject: Temporary 5 Percent Payment Increase for Home Health Services Furnished in a Rural Area for One Year Under the Home Health Prospective Payment System (HH PPS), Change of HH PPS Annual Update from a Fiscal Year Update to a Calendar Year Update, and Adjustment of HH PPS Annual Update to the Home Health Market Basket Percentage Increase Minus 0.8 Percent
CR #: 3085
Job Aid #: N/A

Regional Medicare Swing-Bed Rates

Mon, 14 Nov 2005 10:21:00 EST

Transmittal #: R425PR1
Subject: Regional Medicare Swing-Bed Rates
CR #: N/A
Job Aid #: N/A

Chapter 7--Medicare+Choice-Enrollment and Disenrollment

Mon, 14 Nov 2005 10:22:00 EST

Transmittal #: R47MCM
Subject: Chapter 7--Medicare+Choice-Enrollment and Disenrollment
CR #: N/A
Job Aid #: N/A

Progressive Corrective Action Program Memorandum and Providing Updated Instructions on How Contractors Must Identify, Verify, and Correct Billing Errors.

Mon, 14 Nov 2005 10:23:00 EST

Transmittal #: R66PI
Subject: Progressive Corrective Action Program Memorandum and Providing Updated Instructions on How Contractors Must Identify, Verify, and Correct Billing Errors.
CR #: 3124
Job Aid #: N/A

1st Update to the 2004 Medicare Physician Fee Schedule Database

Mon, 14 Nov 2005 10:23:00 EST

Transmittal #: R105CP
Subject: 1st Update to the 2004 Medicare Physician Fee Schedule Database
CR #: 3128
Job Aid #: N/A

DMERCs and VIPS, Processing NDC Numbers

Mon, 14 Nov 2005 10:24:00 EST

Transmittal #: R104CP
Subject: DMERCs and VIPS, Processing NDC Numbers
CR #: 3141
Job Aid #: N/A

Change in Methodolgy for Determining Payment for Outliers

Mon, 14 Nov 2005 10:25:00 EST

Transmittal #: R77CP
Subject: Change in Methodolgy for Determining Payment for Outliers
CR #: 2998
Job Aid #: N/A

New "K" Codes for Wheelchair Cushions

Mon, 14 Nov 2005 10:26:00 EST

Transmittal #: R83CP
Subject: New "K" Codes for Wheelchair Cushions
CR #: 3069
Job Aid #: N/A

SNF Inpatient Part A Billing

Mon, 14 Nov 2005 10:26:00 EST

Transmittal #: R76CP
Subject: SNF Inpatient Part A Billing
CR #: 3133
Job Aid #: N/A

ESRD Data for Use in Adjusting Claims

Mon, 14 Nov 2005 10:27:00 EST

Transmittal #: R82CP
Subject: ESRD Data for Use in Adjusting Claims
CR #: 3066
Job Aid #: N/A

Update of UB-92 Codes

Mon, 14 Nov 2005 10:28:00 EST

Transmittal #: R81CP
Subject: Update of UB-92 Codes
CR #: 3012
Job Aid #: N/A

Extend Medicare Coverage for Certain Colorectal Cancer Screenings at SNFs

Mon, 14 Nov 2005 10:28:00 EST

Transmittal #: R80CP
Subject: Extend Medicare Coverage for Certain Colorectal Cancer Screenings at SNFs
CR #: 2874
Job Aid #: N/A

Implementation of Changes to Payment for Ambulance Services Required by Section 414 of MMA

Mon, 14 Nov 2005 10:29:00 EST

Transmittal #: R88CP
Subject: Implementation of Changes to Payment for Ambulance Services Required by Section 414 of MMA
CR #: 3099
Job Aid #: JA3099

The Elimination of the 90-Day Grace Period for HCPCS Codes

Mon, 14 Nov 2005 10:29:00 EST

Transmittal #: R89CP
Subject: The Elimination of the 90-Day Grace Period for HCPCS Codes
CR #: 3093
Job Aid #: N/A

Common Working File MSP Modifications

Mon, 14 Nov 2005 10:39:00 EST

Transmittal #: R8MSP
Subject: Common Working File MSP Modifications
CR #: 2775
Job Aid #: N/A

Sending the Primary Payer Covered Charge Amount to the Medicare Secondary Payment (MSPPAY) Module for MSP Home Health Prospective Payment System (HH PPS) Claims

Mon, 14 Nov 2005 10:39:00 EST

Transmittal #: R7MSP
Subject: Sending the Primary Payer Covered Charge Amount to the Medicare Secondary Payment (MSPPAY) Module for MSP Home Health Prospective Payment System (HH PPS) Claims
CR #: 2954
Job Aid #: N/A

Claims Status Codes in ASC X12N 276/277 Claims Status Health Insurance Portability and Accountability Act (HIPAA) Transactions

Mon, 14 Nov 2005 10:40:00 EST

Transmittal #: R96CP
Subject: Claims Status Codes in ASC X12N 276/277 Claims Status Health Insurance Portability and Accountability Act (HIPAA) Transactions
CR #: 3017
Job Aid #: N/A

Elimination of the 90-Day Grace Period for ICD-9-CM Codes

Mon, 14 Nov 2005 10:41:00 EST

Transmittal #: R95CP
Subject: Elimination of the 90-Day Grace Period for ICD-9-CM Codes
CR #: 3094
Job Aid #: N/A

Consolidation of the Claims Crossover Process: Additional Common Working File (CWF) Functionality

Mon, 14 Nov 2005 10:42:00 EST

Transmittal #: R98CP
Subject: Consolidation of the Claims Crossover Process: Additional Common Working File (CWF) Functionality
CR #: 3109
Job Aid #: N/A

Implementation of New Medicare Redetermination Notice (MRN)

Mon, 14 Nov 2005 10:42:00 EST

Transmittal #: R97CP
Subject: Implementation of New Medicare Redetermination Notice (MRN)
CR #: 2620
Job Aid #: N/A

Additional Information in Medicare Summary Notices (MSNs) to Beneficiaries about Skilled Nursing Facility (SNF) Benefits

Mon, 14 Nov 2005 10:43:00 EST

Transmittal #: R94CP
Subject: Additional Information in Medicare Summary Notices (MSNs) to Beneficiaries about Skilled Nursing Facility (SNF) Benefits
CR #: 3098
Job Aid #: N/A

Remittance Advice Remark Code and Claim Adjustment Reason Code Update

Mon, 14 Nov 2005 11:06:00 EST

Transmittal #: R93CP
Subject: Remittance Advice Remark Code and Claim Adjustment Reason Code Update
CR #: 3122
Job Aid #: N/A

Updates to the January 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement

Mon, 14 Nov 2005 11:08:00 EST

Transmittal #: R92CP
Subject: Updates to the January 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement
CR #: 3070
Job Aid #: N/A

Revisions to Processing of Non-covered Charges on Certain Home Health Prospective Payment System Claims

Mon, 14 Nov 2005 11:09:00 EST

Transmittal #: R91CP
Subject: Revisions to Processing of Non-covered Charges on Certain Home Health Prospective Payment System Claims
CR #: 3077
Job Aid #: N/A

Implementation of Skilled Nursing Facility Consolidated Billing CWF Edit for Therapy Codes Considered Separately Payable Physician Services

Mon, 14 Nov 2005 11:10:00 EST

Transmittal #: R90CP
Subject: Implementation of Skilled Nursing Facility Consolidated Billing CWF Edit for Therapy Codes Considered Separately Payable Physician Services
CR #: 2944
Job Aid #: N/A

ESRD Reimbursement for AMCC Tests

Mon, 14 Nov 2005 11:11:00 EST

Transmittal #: R79CP
Subject: ESRD Reimbursement for AMCC Tests
CR #: 2813
Job Aid #: N/A

April Quarterly DMEPOS Fee Schedule Update

Mon, 14 Nov 2005 11:12:00 EST

Transmittal #: R58CP
Subject: April Quarterly DMEPOS Fee Schedule Update
CR #: 3014
Job Aid #: N/A

Medicare Incentive Payments for Physician Care

Mon, 14 Nov 2005 11:12:00 EST

Transmittal #: R78CP
Subject: Medicare Incentive Payments for Physician Care
CR #: 3108
Job Aid #: N/A

Implementation Guide (IG) Edits

Mon, 14 Nov 2005 11:13:00 EST

Transmittal #: R57CP
Subject: Implementation Guide (IG) Edits
CR #: 3001
Job Aid #: N/A

Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases

Mon, 14 Nov 2005 11:14:00 EST

Transmittal #: R49OTN
Subject: Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases
CR #: 3075
Job Aid #: N/A

Special Rules for Critical Access Hospital (CAH) Outpatient Billing

Mon, 14 Nov 2005 11:14:00 EST

Transmittal #: R63CP
Subject: Special Rules for Critical Access Hospital (CAH) Outpatient Billing
CR #: 3051
Job Aid #: N/A

Transfer of "WW" Codes for Oral Anti-Cancer Drugs Billed Using National Drug Codes (NDCs) on Durable Medical Equipment Regional Carrier (DMERC) Claims

Mon, 14 Nov 2005 11:15:00 EST

Transmittal #: R48OTN
Subject: Transfer of "WW" Codes for Oral Anti-Cancer Drugs Billed Using National Drug Codes (NDCs) on Durable Medical Equipment Regional Carrier (DMERC) Claims
CR #: 2863
Job Aid #: N/A

Role Conditions of Participation (COPs) Requirements When Making a Payment Decision

Mon, 14 Nov 2005 11:16:00 EST

Transmittal #: R64PI
Subject: Role Conditions of Participation (COPs) Requirements When Making a Payment Decision
CR #: 3042
Job Aid #: N/A

Fiscal Intermediaries to Perform Medical Review on Long Term Care Hospitals

Mon, 14 Nov 2005 11:16:00 EST

Transmittal #: R65PI
Subject: Fiscal Intermediaries to Perform Medical Review on Long Term Care Hospitals
CR #: 2905
Job Aid #: N/A

Installation of Version 31 of the Provider Statistical and Reimbursement (PS&R) Reporting System

Mon, 14 Nov 2005 11:17:00 EST

Transmittal #: R31FM
Subject: Installation of Version 31 of the Provider Statistical and Reimbursement (PS&R) Reporting System
CR #: 3073
Job Aid #: N/A

MMA Pricing File Clarifications

Mon, 14 Nov 2005 11:18:00 EST

Transmittal #: R75CP
Subject: MMA Pricing File Clarifications
CR #: 3105
Job Aid #: N/A

Program Integrity Management Reporting (PIMR) System for Part A - Phase 4

Mon, 14 Nov 2005 11:18:00 EST

Transmittal #: R56OTN
Subject: Program Integrity Management Reporting (PIMR) System for Part A - Phase 4
CR #: 3113
Job Aid #: N/A

Shared System Maintainer Hours for Resolution of Problems Detected During HIPAA Transaction Release Testing

Mon, 14 Nov 2005 11:20:00 EST

Transmittal #: R55OTN
Subject: Shared System Maintainer Hours for Resolution of Problems Detected During HIPAA Transaction Release Testing
CR #: 3067
Job Aid #: N/A

Surgical Lines with No Charges

Mon, 14 Nov 2005 11:21:00 EST

Transmittal #: R53OTN
Subject: Surgical Lines with No Charges
CR #: 3104
Job Aid #: N/A

Provider Education Article: 2004 Medicare Physician Fee Schedule Increase and Extension of the Annual Participation Enrollment Period

Mon, 14 Nov 2005 11:21:00 EST

Transmittal #: R38OTN
Subject: Provider Education Article: 2004 Medicare Physician Fee Schedule Increase and Extension of the Annual Participation Enrollment Period
CR #: 3040
Job Aid #: N/A

Clarification of Proof of Delivery Requirements

Mon, 14 Nov 2005 11:22:00 EST

Transmittal #: R61PI
Subject: Clarification of Proof of Delivery Requirements
CR #: 2903
Job Aid #: N/A

Home Health Cost Reporting Processes

Mon, 14 Nov 2005 11:22:00 EST

Transmittal #: R37OTN
Subject: Home Health Cost Reporting Processes
CR #: 2993
Job Aid #: N/A

Revisions to Chapter 3 & 4

Mon, 14 Nov 2005 11:23:00 EST

Transmittal #: R29FM
Subject: Revisions to Chapter 3 & 4
CR #: 2911
Job Aid #: N/A

New HCPCS Code for Ambulance Night Differential Charges

Mon, 14 Nov 2005 11:24:00 EST

Transmittal #: R59CP
Subject: New HCPCS Code for Ambulance Night Differential Charges
CR #: 3035
Job Aid #: N/A

Dentists, podiatrists, and optometrists are added to the definition/list of physicians who may opt out of Medicare

Mon, 14 Nov 2005 11:26:00 EST

Transmittal #: R4BP
Subject: Dentists, podiatrists, and optometrists are added to the definition/list of physicians who may opt out of Medicare
CR #: 3016
Job Aid #: N/A

Provider Education Article: Renewed Moratorium on Outpatient Rehabilitation Therapy Caps

Mon, 14 Nov 2005 11:26:00 EST

Transmittal #: R40OTN
Subject: Provider Education Article: Renewed Moratorium on Outpatient Rehabilitation Therapy Caps
CR #: 3045
Job Aid #: N/A

Change in Coding on Medicare Claims for Darbepoetin Alfa (trade name Aranesp) and Epoetin Alfa (trade name Epogen, EPO) For Treatment Of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis

Mon, 14 Nov 2005 11:28:00 EST

Transmittal #: R39OTN
Subject: Change in Coding on Medicare Claims for Darbepoetin Alfa (trade name Aranesp) and Epoetin Alfa (trade name Epogen, EPO) For Treatment Of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis
CR #: 2963
Job Aid #: N/A

Provider Education Article: New Enrollee Rights, New Provider Responsibilities in M+C Program

Mon, 14 Nov 2005 11:28:00 EST

Transmittal #: R41OTN
Subject: Provider Education Article: New Enrollee Rights, New Provider Responsibilities in M+C Program
CR #: 3044
Job Aid #: N/A

Chapter 6, Relationships With Providers

Mon, 14 Nov 2005 11:29:00 EST

Transmittal #: R44MCM
Subject: Chapter 6, Relationships With Providers
CR #: N/A
Job Aid #: N/A

Chapter 4, Benefits and Beneficiary Protection

Mon, 14 Nov 2005 11:30:00 EST

Transmittal #: R43MCM
Subject: Chapter 4, Benefits and Beneficiary Protection
CR #: N/A
Job Aid #: N/A

Chapter 3, Marketing

Mon, 14 Nov 2005 11:30:00 EST

Transmittal #: R42MCM
Subject: Chapter 3, Marketing
CR #: N/A
Job Aid #: N/A

Chapter 2, Enrollment and Disenrollment

Mon, 14 Nov 2005 11:31:00 EST

Transmittal #: R41MCM
Subject: Chapter 2, Enrollment and Disenrollment
CR #: N/A
Job Aid #: N/A

Chapter 18, Preventive and Screening Services

Mon, 14 Nov 2005 11:32:00 EST

Transmittal #: R60CP
Subject: Chapter 18, Preventive and Screening Services
CR #: 2632
Job Aid #: N/A

Payment to Ambulatory Surgical Centers (ASCs) for G0260 and to Physicians for 27096 When 27096 is Performed in an ASC

Mon, 14 Nov 2005 11:33:00 EST

Transmittal #: R42OTN
Subject: Payment to Ambulatory Surgical Centers (ASCs) for G0260 and to Physicians for 27096 When 27096 is Performed in an ASC
CR #: 2979
Job Aid #: N/A

Chapter 15, Covered Medical and Other Health Services

Mon, 14 Nov 2005 11:33:00 EST

Transmittal #: R5BP
Subject: Chapter 15, Covered Medical and Other Health Services
CR #: 2779
Job Aid #: N/A

Automatic Notice of Change to MSP Auxiliary File

Mon, 14 Nov 2005 11:34:00 EST

Transmittal #: R6MSP
Subject: Automatic Notice of Change to MSP Auxiliary File
CR #: 2608
Job Aid #: N/A

Revision to CR 2912: Coding, Testing, and Implementation Phases of CR 2631 for Jurisdiction

Mon, 14 Nov 2005 11:35:00 EST

Transmittal #: R67CP
Subject: Revision to CR 2912: Coding, Testing, and Implementation Phases of CR 2631 for Jurisdiction
CR #: 3039
Job Aid #: N/A

Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.1, Effective April 1, 2004

Mon, 14 Nov 2005 11:36:00 EST

Transmittal #: R66CP
Subject: Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.1, Effective April 1, 2004
CR #: 2997
Job Aid #: N/A

ANSI X12 Transaction 835 Companion Document Change for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), and Fiscal Intermediaries (Fis)

Mon, 14 Nov 2005 11:36:00 EST

Transmittal #: R65CP
Subject: ANSI X12 Transaction 835 Companion Document Change for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), and Fiscal Intermediaries (Fis)
CR #: 2948
Job Aid #: N/A

Coding Change for Ventricular Assist Devices (VADs) for Beneficiaries in an Medicare+Choice (M+C) Plan

Mon, 14 Nov 2005 11:37:00 EST

Transmittal #: R64CP
Subject: Coding Change for Ventricular Assist Devices (VADs) for Beneficiaries in an Medicare+Choice (M+C) Plan
CR #: 3068
Job Aid #: N/A

January 2004 annual update of HCPCS codes used for Home Health Consolidated Billing Enforcement

Mon, 14 Nov 2005 11:38:00 EST

Transmittal #: R62CP
Subject: January 2004 annual update of HCPCS codes used for Home Health Consolidated Billing Enforcement
CR #: 3024
Job Aid #: N/A

Diagnosis coding instructions for anticipated payment and claims to conform with HIPAA requirements

Mon, 14 Nov 2005 11:39:00 EST

Transmittal #: R61CP
Subject: Diagnosis coding instructions for anticipated payment and claims to conform with HIPAA requirements
CR #: 2992
Job Aid #: N/A

Implementation of the Occupational Mix Survey

Mon, 14 Nov 2005 11:39:00 EST

Transmittal #: R47OTN
Subject: Implementation of the Occupational Mix Survey
CR #: 3043
Job Aid #: N/A

Railroad Medicare Carrier Collection of Data

Mon, 14 Nov 2005 11:40:00 EST

Transmittal #: R46OTN
Subject: Railroad Medicare Carrier Collection of Data
CR #: 3041
Job Aid #: N/A

October 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS)

Mon, 14 Nov 2005 11:40:00 EST

Transmittal #: R290CP
Subject: October 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 3420
Job Aid #: N/A

Correction-CWF Edits for Inserts for Therapeutic Shoes

Mon, 14 Nov 2005 11:41:00 EST

Transmittal #: R44OTN
Subject: Correction-CWF Edits for Inserts for Therapeutic Shoes
CR #: 3029
Job Aid #: N/A

File Descriptions and Instructions for Retrieving the 2005 Pricing Files through CMS's Mainframe Telecommunications System

Mon, 14 Nov 2005 11:41:00 EST

Transmittal #: R289CP
Subject: File Descriptions and Instructions for Retrieving the 2005 Pricing Files through CMS's Mainframe Telecommunications System
CR #: 3428
Job Aid #: N/A

Emergency Correction to Healthcare Common Procedure Coding System (HCPCS) Codes for Low Osmolar Contrast Material

Mon, 14 Nov 2005 11:41:00 EST

Transmittal #: R45OTN
Subject: Emergency Correction to Healthcare Common Procedure Coding System (HCPCS) Codes for Low Osmolar Contrast Material
CR #: 3053
Job Aid #: N/A

Correction To The Effective Date On 9 Code Pairs in Correct Coding Initiative (CCI) Version 9.3 (Cardiology edits)

Mon, 14 Nov 2005 11:42:00 EST

Transmittal #: R43OTN
Subject: Correction To The Effective Date On 9 Code Pairs in Correct Coding Initiative (CCI) Version 9.3 (Cardiology edits)
CR #: 3008
Job Aid #: N/A

The Focused Medical Review Report

Mon, 14 Nov 2005 11:43:00 EST

Transmittal #: R62PI
Subject: The Focused Medical Review Report
CR #: 3062
Job Aid #: N/A

Expansion of the Existing Interrupted Stay Policy Under Long Term Care Hospital (LTCH) Prospective Payment System

Mon, 14 Nov 2005 11:43:00 EST

Transmittal #: R240CP
Subject: Expansion of the Existing Interrupted Stay Policy Under Long Term Care Hospital (LTCH) Prospective Payment System
CR #: 3279
Job Aid #: N/A

Benefit Improvement Protection Act (BIPA)

Mon, 14 Nov 2005 11:43:00 EST

Transmittal #: R63PI
Subject: Benefit Improvement Protection Act (BIPA)
CR #: 3010
Job Aid #: N/A

Intravenous Immune Globulin

Mon, 14 Nov 2005 11:44:00 EST

Transmittal #: R74CP
Subject: Intravenous Immune Globulin
CR #: 3060
Job Aid #: N/A

MCE and IPPS Transfers Between Hospitals

Mon, 14 Nov 2005 11:47:00 EST

Transmittal #: R73CP
Subject: MCE and IPPS Transfers Between Hospitals
CR #: 2176
Job Aid #: N/A

Changes to the Laboratory National Coverage Determination (NCD) Edit Software

Mon, 14 Nov 2005 11:48:00 EST

Transmittal #: R71CP
Subject: Changes to the Laboratory National Coverage Determination (NCD) Edit Software
CR #: 3032
Job Aid #: N/A

Update of Address for the Railroad Retirement Board (RRB)

Mon, 14 Nov 2005 11:48:00 EST

Transmittal #: R72CP
Subject: Update of Address for the Railroad Retirement Board (RRB)
CR #: 3034
Job Aid #: N/A

Criteria for Using the CB Modifier

Mon, 14 Nov 2005 11:49:00 EST

Transmittal #: R69CP
Subject: Criteria for Using the CB Modifier
CR #: 2906
Job Aid #: N/A

Cardiac Output Monitoring by Thoracic Electrical Bioimpedance

Mon, 14 Nov 2005 11:50:00 EST

Transmittal #: R6NCD
Subject: Cardiac Output Monitoring by Thoracic Electrical Bioimpedance
CR #: 2689
Job Aid #: N/A

Intravenous Immune Globulin

Mon, 14 Nov 2005 11:51:00 EST

Transmittal #: R6BP
Subject: Intravenous Immune Globulin
CR #: 3059
Job Aid #: N/A

Notice of New Interest Rates for Medicare Overpayments and Underpayments

Mon, 14 Nov 2005 11:52:00 EST

Transmittal #: R30FM
Subject: Notice of New Interest Rates for Medicare Overpayments and Underpayments
CR #: 2829
Job Aid #: N/A

New Requirements for Critical Access Hospitals. These changes have been established with the "Medicare Prescription Drug, Improvement, and Modernization Act" (MPDIMA) of 2003, Pub.L. 108-173

Mon, 14 Nov 2005 11:52:00 EST

Transmittal #: R68CP
Subject: New Requirements for Critical Access Hospitals. These changes have been established with the "Medicare Prescription Drug, Improvement, and Modernization Act" (MPDIMA) of 2003, Pub.L. 108-173
CR #: 3052
Job Aid #: N/A

Provider Data on Outbound Coordination of Benefit (COB) Files

Mon, 14 Nov 2005 11:53:00 EST

Transmittal #: R52OTN
Subject: Provider Data on Outbound Coordination of Benefit (COB) Files
CR #: 3101
Job Aid #: N/A

Changes in Payment for Services Furnished in Ambulatory Surgical Centers for Fiscal Year 2004

Mon, 14 Nov 2005 11:54:00 EST

Transmittal #: R51OTN
Subject: Changes in Payment for Services Furnished in Ambulatory Surgical Centers for Fiscal Year 2004
CR #: 3082
Job Aid #: N/A

ANSI X12 Transaction 270/271 Changes

Mon, 14 Nov 2005 11:54:00 EST

Transmittal #: R50OTN
Subject: ANSI X12 Transaction 270/271 Changes
CR #: 3065
Job Aid #: N/A

Coordination of Medicare and Complementary Insurance Programs

Mon, 14 Nov 2005 11:55:00 EST

Transmittal #: R33FM
Subject: Coordination of Medicare and Complementary Insurance Programs
CR #: 3109
Job Aid #: N/A

Expanded Identification and Workload Reporting for CMS Medicare Systems

Mon, 14 Nov 2005 11:56:00 EST

Transmittal #: R32FM
Subject: Expanded Identification and Workload Reporting for CMS Medicare Systems
CR #: 3023
Job Aid #: N/A

Chapter 7 - Internal Control Requirements Update

Mon, 14 Nov 2005 11:56:00 EST

Transmittal #: R34FM
Subject: Chapter 7 - Internal Control Requirements Update
CR #: 3006
Job Aid #: N/A

Notice of New Interest Rate for Medicare Overpatments and Underpatyments

Mon, 14 Nov 2005 12:09:00 EST

Transmittal #: R51FM
Subject: Notice of New Interest Rate for Medicare Overpatments and Underpatyments
CR #: 2831
Job Aid #: N/A

Notice of New Insterest Rate for Medicare Overpayments and Underpayments

Mon, 14 Nov 2005 12:52:00 EST

Transmittal #: R52FM
Subject: Notice of New Insterest Rate for Medicare Overpayments and Underpayments
CR #: 2831
Job Aid #: N/A

Converting Health Insurance Portability and Accountability ct (HIPAA) Individual Relationship Codes to Common Working File (CWF) Patient Relationship Codes

Mon, 14 Nov 2005 12:54:00 EST

Transmittal #: R9MSP
Subject: Converting Health Insurance Portability and Accountability ct (HIPAA) Individual Relationship Codes to Common Working File (CWF) Patient Relationship Codes
CR #: 3116
Job Aid #: N/A

Update to the Frequency of Billing

Mon, 14 Nov 2005 13:09:00 EST

Transmittal #: R270CP
Subject: Update to the Frequency of Billing
CR #: 3382
Job Aid #: N/A

Number of Drug Pricing Files That Must Be Maintained Online for Medicare

Mon, 14 Nov 2005 13:10:00 EST

Transmittal #: R269CP
Subject: Number of Drug Pricing Files That Must Be Maintained Online for Medicare
CR #: 3231
Job Aid #: N/A

Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2005

Mon, 14 Nov 2005 13:11:00 EST

Transmittal #: R271CP
Subject: Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2005
CR #: 3386
Job Aid #: JA3386

October Quarterly Update For 2004

Mon, 14 Nov 2005 13:12:00 EST

Transmittal #: R272CP
Subject: October Quarterly Update For 2004
CR #: 3377
Job Aid #: N/A

Use of Group Health Plan Payment System to Pay Capitated Payments to Non-Health Plan Demonstration/Program Sites Serving Medicare Fee For Service Beneficiaries- Updated List of Plan Numbers

Mon, 14 Nov 2005 13:13:00 EST

Transmittal #: R5DEMO
Subject: Use of Group Health Plan Payment System to Pay Capitated Payments to Non-Health Plan Demonstration/Program Sites Serving Medicare Fee For Service Beneficiaries- Updated List of Plan Numbers
CR #: 3423
Job Aid #: N/A

Chapter 5 Revisions

Mon, 14 Nov 2005 13:14:00 EST

Transmittal #: R58MCM
Subject: Chapter 5 Revisions
CR #: N/A
Job Aid #: N/A

Chapter 7 Revisions

Mon, 14 Nov 2005 13:15:00 EST

Transmittal #: R57MCM
Subject: Chapter 7 Revisions
CR #: N/A
Job Aid #: N/A

3rd Update to the 2004 Medicare Physician Fee Schedule Database

Mon, 14 Nov 2005 13:16:00 EST

Transmittal #: R278CP
Subject: 3rd Update to the 2004 Medicare Physician Fee Schedule Database
CR #: 3415
Job Aid #: N/A

Further Information Related to CR 3175, Distinct Part Units of Critical Access Hospitals (CAHs)

Mon, 14 Nov 2005 13:23:00 EST

Transmittal #: R276CP
Subject: Further Information Related to CR 3175, Distinct Part Units of Critical Access Hospitals (CAHs)
CR #: 3399
Job Aid #: JA3399

The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2003 for Inpatient Prospective Payment System (IPPS) Hospitals

Mon, 14 Nov 2005 13:24:00 EST

Transmittal #: R275CP
Subject: The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2003 for Inpatient Prospective Payment System (IPPS) Hospitals
CR #: 3403
Job Aid #: N/A

Good Cause Waiver of Late Claim Filing Payment Reduction Penalty

Mon, 14 Nov 2005 13:25:00 EST

Transmittal #: R274CP
Subject: Good Cause Waiver of Late Claim Filing Payment Reduction Penalty
CR #: 3042
Job Aid #: N/A

Good Cause Waiver of Late Claim Filing Payment Reduction Penalty

Mon, 14 Nov 2005 13:26:00 EST

Transmittal #: R282CP
Subject: Good Cause Waiver of Late Claim Filing Payment Reduction Penalty
CR #: 3402
Job Aid #: N/A

MMA Drug Pricing Update-Payment Limits for J9045 (Carboplatin injection) and J9310 (Rituximab cancer treatment)

Mon, 14 Nov 2005 13:27:00 EST

Transmittal #: R106OTN
Subject: MMA Drug Pricing Update-Payment Limits for J9045 (Carboplatin injection) and J9310 (Rituximab cancer treatment)
CR #: 3419
Job Aid #: N/A

Creation of CWF Auxilliary Files and Associated Logic to Properly Calculate Medicare-Equivalent Deductibles for VA Claims

Mon, 14 Nov 2005 13:28:00 EST

Transmittal #: R111OTN
Subject: Creation of CWF Auxilliary Files and Associated Logic to Properly Calculate Medicare-Equivalent Deductibles for VA Claims
CR #: 3450
Job Aid #: N/A

MMA Drug Pricing Update-Payment Limits for J1000 (Depo-estradiol cypionate inj)

Mon, 14 Nov 2005 13:29:00 EST

Transmittal #: R110OTN
Subject: MMA Drug Pricing Update-Payment Limits for J1000 (Depo-estradiol cypionate inj)
CR #: 3418
Job Aid #: N/A

CWF Analysis to Process Claims Per the Renovated Override Code Billing Instructions for ADVATE rAHF-PFM on Medicare Claims

Mon, 14 Nov 2005 13:30:00 EST

Transmittal #: R109OTN
Subject: CWF Analysis to Process Claims Per the Renovated Override Code Billing Instructions for ADVATE rAHF-PFM on Medicare Claims
CR #: 3331
Job Aid #: N/A

New Remark Code Message for Use with Claims for Parenteral Pumps - Durable Medical Equipment Regional Carrier (DMERC) Only

Mon, 14 Nov 2005 13:31:00 EST

Transmittal #: R108OTN
Subject: New Remark Code Message for Use with Claims for Parenteral Pumps - Durable Medical Equipment Regional Carrier (DMERC) Only
CR #: 3405
Job Aid #: N/A

CWF Analysis to Process Claims Per the Renovated Override Code Processing (re: CR3190) and CWF Analysis to Review System Edits for Additional 2-byte Modifiers Added in CR3190. (Phase 2)

Mon, 14 Nov 2005 13:32:00 EST

Transmittal #: R107OTN
Subject: CWF Analysis to Process Claims Per the Renovated Override Code Processing (re: CR3190) and CWF Analysis to Review System Edits for Additional 2-byte Modifiers Added in CR3190. (Phase 2)
CR #: 3320
Job Aid #: N/A

Revision of CR 3269 for the Demonstration Project to Clarify the Definition of Homebound (Homebound Demonstration)

Mon, 14 Nov 2005 13:33:00 EST

Transmittal #: R6DEMO
Subject: Revision of CR 3269 for the Demonstration Project to Clarify the Definition of Homebound (Homebound Demonstration)
CR #: 3432
Job Aid #: N/A

PIM Revisions for Chapter 4

Mon, 14 Nov 2005 13:34:00 EST

Transmittal #: R83PI
Subject: PIM Revisions for Chapter 4
CR #: 3379
Job Aid #: N/A

Change Request 3367, Debt Collection System (DCS), replaces Change Request 2952, Debt Collection System (DCS)

Mon, 14 Nov 2005 13:35:00 EST

Transmittal #: R53FM
Subject: Change Request 3367, Debt Collection System (DCS), replaces Change Request 2952, Debt Collection System (DCS)
CR #: 3367
Job Aid #: N/A

Application of the Medicare Secondary Payer for the Working Aged Provision and the Medicare Secondary for the Disabled Provision to Former Spouses and Certain Family Members with Coverage Under the Federal Employees Health Benefits (FEHB) Program

Mon, 14 Nov 2005 13:36:00 EST

Transmittal #: R18MSP
Subject: Application of the Medicare Secondary Payer for the Working Aged Provision and the Medicare Secondary for the Disabled Provision to Former Spouses and Certain Family Members with Coverage Under the Federal Employees Health Benefits (FEHB) Program
CR #: 3120
Job Aid #: JA3120

Additional Clarification of Bill Types 22x and 23x Submitted by Skilled Nursing Facilities (SNFs) With Instructions for Involuntarily Moving a Beneficiary Out of the SNF and Ending a Benefit Period

Mon, 14 Nov 2005 13:38:00 EST

Transmittal #: R229CP
Subject: Additional Clarification of Bill Types 22x and 23x Submitted by Skilled Nursing Facilities (SNFs) With Instructions for Involuntarily Moving a Beneficiary Out of the SNF and Ending a Benefit Period
CR #: 3323
Job Aid #: JA3323

Use of Transmission Date in the Service Date/Assessment Date Field for Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) Claims

Mon, 14 Nov 2005 13:39:00 EST

Transmittal #: R291CP
Subject: Use of Transmission Date in the Service Date/Assessment Date Field for Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) Claims
CR #: 3433
Job Aid #: N/A

This transmittal is rescinded and replaced with Transmittal 103, dated July 30, 2004

Mon, 14 Nov 2005 13:40:00 EST

Transmittal #: R100OTN
Subject: This transmittal is rescinded and replaced with Transmittal 103, dated July 30, 2004
CR #: 3236
Job Aid #: N/A

This One-Time Notification is a Full Replacement for Transmittal 86 (CR 3142) Interface File from Recovery Management and Accounting System (ReMAS

Mon, 14 Nov 2005 13:41:00 EST

Transmittal #: R99OTN
Subject: This One-Time Notification is a Full Replacement for Transmittal 86 (CR 3142) Interface File from Recovery Management and Accounting System (ReMAS
CR #: 3383
Job Aid #: N/A

Change to Previous Transmittal Regarding the Discontinued Use of Revenue Code 0910

Mon, 14 Nov 2005 13:42:00 EST

Transmittal #: R98OTN
Subject: Change to Previous Transmittal Regarding the Discontinued Use of Revenue Code 0910
CR #: 3343
Job Aid #: N/A

Annual Changes to the Amount in Controversy (AIC) Thresholds for the Administrative Law Judge (ALJ) and Judicial Review Levels of the Claim Appeals Process as Required by Section 940 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003

Mon, 14 Nov 2005 13:43:00 EST

Transmittal #: R96OTN
Subject: Annual Changes to the Amount in Controversy (AIC) Thresholds for the Administrative Law Judge (ALJ) and Judicial Review Levels of the Claim Appeals Process as Required by Section 940 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003
CR #: 3354
Job Aid #: N/A

Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing

Mon, 14 Nov 2005 13:44:00 EST

Transmittal #: R94OTN
Subject: Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing
CR #: 3316
Job Aid #: N/A

Implementation of the Business Segment Identifier (BSI) in the Healthcare Integrated General Ledger Accounting System (HIGLAS)

Mon, 14 Nov 2005 13:46:00 EST

Transmittal #: R97OTN
Subject: Implementation of the Business Segment Identifier (BSI) in the Healthcare Integrated General Ledger Accounting System (HIGLAS)
CR #: 3362
Job Aid #: N/A

Clarification of CR 3064

Mon, 05 Dec 2005 11:32:00 EST

Transmittal #: R17MSP
Subject: Clarification of CR 3064
CR #: 3267
Job Aid #: JA3267

Procedures For Re-Issuance and Stale Dating of Medicare Checks

Mon, 05 Dec 2005 11:36:00 EST

Transmittal #: R49FM
Subject: Procedures For Re-Issuance and Stale Dating of Medicare Checks
CR #: 2951
Job Aid #: JA2951

Provider Identification Numbers

Mon, 05 Dec 2005 11:39:00 EST

Transmittal #: R2SOM
Subject: Provider Identification Numbers
CR #: 3245
Job Aid #: N/A

Chapter 2

Mon, 05 Dec 2005 11:42:00 EST

Transmittal #: R59MCM
Subject: Chapter 2
CR #: N/A
Job Aid #: N/A

Hospital Outpatient Billing and Payment under OPPS for New, Unclassified Drugs or Biologicals Approved by the FDA After January 1, 2004, But Before Assignment of a Product-Specific Drug/Biological HCPCS Code

Mon, 05 Dec 2005 11:44:00 EST

Transmittal #: R188CP
Subject: Hospital Outpatient Billing and Payment under OPPS for New, Unclassified Drugs or Biologicals Approved by the FDA After January 1, 2004, But Before Assignment of a Product-Specific Drug/Biological HCPCS Code
CR #: 3287
Job Aid #: JA3287

Chapter 3

Mon, 05 Dec 2005 11:44:00 EST

Transmittal #: R60MCM
Subject: Chapter 3
CR #: N/A
Job Aid #: N/A

Modification of CMS's Medicare Contingency Plan for HIPAA Implementation

Mon, 05 Dec 2005 11:45:00 EST

Transmittal #: R273CP
Subject: Modification of CMS's Medicare Contingency Plan for HIPAA Implementation
CR #: 2981
Job Aid #: N/A

Update to the Claims Status Codes

Mon, 05 Dec 2005 11:47:00 EST

Transmittal #: R230CP
Subject: Update to the Claims Status Codes
CR #: 3361
Job Aid #: N/A

Standardized Responses to Provider Inquiries Regarding the Negotiated Laboratory National Coverage Determinations (NCDs) Edit Software

Mon, 05 Dec 2005 11:48:00 EST

Transmittal #: R234CP
Subject: Standardized Responses to Provider Inquiries Regarding the Negotiated Laboratory National Coverage Determinations (NCDs) Edit Software
CR #: 3374
Job Aid #: JA3374

Billing Requirements for Hyperbaric Oxygen (HBO) Therapy for the Treatment of Diabetic Wounds of the Lower Extremities

Mon, 05 Dec 2005 11:48:00 EST

Transmittal #: R187CP
Subject: Billing Requirements for Hyperbaric Oxygen (HBO) Therapy for the Treatment of Diabetic Wounds of the Lower Extremities
CR #: 3172
Job Aid #: JA3172

Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Drugs and Electrocardiogram (EKG) Testing Provided During an Ambulance Transport

Mon, 05 Dec 2005 11:50:00 EST

Transmittal #: R185CP
Subject: Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Drugs and Electrocardiogram (EKG) Testing Provided During an Ambulance Transport
CR #: 3212
Job Aid #: N/A

2005 DMEPOS Pricing File Record Layout Expansion and New Pricing Procedures for Certain DMEPOS Items Based on Modifiers

Mon, 05 Dec 2005 11:50:00 EST

Transmittal #: R236CP
Subject: 2005 DMEPOS Pricing File Record Layout Expansion and New Pricing Procedures for Certain DMEPOS Items Based on Modifiers
CR #: 3300
Job Aid #: JA3300

Implementation of Patient Status Code 65, Discharged/Transferred to a Psychiatric Hospital or Psychiatric Distinct Part Unit of a Hospital

Mon, 05 Dec 2005 11:52:00 EST

Transmittal #: R237CP
Subject: Implementation of Patient Status Code 65, Discharged/Transferred to a Psychiatric Hospital or Psychiatric Distinct Part Unit of a Hospital
CR #: 3364
Job Aid #: JA3364

Expanded Identification and Workload Reporting for CMS Medicare Systems

Mon, 05 Dec 2005 11:53:00 EST

Transmittal #: R47FM
Subject: Expanded Identification and Workload Reporting for CMS Medicare Systems
CR #: 3256
Job Aid #: N/A

Implementation of Skilled Nursing Facility Consolidated Billing CWF Edit for Therapy Codes Considered Separately Payable Physician Services

Mon, 05 Dec 2005 11:54:00 EST

Transmittal #: R215CP
Subject: Implementation of Skilled Nursing Facility Consolidated Billing CWF Edit for Therapy Codes Considered Separately Payable Physician Services
CR #: 2944
Job Aid #: N/A

Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Institutional Health Care Claim Implementation Guide (IG) Additional Updates

Mon, 05 Dec 2005 11:54:00 EST

Transmittal #: R238CP
Subject: Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Institutional Health Care Claim Implementation Guide (IG) Additional Updates
CR #: 3321
Job Aid #: N/A

Implementation of Section 414 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003

Mon, 05 Dec 2005 11:55:00 EST

Transmittal #: R220CP
Subject: Implementation of Section 414 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003
CR #: 3099
Job Aid #: N/A

Update to the Frequency of Billing

Mon, 05 Dec 2005 11:56:00 EST

Transmittal #: R239CP
Subject: Update to the Frequency of Billing
CR #: 3382
Job Aid #: N/A

Payment to Bank

Mon, 05 Dec 2005 11:57:00 EST

Transmittal #: R213CP
Subject: Payment to Bank
CR #: 3079
Job Aid #: JA3079

Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.3, Effective October 1, 2004.

Mon, 05 Dec 2005 11:57:00 EST

Transmittal #: R242CP
Subject: Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.3, Effective October 1, 2004.
CR #: 3349
Job Aid #: N/A

Cardiac Pacemaker

Mon, 05 Dec 2005 11:59:00 EST

Transmittal #: R16NCD
Subject: Cardiac Pacemaker
CR #: 3369
Job Aid #: N/A

Patient Status Code and Reason for Patient Visit for the Hospital Outpatient Prospective Payment System (OPPS)

Mon, 05 Dec 2005 12:00:00 EST

Transmittal #: R243CP
Subject: Patient Status Code and Reason for Patient Visit for the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 2800
Job Aid #: N/A

Temporary SNF Extension

Mon, 05 Dec 2005 12:00:00 EST

Transmittal #: R93OTN
Subject: Temporary SNF Extension
CR #: 3352
Job Aid #: N/A

July Update to the Medicare Outpatient Code Editor (OCE) Version 19.2 For Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System

Mon, 05 Dec 2005 12:01:00 EST

Transmittal #: R186CP
Subject: July Update to the Medicare Outpatient Code Editor (OCE) Version 19.2 For Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System
CR #: 3319
Job Aid #: JA3319

Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Drugs and Electrocardiogram (EKG) Testing Provided During an Ambulance Transport

Mon, 05 Dec 2005 12:32:00 EST

Transmittal #: R184CP
Subject: Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Drugs and Electrocardiogram (EKG) Testing Provided During an Ambulance Transport
CR #: 3314
Job Aid #: N/A

DMERC/Local Carriers/SADMERC - Drug Pricing Limits as of January 1, 2005

Mon, 05 Dec 2005 12:33:00 EST

Transmittal #: R248CP
Subject: DMERC/Local Carriers/SADMERC - Drug Pricing Limits as of January 1, 2005
CR #: 3232
Job Aid #: N/A

Medicare IRF Classification Requirements

Mon, 05 Dec 2005 12:35:00 EST

Transmittal #: R221CP
Subject: Medicare IRF Classification Requirements
CR #: 3334
Job Aid #: JA3334

Number of Drug Pricing Files That Must Be Maintained Online for Medicare

Mon, 05 Dec 2005 12:36:00 EST

Transmittal #: R244CP
Subject: Number of Drug Pricing Files That Must Be Maintained Online for Medicare
CR #: 3231
Job Aid #: N/A

MSN Messages

Mon, 05 Dec 2005 12:36:00 EST

Transmittal #: R214CP
Subject: MSN Messages
CR #: 2617
Job Aid #: N/A

Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision

Mon, 05 Dec 2005 12:37:00 EST

Transmittal #: R227CP
Subject: Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision
CR #: 3222
Job Aid #: N/A

New Medicare Summary Notice Message 31.18

Mon, 05 Dec 2005 12:38:00 EST

Transmittal #: R249CP
Subject: New Medicare Summary Notice Message 31.18
CR #: 2989
Job Aid #: N/A

Coordination of Benefits Agreement (COBA) Claims Selection Options

Mon, 05 Dec 2005 12:39:00 EST

Transmittal #: R250CP
Subject: Coordination of Benefits Agreement (COBA) Claims Selection Options
CR #: 3404
Job Aid #: N/A

October Quarterly Update to 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing Enforcement

Mon, 05 Dec 2005 12:40:00 EST

Transmittal #: R224CP
Subject: October Quarterly Update to 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing Enforcement
CR #: 3348
Job Aid #: N/A

Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement

Mon, 05 Dec 2005 12:40:00 EST

Transmittal #: R226CP
Subject: Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement
CR #: 3350
Job Aid #: N/A

Paper Remittance Advice format change to accommodate the forced balancing amount to balance at the claim level as well as the provider level, a flat file change, and a change in the companion document for fiscal intermediaries (FIs).

Mon, 05 Dec 2005 12:41:00 EST

Transmittal #: R252CP
Subject: Paper Remittance Advice format change to accommodate the forced balancing amount to balance at the claim level as well as the provider level, a flat file change, and a change in the companion document for fiscal intermediaries (FIs).
CR #: 3344
Job Aid #: JA3344

Changes to the Laboratory National Coverage Determination (NCD)Edit Software for October 2004

Mon, 05 Dec 2005 12:42:00 EST

Transmittal #: R225CP
Subject: Changes to the Laboratory National Coverage Determination (NCD)Edit Software for October 2004
CR #: 3358
Job Aid #: JA3358

Editing Of Hospital And Skilled Nursing Facility Part B Inpatient Services

Mon, 05 Dec 2005 12:43:00 EST

Transmittal #: R251CP
Subject: Editing Of Hospital And Skilled Nursing Facility Part B Inpatient Services
CR #: 3366
Job Aid #: N/A

Fiscal Intermediary Shared System (FISS) Changes to Allow for Provider Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills

Mon, 05 Dec 2005 12:44:00 EST

Transmittal #: R253CP
Subject: Fiscal Intermediary Shared System (FISS) Changes to Allow for Provider Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills
CR #: 3308
Job Aid #: N/A

Additional Health Insurance Health Insurance Portability and Accountability Act (HIPAA) Coordination of Benefits (COB) Information for Trading Partners

Mon, 05 Dec 2005 12:46:00 EST

Transmittal #: R83OTN
Subject: Additional Health Insurance Health Insurance Portability and Accountability Act (HIPAA) Coordination of Benefits (COB) Information for Trading Partners
CR #: 3255
Job Aid #: N/A

Implementation of the Quarterly Strategy Analysis

Mon, 05 Dec 2005 12:47:00 EST

Transmittal #: R81PI
Subject: Implementation of the Quarterly Strategy Analysis
CR #: 3294
Job Aid #: N/A

Use of Group Health Plan Payment System to Pay Capitated Payments to Non Health Plan Demonstrations Serving Medicare Fee For Service Beneficiaries

Mon, 05 Dec 2005 12:47:00 EST

Transmittal #: R4DEMO
Subject: Use of Group Health Plan Payment System to Pay Capitated Payments to Non Health Plan Demonstrations Serving Medicare Fee For Service Beneficiaries
CR #: 3283
Job Aid #: N/A

Home Health Demand Bills

Mon, 05 Dec 2005 12:49:00 EST

Transmittal #: R82PI
Subject: Home Health Demand Bills
CR #: 3266
Job Aid #: N/A

Removal of Coding from National Coverage Determination on Stem Cell Transplantation

Mon, 05 Dec 2005 12:50:00 EST

Transmittal #: R13NCD
Subject: Removal of Coding from National Coverage Determination on Stem Cell Transplantation
CR #: 3265
Job Aid #: N/A

Changes in the Medicare Benefit Policy Manual-Chapter 10

Mon, 05 Dec 2005 12:52:00 EST

Transmittal #: R14BP
Subject: Changes in the Medicare Benefit Policy Manual-Chapter 10
CR #: 3225
Job Aid #: N/A

Diabetes Self Management Training Services

Mon, 05 Dec 2005 12:54:00 EST

Transmittal #: R13BP
Subject: Diabetes Self Management Training Services
CR #: 3185
Job Aid #: JA3185

CMS policy for testing quarterly release of the Medicare shared systems and the CWF

Mon, 05 Dec 2005 12:56:00 EST

Transmittal #: R6GI
Subject: CMS policy for testing quarterly release of the Medicare shared systems and the CWF
CR #: 3011
Job Aid #: N/A

Chiropractic Billing

Mon, 05 Dec 2005 12:56:00 EST

Transmittal #: R12BP
Subject: Chiropractic Billing
CR #: 3063
Job Aid #: N/A

End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry Test(s)

Mon, 05 Dec 2005 12:58:00 EST

Transmittal #: R198CP
Subject: End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry Test(s)
CR #: 2813
Job Aid #: N/A

Emergency Hospital Outpatient billing of Epotein Alfa (EPO) and Darbepoetin Alfa (Aranesp)

Mon, 05 Dec 2005 13:01:00 EST

Transmittal #: R197CP
Subject: Emergency Hospital Outpatient billing of Epotein Alfa (EPO) and Darbepoetin Alfa (Aranesp)
CR #: 3184
Job Aid #: N/A

Payment Denial for Medicare Services Furnished to Alien Beneficiaries Who Are Not Lawfully Present in the U. S.

Mon, 05 Dec 2005 13:04:00 EST

Transmittal #: R196CP
Subject: Payment Denial for Medicare Services Furnished to Alien Beneficiaries Who Are Not Lawfully Present in the U. S.
CR #: 2825
Job Aid #: N/A

Clarification and Revision of Change Request (CR) 3084, Implementation of Section 508(f) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173)

Mon, 05 Dec 2005 13:05:00 EST

Transmittal #: R88OTN
Subject: Clarification and Revision of Change Request (CR) 3084, Implementation of Section 508(f) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173)
CR #: 3342
Job Aid #: N/A

July 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS)

Mon, 05 Dec 2005 13:07:00 EST

Transmittal #: R195CP
Subject: July 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 3324
Job Aid #: N/A

October 2004 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 5.3

Mon, 05 Dec 2005 13:07:00 EST

Transmittal #: R254CP
Subject: October 2004 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 5.3
CR #: 3395
Job Aid #: N/A

Medical Review (MR) Progressive Corrective Action (PCA) for Part A

Mon, 05 Dec 2005 13:09:00 EST

Transmittal #: R78PI
Subject: Medical Review (MR) Progressive Corrective Action (PCA) for Part A
CR #: 3111
Job Aid #: N/A

October Update to the Medicare Outpatient Code Editor (OCE) Version 20.0 for Bills From Hospitals that are not Paid Under the Outpatient Prospective Payment System (OPPS)

Mon, 05 Dec 2005 13:09:00 EST

Transmittal #: R255CP
Subject: October Update to the Medicare Outpatient Code Editor (OCE) Version 20.0 for Bills From Hospitals that are not Paid Under the Outpatient Prospective Payment System (OPPS)
CR #: 3396
Job Aid #: N/A

Use of Group Health Plan Payment System/MMCS to Pay Capitated Payments to Chronic Care Improvement Organizations Serving Medicare Fee-For-Service Beneficiaries under Section 721 of the MMA

Mon, 05 Dec 2005 13:10:00 EST

Transmittal #: R256CP
Subject: Use of Group Health Plan Payment System/MMCS to Pay Capitated Payments to Chronic Care Improvement Organizations Serving Medicare Fee-For-Service Beneficiaries under Section 721 of the MMA
CR #: 3410
Job Aid #: JA3410

Medicare HIPAA Electronic Claims Compliance Report

Mon, 05 Dec 2005 13:10:00 EST

Transmittal #: R204CP
Subject: Medicare HIPAA Electronic Claims Compliance Report
CR #: 3306
Job Aid #: N/A

New Waived Tests - October 1, 2004

Mon, 05 Dec 2005 13:11:00 EST

Transmittal #: R258CP
Subject: New Waived Tests - October 1, 2004
CR #: 3372
Job Aid #: N/A

Shared Systems Changes for Medicare Part B Drugs for ESRD Independent Dialysis Facilities

Mon, 05 Dec 2005 13:12:00 EST

Transmittal #: R257CP
Subject: Shared Systems Changes for Medicare Part B Drugs for ESRD Independent Dialysis Facilities
CR #: 3332
Job Aid #: N/A

Scheduled Release for October Updates to Software Programs and Pricing/Coding Files

Mon, 05 Dec 2005 13:14:00 EST

Transmittal #: R259CP
Subject: Scheduled Release for October Updates to Software Programs and Pricing/Coding Files
CR #: 3397
Job Aid #: N/A

Cryosurgery of the Prostate

Mon, 05 Dec 2005 13:16:00 EST

Transmittal #: R260CP
Subject: Cryosurgery of the Prostate
CR #: 3168
Job Aid #: N/A

Billing and Requirements for Islet Cell Transplantation for Beneficiaries in a National Institutes of Health (NIH) Clinical Trial

Mon, 05 Dec 2005 13:18:00 EST

Transmittal #: R261CP
Subject: Billing and Requirements for Islet Cell Transplantation for Beneficiaries in a National Institutes of Health (NIH) Clinical Trial
CR #: 3385
Job Aid #: JA3385

Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2005

Mon, 05 Dec 2005 13:19:00 EST

Transmittal #: R263CP
Subject: Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2005
CR #: 3378
Job Aid #: N/A

Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2005

Mon, 05 Dec 2005 13:20:00 EST

Transmittal #: R264CP
Subject: Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2005
CR #: 3386
Job Aid #: JA3386

Billing Payment in a Health Professional Shortage Area

Mon, 05 Dec 2005 13:20:00 EST

Transmittal #: R203CP
Subject: Billing Payment in a Health Professional Shortage Area
CR #: 3336
Job Aid #: JA3336

Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2005

Mon, 05 Dec 2005 13:21:00 EST

Transmittal #: R268CP
Subject: Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2005
CR #: 3368
Job Aid #: N/A

Revision of Common Working File (CWF) Editing for Same-Day, Same- Provider Acute Care Readmissions

Mon, 05 Dec 2005 13:22:00 EST

Transmittal #: R266CP
Subject: Revision of Common Working File (CWF) Editing for Same-Day, Same- Provider Acute Care Readmissions
CR #: 3389
Job Aid #: JA3389

Revised Updated SNF NO PAY File for July 2004

Mon, 05 Dec 2005 13:23:00 EST

Transmittal #: R202CP
Subject: Revised Updated SNF NO PAY File for July 2004
CR #: 3338
Job Aid #: N/A

Unsolicited/Voluntary Refunds

Mon, 05 Dec 2005 13:24:00 EST

Transmittal #: R50FM
Subject: Unsolicited/Voluntary Refunds
CR #: 3274
Job Aid #: N/A

IOM Manualization of Indian Health Services

Mon, 05 Dec 2005 13:24:00 EST

Transmittal #: R201CP
Subject: IOM Manualization of Indian Health Services
CR #: 3302
Job Aid #: N/A

Modification to Post-payment Adjustment Process for Home Health Prospective Payment System Claims Failing to Report Prior Inpatient Discharges

Mon, 05 Dec 2005 13:25:00 EST

Transmittal #: R95OTN
Subject: Modification to Post-payment Adjustment Process for Home Health Prospective Payment System Claims Failing to Report Prior Inpatient Discharges
CR #: 3400
Job Aid #: N/A

Update to the Common Working File Edits for Skilled Nursing Facility (SNF) Consolidated Billing (CB) to Expand the Bypass for Pharmacy Services.

Mon, 05 Dec 2005 13:26:00 EST

Transmittal #: R200CP
Subject: Update to the Common Working File Edits for Skilled Nursing Facility (SNF) Consolidated Billing (CB) to Expand the Bypass for Pharmacy Services.
CR #: 3277
Job Aid #: N/A

Medicare Need for a Specific Line Item Date of Service (LIDOS) for Each Revenue Code on ALL Outpatient and Inpatient Part B Claims

Mon, 05 Dec 2005 13:27:00 EST

Transmittal #: R199CP
Subject: Medicare Need for a Specific Line Item Date of Service (LIDOS) for Each Revenue Code on ALL Outpatient and Inpatient Part B Claims
CR #: 3337
Job Aid #: JA3337

Change of the Premera Blue Cross Medicare Part A Plan Under Contract to BCBSA to a Part A Fiscal Intermediary Contract with Noridian Mutual Insurance Company in the States of Washington and Alaska

Mon, 05 Dec 2005 13:28:00 EST

Transmittal #: R101OTN
Subject: Change of the Premera Blue Cross Medicare Part A Plan Under Contract to BCBSA to a Part A Fiscal Intermediary Contract with Noridian Mutual Insurance Company in the States of Washington and Alaska
CR #: 3380
Job Aid #: N/A

Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee

Mon, 05 Dec 2005 13:30:00 EST

Transmittal #: R14NCD
Subject: Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee
CR #: 3281
Job Aid #: JA3281

Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit

Mon, 05 Dec 2005 13:31:00 EST

Transmittal #: R205CP
Subject: Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit
CR #: 3226
Job Aid #: N/A

Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit

Mon, 05 Dec 2005 13:35:00 EST

Transmittal #: R15BP
Subject: Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit
CR #: 3226
Job Aid #: N/A

Installation of Version 33.0 of the Provider Statistical and Reimbursement (PS&R) Reporting System-Modification of CR 3131

Mon, 05 Dec 2005 13:37:00 EST

Transmittal #: R46FM
Subject: Installation of Version 33.0 of the Provider Statistical and Reimbursement (PS&R) Reporting System-Modification of CR 3131
CR #: 3313
Job Aid #: N/A

Chapter 36, Hospital and Hospital Healthcare Complex Cost Report, Form CMS 2552-96

Mon, 05 Dec 2005 13:40:00 EST

Transmittal #: R12P236
Subject: Chapter 36, Hospital and Hospital Healthcare Complex Cost Report, Form CMS 2552-96
CR #: N/A
Job Aid #: N/A

Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)

Mon, 05 Dec 2005 13:43:00 EST

Transmittal #: R210CP
Subject: Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
CR #: 3303
Job Aid #: JA3303

Correction to CR 2944, Transmittal 90, Issued on February 6, 2004

Mon, 05 Dec 2005 13:46:00 EST

Transmittal #: R209CP
Subject: Correction to CR 2944, Transmittal 90, Issued on February 6, 2004
CR #: 3333
Job Aid #: JA3333

Long Term Care Hospital Prospective Payment System (LTCH PPS) Fiscal Year 2005-Update

Mon, 05 Dec 2005 13:48:00 EST

Transmittal #: R208CP
Subject: Long Term Care Hospital Prospective Payment System (LTCH PPS) Fiscal Year 2005-Update
CR #: 3335
Job Aid #: N/A

Expansion of Policy Where Patient is a Member of a Medicare Advantage (MA) Organization For Only a Portion of the Billing Period to Include Inpatient Rehabilitation Facilities (IRF) and Long Term Care Hospitals (LTCH)

Mon, 05 Dec 2005 13:50:00 EST

Transmittal #: R207CP
Subject: Expansion of Policy Where Patient is a Member of a Medicare Advantage (MA) Organization For Only a Portion of the Billing Period to Include Inpatient Rehabilitation Facilities (IRF) and Long Term Care Hospitals (LTCH)
CR #: 3309
Job Aid #: JA3309

NCD: Sensory Nerve Conduction Threshold Test (sNCTs) (NOTE THAT Change Request (CR) 3339 CONSTITUTES A TECHNICAL CORRECTION TO PREVIOUSLY ISSUED CR 2988 dated 03/19/04. CR 2988 ORIGINALLY COMMUNICATED ON MARCH 19, 2004 VIA RO-2541, SHOULD BE DISCARDED AND REPLACED WITH CR 3339.

Mon, 05 Dec 2005 13:52:00 EST

Transmittal #: R15NCD
Subject: NCD: Sensory Nerve Conduction Threshold Test (sNCTs) (NOTE THAT Change Request (CR) 3339 CONSTITUTES A TECHNICAL CORRECTION TO PREVIOUSLY ISSUED CR 2988 dated 03/19/04. CR 2988 ORIGINALLY COMMUNICATED ON MARCH 19, 2004 VIA RO-2541, SHOULD BE DISCARDED AND REPLACED WITH CR 3339.
CR #: 3339
Job Aid #: JA3339

MMA Drug Pricing Update-Payment Limits for J7308 (Levulan Kerastick) and J9395 (Faslodex)

Mon, 05 Dec 2005 13:54:00 EST

Transmittal #: R90OTN
Subject: MMA Drug Pricing Update-Payment Limits for J7308 (Levulan Kerastick) and J9395 (Faslodex)
CR #: 3312
Job Aid #: JA3312

Chapter 4, Benefits and Beneficiary Protection

Mon, 05 Dec 2005 13:55:00 EST

Transmittal #: R49MCM
Subject: Chapter 4, Benefits and Beneficiary Protection
CR #: N/A
Job Aid #: N/A

Incident-To Services on Form CMS-1500

Mon, 05 Dec 2005 13:56:00 EST

Transmittal #: R17BP
Subject: Incident-To Services on Form CMS-1500
CR #: 3242
Job Aid #: N/A

Medicare Systems Acceptance of New Provider Numbers for Federally Qualified Health Centers (FQHC)

Mon, 05 Dec 2005 13:57:00 EST

Transmittal #: R3SOM
Subject: Medicare Systems Acceptance of New Provider Numbers for Federally Qualified Health Centers (FQHC)
CR #: 3537
Job Aid #: N/A

Shared System Maintainer Hours for Resolution of Problems Detected As A Result of Implementation of CR 2525 and CR 2527

Mon, 05 Dec 2005 13:57:00 EST

Transmittal #: R89OTN
Subject: Shared System Maintainer Hours for Resolution of Problems Detected As A Result of Implementation of CR 2525 and CR 2527
CR #: 3305
Job Aid #: N/A

Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial

Mon, 05 Dec 2005 13:59:00 EST

Transmittal #: R75PI
Subject: Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial
CR #: 3089
Job Aid #: N/A

Distinct Part Units for Critical Access Hospitals

Mon, 05 Dec 2005 14:01:00 EST

Transmittal #: R144CP
Subject: Distinct Part Units for Critical Access Hospitals
CR #: 3175
Job Aid #: N/A

Hospital Partial Hospitalization Services Billing Requirements

Mon, 05 Dec 2005 14:02:00 EST

Transmittal #: R180CP
Subject: Hospital Partial Hospitalization Services Billing Requirements
CR #: 3297
Job Aid #: N/A

Data Element Requirements Matrix - Carrier

Mon, 05 Dec 2005 14:04:00 EST

Transmittal #: R145CP
Subject: Data Element Requirements Matrix - Carrier
CR #: 3164
Job Aid #: N/A

Evaluation and Management Service Codes

Mon, 05 Dec 2005 14:08:00 EST

Transmittal #: R178CP
Subject: Evaluation and Management Service Codes
CR #: 2321
Job Aid #: N/A

Payment for Chemotherapy Administration Services, Nonchemotherapy Drug Infusion Services, and Drug Injection Services

Mon, 05 Dec 2005 14:08:00 EST

Transmittal #: R147CP
Subject: Payment for Chemotherapy Administration Services, Nonchemotherapy Drug Infusion Services, and Drug Injection Services
CR #: 3192
Job Aid #: N/A

Instructions for Downloading the Medicare Zip Code File

Mon, 05 Dec 2005 14:11:00 EST

Transmittal #: R176CP
Subject: Instructions for Downloading the Medicare Zip Code File
CR #: 3270
Job Aid #: N/A

General Instructions for Completion of Form CMS-1450 for Billing

Mon, 05 Dec 2005 14:11:00 EST

Transmittal #: R149CP
Subject: General Instructions for Completion of Form CMS-1450 for Billing
CR #: 3183
Job Aid #: N/A

Updated SNF NO PAY File for July 2004

Mon, 05 Dec 2005 14:13:00 EST

Transmittal #: R177CP
Subject: Updated SNF NO PAY File for July 2004
CR #: 3275
Job Aid #: N/A

Updated SNF NO PAY File for July 2004

Mon, 05 Dec 2005 14:15:00 EST

Transmittal #: R182CP
Subject: Updated SNF NO PAY File for July 2004
CR #: 3275
Job Aid #: N/A

Revised American National Standards Institute X12N 837 Professional Health Care Claim Companion Document

Mon, 05 Dec 2005 14:16:00 EST

Transmittal #: R73OTN
Subject: Revised American National Standards Institute X12N 837 Professional Health Care Claim Companion Document
CR #: 3177
Job Aid #: N/A

Retirement of Manual

Mon, 05 Dec 2005 14:18:00 EST

Transmittal #: R16HMO
Subject: Retirement of Manual
CR #: N/A
Job Aid #: N/A

Emergency Correction Regarding Correction to Healthcare Common Procedure Coding System (HCPCS) Codes for Low Osmolar Contrast Material

Mon, 05 Dec 2005 14:18:00 EST

Transmittal #: R74OTN
Subject: Emergency Correction Regarding Correction to Healthcare Common Procedure Coding System (HCPCS) Codes for Low Osmolar Contrast Material
CR #: 3187
Job Aid #: N/A

Chapter 10, Organization Compliance With State Law and Pre-emption by Federal Law

Mon, 05 Dec 2005 14:19:00 EST

Transmittal #: R55MCM
Subject: Chapter 10, Organization Compliance With State Law and Pre-emption by Federal Law
CR #: N/A
Job Aid #: N/A

One time instructions for audit intermediary cost reporting processes to accommodate claims processing error that prevented some supply charges from being reported on home health prospective payment system claims

Mon, 05 Dec 2005 14:20:00 EST

Transmittal #: R75OTN
Subject: One time instructions for audit intermediary cost reporting processes to accommodate claims processing error that prevented some supply charges from being reported on home health prospective payment system claims
CR #: 3147
Job Aid #: N/A

Updated SNF NO PAY File for April 2004

Mon, 05 Dec 2005 14:23:00 EST

Transmittal #: R143CP
Subject: Updated SNF NO PAY File for April 2004
CR #: 3238
Job Aid #: N/A

Chapter 19, Managed Care and M+C Systems Requirements

Mon, 05 Dec 2005 14:23:00 EST

Transmittal #: R54MCM
Subject: Chapter 19, Managed Care and M+C Systems Requirements
CR #: N/A
Job Aid #: N/A

Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial

Mon, 05 Dec 2005 14:25:00 EST

Transmittal #: R87PI
Subject: Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial
CR #: 3363
Job Aid #: N/A

Chapter 11, Contracts With Medicare+Choice Organizations

Mon, 05 Dec 2005 14:25:00 EST

Transmittal #: R53MCM
Subject: Chapter 11, Contracts With Medicare+Choice Organizations
CR #: N/A
Job Aid #: N/A

Provider/Supplier Communications - Revisions and Additions to Existing Contractor Requirements

Mon, 05 Dec 2005 14:27:00 EST

Transmittal #: R6COM
Subject: Provider/Supplier Communications - Revisions and Additions to Existing Contractor Requirements
CR #: 3179
Job Aid #: N/A

Hospital Concerns Regarding Changing of Patient Status Code Due to Common Working File Edit 7272

Mon, 05 Dec 2005 14:28:00 EST

Transmittal #: R140CP
Subject: Hospital Concerns Regarding Changing of Patient Status Code Due to Common Working File Edit 7272
CR #: 3240
Job Aid #: N/A

Skilled Nursing Facility (SNF) Consolidated Billing: Services Furnished Under an "Arrangement" With an Outside Entity

Mon, 05 Dec 2005 14:29:00 EST

Transmittal #: R183CP
Subject: Skilled Nursing Facility (SNF) Consolidated Billing: Services Furnished Under an "Arrangement" With an Outside Entity
CR #: 3248
Job Aid #: N/A

Release of Basic Manual

Mon, 05 Dec 2005 14:29:00 EST

Transmittal #: R1SOM
Subject: Release of Basic Manual
CR #: N/A
Job Aid #: N/A

Installation of Version 34.0 of the Provider Statistical and Reimbursement (PS&R) Reporting System

Mon, 05 Dec 2005 14:30:00 EST

Transmittal #: R39FM
Subject: Installation of Version 34.0 of the Provider Statistical and Reimbursement (PS&R) Reporting System
CR #: 3182
Job Aid #: N/A

Automated Prepayment

Mon, 05 Dec 2005 14:31:00 EST

Transmittal #: R72PI
Subject: Automated Prepayment
CR #: 3088
Job Aid #: N/A

Chapter 2, End Stage Renal Disease

Mon, 05 Dec 2005 14:33:00 EST

Transmittal #: R51MCM
Subject: Chapter 2, End Stage Renal Disease
CR #: N/A
Job Aid #: N/A

Rescission of Transmittal 16

Mon, 05 Dec 2005 14:33:00 EST

Transmittal #: R17HMO
Subject: Rescission of Transmittal 16
CR #: N/A
Job Aid #: N/A

Update to the Healthcare Provider taxonomy Codes (HPTC) Version 4.0

Mon, 05 Dec 2005 14:34:00 EST

Transmittal #: R71OTN
Subject: Update to the Healthcare Provider taxonomy Codes (HPTC) Version 4.0
CR #: 3188
Job Aid #: N/A

Instructions Related to "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments

Mon, 05 Dec 2005 14:35:00 EST

Transmittal #: R87OTN
Subject: Instructions Related to "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments
CR #: 3247
Job Aid #: N/A

Changes in Determining Rural Status of Hospitals for Transitional Outpatient Payments (TOPs) for 2004

Mon, 05 Dec 2005 14:36:00 EST

Transmittal #: R72OTN
Subject: Changes in Determining Rural Status of Hospitals for Transitional Outpatient Payments (TOPs) for 2004
CR #: 3214
Job Aid #: N/A

Interface File from Recovery Management and Accounting System (ReMAS)

Mon, 05 Dec 2005 14:36:00 EST

Transmittal #: R86OTN
Subject: Interface File from Recovery Management and Accounting System (ReMAS)
CR #: 3142
Job Aid #: N/A

Addition of Two "WW" Codes to Identify Xeloda (Capecitabine)

Mon, 05 Dec 2005 14:39:00 EST

Transmittal #: R136CP
Subject: Addition of Two "WW" Codes to Identify Xeloda (Capecitabine)
CR #: 3169
Job Aid #: N/A

CD-ROM Initiative for Distribution of the Annual Disclosure, Dear Doctor Letter and Participation Enrollment Material

Mon, 05 Dec 2005 14:39:00 EST

Transmittal #: R85OTN
Subject: CD-ROM Initiative for Distribution of the Annual Disclosure, Dear Doctor Letter and Participation Enrollment Material
CR #: 3292
Job Aid #: N/A

Instructions for Carriers, DMERCs, FIs, and full PSCs when interacting with the Comprehensive Error Rate Testing (CERT) Contractor (i.e., handling appeals of CERT-initiated denials, contacting non-responders, tracking over/underpayments

Mon, 05 Dec 2005 14:41:00 EST

Transmittal #: R77PI
Subject: Instructions for Carriers, DMERCs, FIs, and full PSCs when interacting with the Comprehensive Error Rate Testing (CERT) Contractor (i.e., handling appeals of CERT-initiated denials, contacting non-responders, tracking over/underpayments
CR #: 3229
Job Aid #: N/A

Manualization of Section 4118 of the Medicare Carriers Manual, Part 3

Mon, 05 Dec 2005 14:41:00 EST

Transmittal #: R137CP
Subject: Manualization of Section 4118 of the Medicare Carriers Manual, Part 3
CR #: 3134
Job Aid #: N/A

Addition of Instructions for Form CMS-2591 to Chapter 6

Mon, 05 Dec 2005 14:42:00 EST

Transmittal #: R45FM
Subject: Addition of Instructions for Form CMS-2591 to Chapter 6
CR #: N/A
Job Aid #: N/A

Clarification of Complex Medical Review

Mon, 05 Dec 2005 14:43:00 EST

Transmittal #: R76PI
Subject: Clarification of Complex Medical Review
CR #: 3211
Job Aid #: N/A

The Consolidation of the Claims Crossover Process: Smaller-Scale Initial Implementation

Mon, 05 Dec 2005 14:43:00 EST

Transmittal #: R138CP
Subject: The Consolidation of the Claims Crossover Process: Smaller-Scale Initial Implementation
CR #: 3218
Job Aid #: N/A

Skilled Nursing Facility Consolidated Billing L Codes - DMERCs and Fis

Mon, 05 Dec 2005 14:45:00 EST

Transmittal #: R191CP
Subject: Skilled Nursing Facility Consolidated Billing L Codes - DMERCs and Fis
CR #: 3295
Job Aid #: JA3295

Chapter 1, Budget Preparation

Mon, 05 Dec 2005 14:45:00 EST

Transmittal #: R38FM
Subject: Chapter 1, Budget Preparation
CR #: 3218
Job Aid #: N/A

Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing

Mon, 05 Dec 2005 14:46:00 EST

Transmittal #: R76OTN
Subject: Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing
CR #: 3178
Job Aid #: N/A

Healthcare Common Procedure Coding System (HCPCS) Correction

Mon, 05 Dec 2005 14:47:00 EST

Transmittal #: R192CP
Subject: Healthcare Common Procedure Coding System (HCPCS) Correction
CR #: 3282
Job Aid #: N/A

Virginia Cardiac Surgery Initiative Demonstration - Modifications & Corrections to Change Request 2382

Mon, 05 Dec 2005 14:48:00 EST

Transmittal #: R2DEMO
Subject: Virginia Cardiac Surgery Initiative Demonstration - Modifications & Corrections to Change Request 2382
CR #: 3199
Job Aid #: N/A

Instructions Related to "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments

Mon, 05 Dec 2005 14:50:00 EST

Transmittal #: R77OTN
Subject: Instructions Related to "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments
CR #: 3247
Job Aid #: N/A

End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests

Mon, 05 Dec 2005 14:51:00 EST

Transmittal #: R190CP
Subject: End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests
CR #: 3239
Job Aid #: JA3239

Renovate Override Code Processing In Common Working File

Mon, 05 Dec 2005 14:51:00 EST

Transmittal #: R78OTN
Subject: Renovate Override Code Processing In Common Working File
CR #: 3190
Job Aid #: N/A

Unsolicited/Voluntary Refunds

Mon, 05 Dec 2005 14:53:00 EST

Transmittal #: R42FM
Subject: Unsolicited/Voluntary Refunds
CR #: 3274
Job Aid #: N/A

Expanded Identification and Workload Reporting for CMS Medicare Systems

Mon, 05 Dec 2005 14:56:00 EST

Transmittal #: R43FM
Subject: Expanded Identification and Workload Reporting for CMS Medicare Systems
CR #: 3256
Job Aid #: N/A

Requirement for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), Fiscal Intermediaries (FIs), and Full Program Safeguard Contractors (PSCs) to Encourage Providers to Submit Medical Records to the Comprehensive Error Rate Testing (CERT) Contractor for Use in the November 2004 Improper Medicare Fee-For-Service (FFS) Payments Report

Mon, 05 Dec 2005 14:58:00 EST

Transmittal #: R81OTN
Subject: Requirement for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), Fiscal Intermediaries (FIs), and Full Program Safeguard Contractors (PSCs) to Encourage Providers to Submit Medical Records to the Comprehensive Error Rate Testing (CERT) Contractor for Use in the November 2004 Improper Medicare Fee-For-Service (FFS) Payments Report
CR #: 3157
Job Aid #: N/A

Informing Beneficiaries about whicl local Medical Review Policy (LMRP) and /or Local Coverage Determinatin (LCD) and o/or National Coverage Determination (NCD) is associated with their claim denia

Mon, 05 Dec 2005 14:58:00 EST

Transmittal #: R161CP
Subject: Informing Beneficiaries about whicl local Medical Review Policy (LMRP) and /or Local Coverage Determinatin (LCD) and o/or National Coverage Determination (NCD) is associated with their claim denia
CR #: 3089
Job Aid #: N/A

Chapter 7 - Contract Administrative Requirements

Mon, 05 Dec 2005 15:03:00 EST

Transmittal #: R5GI
Subject: Chapter 7 - Contract Administrative Requirements
CR #: 2765
Job Aid #: N/A

Changes in Determining Rural Status of Hospitals for Transitional Outpatient Payments (TOPs) for 2004

Mon, 05 Dec 2005 15:04:00 EST

Transmittal #: R82OTN
Subject: Changes in Determining Rural Status of Hospitals for Transitional Outpatient Payments (TOPs) for 2004
CR #: 3214
Job Aid #: N/A

Chapter 6, Hospital Services Covered Under Part B

Mon, 05 Dec 2005 15:07:00 EST

Transmittal #: R10BP
Subject: Chapter 6, Hospital Services Covered Under Part B
CR #: 3298
Job Aid #: N/A

Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site Other than a Physician's Office or Hospital

Mon, 05 Dec 2005 15:07:00 EST

Transmittal #: R163CP
Subject: Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site Other than a Physician's Office or Hospital
CR #: 3196
Job Aid #: JA3196

Chapter 1, General Billing Requirements

Mon, 05 Dec 2005 15:08:00 EST

Transmittal #: R169CP
Subject: Chapter 1, General Billing Requirements
CR #: 2631
Job Aid #: JA0429

Key Shop and Optical Character Recognition (OCR)/Image Character Recognition (ICR) Output Mapping

Mon, 05 Dec 2005 15:09:00 EST

Transmittal #: R162CP
Subject: Key Shop and Optical Character Recognition (OCR)/Image Character Recognition (ICR) Output Mapping
CR #: 3180
Job Aid #: N/A

Chapter 12, Physician/Practitioner Billing

Mon, 05 Dec 2005 15:10:00 EST

Transmittal #: R168CP
Subject: Chapter 12, Physician/Practitioner Billing
CR #: 1756
Job Aid #: N/A

End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry Test(s)

Mon, 05 Dec 2005 15:10:00 EST

Transmittal #: R164CP
Subject: End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry Test(s)
CR #: 2813
Job Aid #: N/A

Healthcare Common Procedure Coding System (HCPCS) Corrections Involving 0040T and A9603

Mon, 05 Dec 2005 15:12:00 EST

Transmittal #: R174CP
Subject: Healthcare Common Procedure Coding System (HCPCS) Corrections Involving 0040T and A9603
CR #: 3258
Job Aid #: N/A

Program Integrity Management Reporting System (PIMR) Section 7.2 of the Program Integrity Manual (PIM)

Mon, 05 Dec 2005 15:13:00 EST

Transmittal #: R73PI
Subject: Program Integrity Management Reporting System (PIMR) Section 7.2 of the Program Integrity Manual (PIM)
CR #: 2646
Job Aid #: N/A

2nd Update to the 2004 Medicare Physician Fee Schedule Database

Mon, 05 Dec 2005 15:15:00 EST

Transmittal #: R173CP
Subject: 2nd Update to the 2004 Medicare Physician Fee Schedule Database
CR #: 3286
Job Aid #: N/A

Change in Interest Calculation for Medicare Overpayments and Underpayments and Medicare Secondary Payer (MSP) Recoveries

Mon, 05 Dec 2005 15:16:00 EST

Transmittal #: R41FM
Subject: Change in Interest Calculation for Medicare Overpayments and Underpayments and Medicare Secondary Payer (MSP) Recoveries
CR #: 3163
Job Aid #: N/A

New Waived Tests - July 1, 2004

Mon, 05 Dec 2005 15:16:00 EST

Transmittal #: R172CP
Subject: New Waived Tests - July 1, 2004
CR #: 3254
Job Aid #: N/A

July Quarterly Update for 2004 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule

Mon, 05 Dec 2005 15:17:00 EST

Transmittal #: R171CP
Subject: July Quarterly Update for 2004 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule
CR #: 3253
Job Aid #: N/A

Chapter 1, General Billing Requirements

Mon, 05 Dec 2005 15:19:00 EST

Transmittal #: R170CP
Subject: Chapter 1, General Billing Requirements
CR #: 2815
Job Aid #: N/A

Demonstration Project to Clarify the Definition of Homebound - Section 702 of MMA

Mon, 05 Dec 2005 15:20:00 EST

Transmittal #: R3DEMO
Subject: Demonstration Project to Clarify the Definition of Homebound - Section 702 of MMA
CR #: 3269
Job Aid #: JA3269

Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases - Skilled Nursing Facility (SNF) Consolidated Billing (CB) as it Applies to RHC and FQHC Service

Mon, 05 Dec 2005 15:20:00 EST

Transmittal #: R390CP
Subject: Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases - Skilled Nursing Facility (SNF) Consolidated Billing (CB) as it Applies to RHC and FQHC Service
CR #: 3575
Job Aid #: N/A

Chapter 17, Subchapter A, TEFRA Cost-Based Payment Process and Principles

Mon, 05 Dec 2005 15:22:00 EST

Transmittal #: R52MCM
Subject: Chapter 17, Subchapter A, TEFRA Cost-Based Payment Process and Principles
CR #: N/A
Job Aid #: N/A

The Supplemental Security Income (SSI) Medicare Beneficiary Data for Fiscal Year 2003 for Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS)

Mon, 05 Dec 2005 15:22:00 EST

Transmittal #: R392CP
Subject: The Supplemental Security Income (SSI) Medicare Beneficiary Data for Fiscal Year 2003 for Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS)
CR #: 3567
Job Aid #: N/A

18-Month Moratorium on Physician Self-Referrals to Specialty Hospitals; Processing of Form CMS-855A Applications to Become a Medicare Certified Hospital

Mon, 05 Dec 2005 15:23:00 EST

Transmittal #: R79OTN
Subject: 18-Month Moratorium on Physician Self-Referrals to Specialty Hospitals; Processing of Form CMS-855A Applications to Become a Medicare Certified Hospital
CR #: 3193
Job Aid #: N/A

Consolidation of the Claims Crossover Process: Full-scale Implementation of the Coordination of Benefits Agreement (COBA) Initiative

Mon, 05 Dec 2005 15:25:00 EST

Transmittal #: R158CP
Subject: Consolidation of the Claims Crossover Process: Full-scale Implementation of the Coordination of Benefits Agreement (COBA) Initiative
CR #: 3273
Job Aid #: N/A

Clarification of payments and billing procedures for hospitals subject to the Maryland waiver.

Mon, 05 Dec 2005 15:26:00 EST

Transmittal #: R156CP
Subject: Clarification of payments and billing procedures for hospitals subject to the Maryland waiver.
CR #: 3200
Job Aid #: N/A

Inclusion of Core-Based Statistical Area (CBSA) Data Elements to the Provider Specific Files

Mon, 05 Dec 2005 15:30:00 EST

Transmittal #: R152CP
Subject: Inclusion of Core-Based Statistical Area (CBSA) Data Elements to the Provider Specific Files
CR #: 3272
Job Aid #: N/A

Enhancement to Home Health Consolidated Billing Edits

Mon, 05 Dec 2005 15:30:00 EST

Transmittal #: R165CP
Subject: Enhancement to Home Health Consolidated Billing Edits
CR #: 3186
Job Aid #: N/A

Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.2, Effective July, 1, 2004.

Mon, 05 Dec 2005 15:32:00 EST

Transmittal #: R150CP
Subject: Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.2, Effective July, 1, 2004.
CR #: 3244
Job Aid #: N/A

Cardiac Pacemakers

Mon, 05 Dec 2005 15:33:00 EST

Transmittal #: R12NCD
Subject: Cardiac Pacemakers
CR #: 3290
Job Aid #: N/A

Scheduled Release for July Updates to Software Programs and Pricing/Coding Files

Mon, 05 Dec 2005 15:34:00 EST

Transmittal #: R4GI
Subject: Scheduled Release for July Updates to Software Programs and Pricing/Coding Files
CR #: 3278
Job Aid #: N/A

Medicare Systems Acceptance of New Provider Numbers for Home Health Agencies

Mon, 05 Dec 2005 15:35:00 EST

Transmittal #: R80OTN
Subject: Medicare Systems Acceptance of New Provider Numbers for Home Health Agencies
CR #: 3245
Job Aid #: N/A

Type of Service Corrections

Mon, 05 Dec 2005 15:36:00 EST

Transmittal #: R153CP
Subject: Type of Service Corrections
CR #: 3189
Job Aid #: N/A

Information and Education Resources for Medicare Providers, Suppliers, and Physicians

Wed, 07 Dec 2005 17:19:00 EST

Transmittal #: SE0454
Subject: Information and Education Resources for Medicare Providers, Suppliers, and Physicians
CR #: N/A
Job Aid #: N/A

Guidance Regarding Elimination of Standard Paper Remittance (SPR) Advice Notices in the Old Format

Wed, 07 Dec 2005 17:19:00 EST

Transmittal #: SE0451
Subject: Guidance Regarding Elimination of Standard Paper Remittance (SPR) Advice Notices in the Old Format
CR #: N/A
Job Aid #: JA0451

Clarification of Medicare's Transfer Policy Under the Inpatient Prospective Payment System (IPPS)

Wed, 07 Dec 2005 17:19:00 EST

Transmittal #: SE0459
Subject: Clarification of Medicare's Transfer Policy Under the Inpatient Prospective Payment System (IPPS)
CR #: N/A
Job Aid #: N/A

Inappropriate Access to or Use of Electronic Data Interchange (EDI) Transaction Data by Third Party Entities

Wed, 07 Dec 2005 17:19:00 EST

Transmittal #: SE0461
Subject: Inappropriate Access to or Use of Electronic Data Interchange (EDI) Transaction Data by Third Party Entities
CR #: N/A
Job Aid #: N/A

"Incident to" Services

Wed, 07 Dec 2005 17:19:00 EST

Transmittal #: SE0441
Subject: "Incident to" Services
CR #: N/A
Job Aid #: JA0441

Use Condition Code 59 When an ESRD Beneficiary Receives Non-Scheduled or Emergency Dialysis Services at a Non-Primary ESRD Dialysis Facility

Wed, 07 Dec 2005 17:19:00 EST

Transmittal #: SE0452
Subject: Use Condition Code 59 When an ESRD Beneficiary Receives Non-Scheduled or Emergency Dialysis Services at a Non-Primary ESRD Dialysis Facility
CR #: N/A
Job Aid #: JA0452

MMA - Drug Administration Coding Changes and Reimbursement

Wed, 07 Dec 2005 17:19:00 EST

Transmittal #: SE0462
Subject: MMA - Drug Administration Coding Changes and Reimbursement
CR #: N/A
Job Aid #: N/A

Guidance for Part A Providers Switching to Electronic Remittance Advices (ERAs)

Wed, 07 Dec 2005 17:19:00 EST

Transmittal #: SE0447
Subject: Guidance for Part A Providers Switching to Electronic Remittance Advices (ERAs)
CR #: N/A
Job Aid #: JA0447

MMA - Medicare Prescription Drug, Improvement and Modernization Act of 2003 Information for Medicare Rural Health Providers, Suppliers, and Physicians

Wed, 07 Dec 2005 17:19:00 EST

Transmittal #: SE0450
Subject: MMA - Medicare Prescription Drug, Improvement and Modernization Act of 2003 Information for Medicare Rural Health Providers, Suppliers, and Physicians
CR #: N/A
Job Aid #: N/A

Temporary Hold of Outpatient Claims Subject to the Outpatient Prospective Payment System (OPPS) in April 2004

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0413
Subject: Temporary Hold of Outpatient Claims Subject to the Outpatient Prospective Payment System (OPPS) in April 2004
CR #: N/A
Job Aid #: N/A

Non-Physician Practitioner Questions and Answers

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0418
Subject: Non-Physician Practitioner Questions and Answers
CR #: N/A
Job Aid #: JA0418

Skilled Nursing Facility Consolidated Billing as It Relates to Certain Types of Exceptionally Intensive Outpatient Hospital Services

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0432
Subject: Skilled Nursing Facility Consolidated Billing as It Relates to Certain Types of Exceptionally Intensive Outpatient Hospital Services
CR #: N/A
Job Aid #: JA0432

Reminder: Hospital Discounts Permitted for Indigent, Uninsured, and Underinsured Patients

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0405
Subject: Reminder: Hospital Discounts Permitted for Indigent, Uninsured, and Underinsured Patients
CR #: N/A
Job Aid #: N/A

Temporary Hold of Inpatient Claims in April 2004

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0411
Subject: Temporary Hold of Inpatient Claims in April 2004
CR #: N/A
Job Aid #: N/A

Centers for Medicare & Medicaid Services (CMS) Working to Improve Provider Enrollment Process

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0417
Subject: Centers for Medicare & Medicaid Services (CMS) Working to Improve Provider Enrollment Process
CR #: N/A
Job Aid #: N/A

Skilled Nursing Facility Consolidated Billing

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0431
Subject: Skilled Nursing Facility Consolidated Billing
CR #: N/A
Job Aid #: N/A

Skilled Nursing Facility Consolidated Billing as It Relates to Dialysis Coverage

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0435
Subject: Skilled Nursing Facility Consolidated Billing as It Relates to Dialysis Coverage
CR #: N/A
Job Aid #: JA0435

Skilled Nursing Facility Consolidated Billing as It Relates to Certain Diagnostic Tests

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0440
Subject: Skilled Nursing Facility Consolidated Billing as It Relates to Certain Diagnostic Tests
CR #: N/A
Job Aid #: JA0440

Reminder of the Required Three-day Hospital Stay for SNF Admissions

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0403
Subject: Reminder of the Required Three-day Hospital Stay for SNF Admissions
CR #: N/A
Job Aid #: N/A

Medicare Resources for Researching Inpatient Discharges within 14 Days of a Home Health Admission

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0410
Subject: Medicare Resources for Researching Inpatient Discharges within 14 Days of a Home Health Admission
CR #: N/A
Job Aid #: N/A

OIG Alert About Charging Extra for Covered Services

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0421
Subject: OIG Alert About Charging Extra for Covered Services
CR #: N/A
Job Aid #: JA0421

Clarification of Change Request 2631

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0429
Subject: Clarification of Change Request 2631
CR #: N/A
Job Aid #: JA0429

Medicare Providers: Their Vendors, Clearinghouses, or Other Third-Party Billers and the HIPAA/Medicare Contingency Plan

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0414
Subject: Medicare Providers: Their Vendors, Clearinghouses, or Other Third-Party Billers and the HIPAA/Medicare Contingency Plan
CR #: N/A
Job Aid #: N/A

MMA - CMS to Increase Payments to Hospitals Reclassified Under Medicare Reform Law

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0419
Subject: MMA - CMS to Increase Payments to Hospitals Reclassified Under Medicare Reform Law
CR #: N/A
Job Aid #: N/A

Clarification for Billing Left Ventricular Assist Devices

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0424
Subject: Clarification for Billing Left Ventricular Assist Devices
CR #: N/A
Job Aid #: N/A

Clarification of Epoetin Alfa (EPO) Billing Procedures and Codes in ESRD

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0406
Subject: Clarification of Epoetin Alfa (EPO) Billing Procedures and Codes in ESRD
CR #: N/A
Job Aid #: JA0406

Modification of Requirements in CR2716, CWF Edits to Ensure Accurate Coding and Payments for Discharge and/or Transfer Policies

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0408
Subject: Modification of Requirements in CR2716, CWF Edits to Ensure Accurate Coding and Payments for Discharge and/or Transfer Policies
CR #: N/A
Job Aid #: N/A

Reminder to Stop Duplicate Billings

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0415
Subject: Reminder to Stop Duplicate Billings
CR #: N/A
Job Aid #: N/A

MMA - Section 937 - Correction of Minor Errors and Omissions Without Appeals

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0420
Subject: MMA - Section 937 - Correction of Minor Errors and Omissions Without Appeals
CR #: N/A
Job Aid #: N/A

Use of Group Health Plan Payment System for Medicare Disease Management Demonstration Serving Medicare Fee For Service Beneficiaries

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0425
Subject: Use of Group Health Plan Payment System for Medicare Disease Management Demonstration Serving Medicare Fee For Service Beneficiaries
CR #: N/A
Job Aid #: N/A

MMA - Medicare Prescription Drug, Improvement, and Modernization Act - Skilled Nursing Facility Consolidated Billing and Services of Rural Health Clinics and Federally Qualified Health Centers

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0438
Subject: MMA - Medicare Prescription Drug, Improvement, and Modernization Act - Skilled Nursing Facility Consolidated Billing and Services of Rural Health Clinics and Federally Qualified Health Centers
CR #: N/A
Job Aid #: N/A

Announcing the New Medlearn MattersInformation for Medicare Providers Educational Resource for Medicare Providers

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0401
Subject: Announcing the New Medlearn MattersInformation for Medicare Providers Educational Resource for Medicare Providers
CR #: N/A
Job Aid #: N/A

Skilled Nursing Facility Consolidated Billing and Erythropoietin (EPO, Epoetin Alfa) and Darbepoetin Alfa (Aranesp)

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0434
Subject: Skilled Nursing Facility Consolidated Billing and Erythropoietin (EPO, Epoetin Alfa) and Darbepoetin Alfa (Aranesp)
CR #: N/A
Job Aid #: JA0434

Skilled Nursing Facility Consolidated Billing as It Relates to Clinical Social Workers

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0439
Subject: Skilled Nursing Facility Consolidated Billing as It Relates to Clinical Social Workers
CR #: N/A
Job Aid #: JA0439

Treatment of Certain Dental Claims as a Result of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

Thu, 08 Dec 2005 08:13:00 EST

Transmittal #: SE0402
Subject: Treatment of Certain Dental Claims as a Result of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003
CR #: N/A
Job Aid #: N/A

Cost Reporting Forms, Chapter 18

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R7P218
Subject: Cost Reporting Forms, Chapter 18
CR #: N/A
Job Aid #: N/A

Good Cause Waiver of Late Claim Filing Payment Reduction Penalty and Monitoring of Late Claims Submissions. Full Replacement of CR 3402, Which Was Rescinded

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R420CP
Subject: Good Cause Waiver of Late Claim Filing Payment Reduction Penalty and Monitoring of Late Claims Submissions. Full Replacement of CR 3402, Which Was Rescinded
CR #: 3549
Job Aid #: N/A

Modification of CROWD Form 5

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R40FM
Subject: Modification of CROWD Form 5
CR #: 3257
Job Aid #: N/A

July 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS): Payment for Drugs, Biologicals and Radiopharmaceuticals

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R194CP
Subject: July 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS): Payment for Drugs, Biologicals and Radiopharmaceuticals
CR #: 3322
Job Aid #: N/A

Manualization for 2502

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R142CP
Subject: Manualization for 2502
CR #: 2502
Job Aid #: N/A

PIM Fraud and Abuse Complaint Screening Revisions

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R80PI
Subject: PIM Fraud and Abuse Complaint Screening Revisions
CR #: 3341
Job Aid #: N/A

Indian Health Service (IHS) or Tribal Critical Access Hospital (CAH) Payment Methodology for Inpatient and Outpatient Services

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R231CP
Subject: Indian Health Service (IHS) or Tribal Critical Access Hospital (CAH) Payment Methodology for Inpatient and Outpatient Services
CR #: 3235
Job Aid #: N/A

Section 511 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Special Adjustment for Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Rates for Acquired Immune Deficiency Syndrome (AIDS)

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R160CP
Subject: Section 511 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Special Adjustment for Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Rates for Acquired Immune Deficiency Syndrome (AIDS)
CR #: 3291
Job Aid #: N/A

Incident-To Services on Form CMS-1500

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R148CP
Subject: Incident-To Services on Form CMS-1500
CR #: 3138
Job Aid #: N/A

Ambulance Inflation Factor (AIF)

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R411CP
Subject: Ambulance Inflation Factor (AIF)
CR #: 3599
Job Aid #: N/A

Processing Part B Claims for Indian Health Services (HIS)

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R241CP
Subject: Processing Part B Claims for Indian Health Services (HIS)
CR #: 3288
Job Aid #: N/A

Discontinued Use of Revenue Code 0910

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R167CP
Subject: Discontinued Use of Revenue Code 0910
CR #: 3194
Job Aid #: N/A

ANSI X12 Transaction 835 Flat File and Companion Document Correction for Carriers and DMERCs, and Deletion of a Hard Coded Reason Code A2 that Has Been Deactivated

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R103OTN
Subject: ANSI X12 Transaction 835 Flat File and Companion Document Correction for Carriers and DMERCs, and Deletion of a Hard Coded Reason Code A2 that Has Been Deactivated
CR #: 3236
Job Aid #: N/A

Blood-Derived Products for Chronic Non-Healing Wounds

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R19NCD
Subject: Blood-Derived Products for Chronic Non-Healing Wounds
CR #: 3384
Job Aid #: N/A

Update Medicare Secondary Payer (MSP) Group Health Plan Recovery Demand Letters to Employers and Insurers for Data Match and Non-Data Match Debts

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R16MSP
Subject: Update Medicare Secondary Payer (MSP) Group Health Plan Recovery Demand Letters to Employers and Insurers for Data Match and Non-Data Match Debts
CR #: 3216
Job Aid #: N/A

Arrangements for Physical, Occupational, and Speech Language Pathology Services (PT, OT, SLP)

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R9BP
Subject: Arrangements for Physical, Occupational, and Speech Language Pathology Services (PT, OT, SLP)
CR #: 3134
Job Aid #: N/A

Standard Terminology for Claims Processing Systems

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R8GI
Subject: Standard Terminology for Claims Processing Systems
CR #: 3086
Job Aid #: N/A

Introduction of "Medlearn Matters - Information for Medicare Providers" and Instructions for Carrier/Intermediary Use of This New Provider Education Vehicle

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R54OTN
Subject: Introduction of "Medlearn Matters - Information for Medicare Providers" and Instructions for Carrier/Intermediary Use of This New Provider Education Vehicle
CR #: 3129
Job Aid #: N/A

Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2005 for 9 Metropolitan Statistical Areas (MSAs) with New Wage Index Values Effective January 1, 2005

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R413CP
Subject: Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2005 for 9 Metropolitan Statistical Areas (MSAs) with New Wage Index Values Effective January 1, 2005
CR #: 3651
Job Aid #: N/A

Medicare HIPAA Electronic Claims Compliance Report - Reporting Timeframe Extension

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R410CP
Subject: Medicare HIPAA Electronic Claims Compliance Report - Reporting Timeframe Extension
CR #: 3611
Job Aid #: N/A

Instructions for Downloading the Medicare Zip Code File

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R235CP
Subject: Instructions for Downloading the Medicare Zip Code File
CR #: 3340
Job Aid #: N/A

New DMERC/VIPS Systems Requirement

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R166CP
Subject: New DMERC/VIPS Systems Requirement
CR #: 2761
Job Aid #: N/A

Update to the Healthcare Provider Taxonomy Codes (HPTC)/Medicare Specialty Code Crosswalk

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R102OTN
Subject: Update to the Healthcare Provider Taxonomy Codes (HPTC)/Medicare Specialty Code Crosswalk
CR #: 3259
Job Aid #: N/A

Annual Type of Service (TOS)

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R359CP
Subject: Annual Type of Service (TOS)
CR #: 3519
Job Aid #: N/A

General Policy

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R228CP
Subject: General Policy
CR #: 3267
Job Aid #: N/A

Instructions for Downloading the Medicare Zip Code File

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R181CP
Subject: Instructions for Downloading the Medicare Zip Code File
CR #: 3198
Job Aid #: N/A

Chapter 32, Billing Instructions for Special Services

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R130aCP
Subject: Chapter 32, Billing Instructions for Special Services
CR #: 2323
Job Aid #: N/A

SNF Certification and Recertification

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R74PI
Subject: SNF Certification and Recertification
CR #: 3150
Job Aid #: N/A

Manualization of INR Monitoring

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R216CP
Subject: Manualization of INR Monitoring
CR #: 2323
Job Aid #: N/A

National 1-800-MEDICARE (1-800-633-4227) Implementation (section 923(d) of MMA)

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R159CP
Subject: National 1-800-MEDICARE (1-800-633-4227) Implementation (section 923(d) of MMA)
CR #: 3195
Job Aid #: N/A

Electrocardiographic Services

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R26NCD
Subject: Electrocardiographic Services
CR #: 3590
Job Aid #: N/A

Change in Interest Calculation for Medicare Overpayments and Underpayments and Medicare Secondary Payer (MSP) Recoveries

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R15MSP
Subject: Change in Interest Calculation for Medicare Overpayments and Underpayments and Medicare Secondary Payer (MSP) Recoveries
CR #: 3163
Job Aid #: N/A

Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R119OTN
Subject: Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing
CR #: 3495
Job Aid #: N/A

Introduction of "Medlearn Matters - Information for Medicare Providers" and Instructions for Carrier/Intermediary Use of This New Provider Education Vehicle

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R5COM
Subject: Introduction of "Medlearn Matters - Information for Medicare Providers" and Instructions for Carrier/Intermediary Use of This New Provider Education Vehicle
CR #: 3097
Job Aid #: N/A

Clarification to CR 3069 - New "K" Codes for Wheelchair Cushions

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R179CP
Subject: Clarification to CR 3069 - New "K" Codes for Wheelchair Cushions
CR #: 3289
Job Aid #: N/A

Chapter 5, Contractor Prepayment Processing Requirements

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R14MSP
Subject: Chapter 5, Contractor Prepayment Processing Requirements
CR #: 2074
Job Aid #: N/A

Updated Policy and Claims Processing Instructions for Ambulatory Blood Pressure Monitoring (ABPM)

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R109CP
Subject: Updated Policy and Claims Processing Instructions for Ambulatory Blood Pressure Monitoring (ABPM)
CR #: 2726
Job Aid #: N/A

Notice of New Interest Rate for Medicare Overpayments and Underpayments

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R44FM
Subject: Notice of New Interest Rate for Medicare Overpayments and Underpayments
CR #: 2830
Job Aid #: N/A

Skilled Nursing Facility (SNF) Consolidated Billing Service Furnished under an Arrangement with an Outside Entity

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R412CP
Subject: Skilled Nursing Facility (SNF) Consolidated Billing Service Furnished under an Arrangement with an Outside Entity
CR #: 3592
Job Aid #: JA3592

Manualization of the Negotiated Clinical Diagnostic Laboratory National Coverage Determinations

Mon, 12 Dec 2005 14:38:00 EST

Transmittal #: R17NCD
Subject: Manualization of the Negotiated Clinical Diagnostic Laboratory National Coverage Determinations
CR #: 2130
Job Aid #: N/A

Remittance Advice Remark Code and Claim Adjustment Reason Code Update

Wed, 11 Jan 2006 15:16:00 EST

Transmittal #: R154CP
Subject: Remittance Advice Remark Code and Claim Adjustment Reason Code Update
CR #: 3227
Job Aid #: N/A

Remittance Advice Remark Code and Claim Adjustment Reason Code Update

Wed, 11 Jan 2006 15:21:00 EST

Transmittal #: R313CP
Subject: Remittance Advice Remark Code and Claim Adjustment Reason Code Update
CR #: 3466
Job Aid #: N/A

Emergency Update to the 2005 Medicare Physician Fee Schedule Database

Thu, 12 Jan 2006 08:30:00 EST

Transmittal #: R414CP
Subject: Emergency Update to the 2005 Medicare Physician Fee Schedule Database
CR #: 3595
Job Aid #: N/A

Update to Chapter 1, Section 220.6 - Dementia and Neurodegenerative Diseases

Tue, 07 Feb 2006 11:21:00 EST

Transmittal #: R24NCD
Subject: Update to Chapter 1, Section 220.6 - Dementia and Neurodegenerative Diseases
CR #: 3426
Job Aid #: JA3426

Payment for Emergency Medical Treatment and Labor Act (EMTALA) - Mandated Screening and Stabilization Services

Tue, 07 Feb 2006 11:24:00 EST

Transmittal #: R84PI
Subject: Payment for Emergency Medical Treatment and Labor Act (EMTALA) - Mandated Screening and Stabilization Services
CR #: 3437
Job Aid #: N/A

Coverage of Routine Costs of Clinical Trials Involving Investigational Device Exemption (IDE) Category A Devices

Fri, 15 Jun 2007 14:27:00 EST

Transmittal #: R131OTN
Subject: Coverage of Routine Costs of Clinical Trials Involving Investigational Device Exemption (IDE) Category A Devices
CR #: 3548
Job Aid #: N/A

Updated SNF Help File Available for Calendar Year 2004

Tue, 21 Aug 2007 07:11:00 EST

Transmittal #: R189CP
Subject: Updated SNF Help File Available for Calendar Year 2004
CR #: 3252
Job Aid #: JA3252

Additional Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Institutional Health Care Claim Implementation Guide (IG) Instruction and Clarification of Transmittal 107/100-04 (CR 3031)

Tue, 21 Aug 2007 07:12:00 EST

Transmittal #: R175CP
Subject: Additional Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Institutional Health Care Claim Implementation Guide (IG) Instruction and Clarification of Transmittal 107/100-04 (CR 3031)
CR #: 3264
Job Aid #: JA3264

Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills

Tue, 21 Aug 2007 07:13:00 EST

Transmittal #: R378CP
Subject: Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills
CR #: 3568
Job Aid #: JA3568

MMA - Medicare Replacement Drug Demonstration

Tue, 21 Aug 2007 07:15:00 EST

Transmittal #: SE0443
Subject: MMA - Medicare Replacement Drug Demonstration
CR #: N/A
Job Aid #: JA0443

Skilled Nursing Facility Consolidated Billing as It Relates to Prosthetics and Orthotics

Tue, 21 Aug 2007 07:16:00 EST

Transmittal #: SE0437
Subject: Skilled Nursing Facility Consolidated Billing as It Relates to Prosthetics and Orthotics
CR #: N/A
Job Aid #: JA0437

Referral of Patients for X-rays by Chiropractors

Tue, 28 Aug 2007 08:08:00 EST

Transmittal #: SE0416
Subject: Referral of Patients for X-rays by Chiropractors
CR #: N/A
Job Aid #: JA0416

Skilled Nursing Facility Consolidated Billing as It Relates to Ambulance Services

Thu, 02 Jul 2009 07:34:00 EST

Transmittal #: SE0433
Subject: Skilled Nursing Facility Consolidated Billing as It Relates to Ambulance Services
CR #: N/A
Job Aid #: JA0433

Skilled Nursing Facility Consolidated Billing and Preventive/Screening Services

Tue, 11 Aug 2009 08:44:00 EST

Transmittal #: SE0436
Subject: Skilled Nursing Facility Consolidated Billing and Preventive/Screening Services
CR #: N/A
Job Aid #: JA0436

MMA - New Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary for Physicians and Other Health Care Professionals

Tue, 01 Sep 2009 09:54:00 EST

Transmittal #: SE0422
Subject: MMA - New Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary for Physicians and Other Health Care Professionals
CR #: N/A
Job Aid #: N/A

MMA - New Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary for Pharmacists and Other Pharmacy Professionals

Tue, 01 Sep 2009 09:55:00 EST

Transmittal #: SE0423
Subject: MMA - New Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary for Pharmacists and Other Pharmacy Professionals
CR #: N/A
Job Aid #: N/A

MMA - Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary of New Initiative of Interest to Physicians and Other Health Care Professionals

Tue, 01 Sep 2009 09:56:00 EST

Transmittal #: SE0457
Subject: MMA - Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary of New Initiative of Interest to Physicians and Other Health Care Professionals
CR #: N/A
Job Aid #: N/A

MMA - Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary of New Initiative of Interest to Pharmacists and Pharmacy Professionals

Tue, 01 Sep 2009 09:56:00 EST

Transmittal #: SE0458
Subject: MMA - Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary of New Initiative of Interest to Pharmacists and Pharmacy Professionals
CR #: N/A
Job Aid #: N/A

Treatment of Obesity

Thu, 10 Sep 2009 08:07:00 EST

Transmittal #: R23NCD
Subject: Treatment of Obesity
CR #: 3502
Job Aid #: JA3502

Payment For Outpatient End Stage Renal Disease (ESRD)-Related Services

Thu, 15 Oct 2009 10:15:00 EST

Transmittal #: R300CP
Subject: Payment For Outpatient End Stage Renal Disease (ESRD)-Related Services
CR #: 3414
Job Aid #: JA3414

Clarification of Billing for Separately Billable ESRD Drugs

Fri, 20 Nov 2009 07:54:00 EST

Transmittal #: R146CP
Subject: Clarification of Billing for Separately Billable ESRD Drugs
CR #: 3176
Job Aid #: N/A