2005 Job Aids

Revisions to Payment for Services Provided Under a Contractual Arrangement - - Carrier Claims Only

Wed, 01 Jun 2005 00:00:00 EST

Transmittal #: R472CP
Subject: Revisions to Payment for Services Provided Under a Contractual Arrangement - - Carrier Claims Only
CR #: 3628
Job Aid #: JA3628

The Medically Unbelievable Edits

Thu, 10 Nov 2005 10:25:00 EST

Transmittal #: R105PI
Subject: The Medically Unbelievable Edits
CR #: 2987
Job Aid #: N/A

Requirement that Medicare Carrier System (MCS) Not Allow the Re-review of Previously Denied Claims

Thu, 10 Nov 2005 10:26:00 EST

Transmittal #: R104PI
Subject: Requirement that Medicare Carrier System (MCS) Not Allow the Re-review of Previously Denied Claims
CR #: 3622
Job Aid #: N/A

Change in Statistical Sampling Instructions

Thu, 10 Nov 2005 10:28:00 EST

Transmittal #: R108PI
Subject: Change in Statistical Sampling Instructions
CR #: 3734
Job Aid #: N/A

Revise CERT Shared Systems Modules to Retrieve Claims Files Using Only Internal Control Number as a Key

Thu, 10 Nov 2005 10:31:00 EST

Transmittal #: R110PI
Subject: Revise CERT Shared Systems Modules to Retrieve Claims Files Using Only Internal Control Number as a Key
CR #: 3814
Job Aid #: N/A

Change in Provider Enrollment Appeals Process

Thu, 10 Nov 2005 10:45:00 EST

Transmittal #: R95PI
Subject: Change in Provider Enrollment Appeals Process
CR #: 3601
Job Aid #: N/A

Shared System Maintainer Hours for PECOS Problems and/or Implementation Changes

Thu, 10 Nov 2005 10:51:00 EST

Transmittal #: R113PI
Subject: Shared System Maintainer Hours for PECOS Problems and/or Implementation Changes
CR #: 3874
Job Aid #: N/A

Requirement that Part B/Carriers Submit All Provider Addresses to the Comprehensive Error Rate Testing (CERT) Program Contractor

Thu, 10 Nov 2005 10:52:00 EST

Transmittal #: R112PI
Subject: Requirement that Part B/Carriers Submit All Provider Addresses to the Comprehensive Error Rate Testing (CERT) Program Contractor
CR #: 3805
Job Aid #: N/A

Next Generation Desktop (NGD) Testing Requirements

Thu, 10 Nov 2005 10:54:00 EST

Transmittal #: R12COM
Subject: Next Generation Desktop (NGD) Testing Requirements
CR #: 3493
Job Aid #: N/A

Provider Extract File

Thu, 10 Nov 2005 11:20:00 EST

Transmittal #: R27GI
Subject: Provider Extract File
CR #: 3801
Job Aid #: N/A

Implement New Medicare Plan ID and Carrier Number for the Single Testing Contractor (STC)

Thu, 10 Nov 2005 11:21:00 EST

Transmittal #: R26GI
Subject: Implement New Medicare Plan ID and Carrier Number for the Single Testing Contractor (STC)
CR #: 3978
Job Aid #: N/A

Next Generation Desktop (NGD) Testing Requirements

Thu, 10 Nov 2005 11:22:00 EST

Transmittal #: R25GI
Subject: Next Generation Desktop (NGD) Testing Requirements
CR #: 3493
Job Aid #: N/A

2005 Scheduled Release for July Updates to Software Programs and Pricing/Coding Files

Thu, 10 Nov 2005 11:23:00 EST

Transmittal #: R24GI
Subject: 2005 Scheduled Release for July Updates to Software Programs and Pricing/Coding Files
CR #: 3865
Job Aid #: N/A

Update Medicare Secondary Payer (MSP) Manual Publication 100-05 to reflect statutory changes included in the Medicare Modernization Act (MMA)

Thu, 10 Nov 2005 11:40:00 EST

Transmittal #: R25MSP
Subject: Update Medicare Secondary Payer (MSP) Manual Publication 100-05 to reflect statutory changes included in the Medicare Modernization Act (MMA)
CR #: 3219
Job Aid #: N/A

Notification to Affiliated Contractors of the establishment of Medicare Secondary Payer (MSP) Recovery Audit Contractors (RACs) and the impact to the Affiliated Contractors current MSP recovery processes

Thu, 10 Nov 2005 11:41:00 EST

Transmittal #: R24MSP
Subject: Notification to Affiliated Contractors of the establishment of Medicare Secondary Payer (MSP) Recovery Audit Contractors (RACs) and the impact to the Affiliated Contractors current MSP recovery processes
CR #: 3724
Job Aid #: N/A

Modification to Online Medicare Secondary Payer Questionnaire

Thu, 10 Nov 2005 11:42:00 EST

Transmittal #: R23MSP
Subject: Modification to Online Medicare Secondary Payer Questionnaire
CR #: 3504
Job Aid #: N/A

Coordination of Benefits Agreement (COBA) Detailed Error Report Notification Process

Thu, 10 Nov 2005 12:07:00 EST

Transmittal #: R474CP
Subject: Coordination of Benefits Agreement (COBA) Detailed Error Report Notification Process
CR #: 3709
Job Aid #: N/A

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

Thu, 10 Nov 2005 12:21:00 EST

Transmittal #: R508CP
Subject: April 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes
CR #: 3756
Job Aid #: N/A

New Healthcare Common Procedure Coding System (HCPCS) for Intravenous Globulin (IVIG)

Thu, 10 Nov 2005 12:22:00 EST

Transmittal #: R507CP
Subject: New Healthcare Common Procedure Coding System (HCPCS) for Intravenous Globulin (IVIG)
CR #: 3745
Job Aid #: JA3745

Updated Manual Instructions for Item 24G (Days or Units), Chapter 26

Thu, 10 Nov 2005 13:11:00 EST

Transmittal #: R506CP
Subject: Updated Manual Instructions for Item 24G (Days or Units), Chapter 26
CR #: 3753
Job Aid #: N/A

Manualization of Carrier Claims Processing Instructions for Stem Cell Transplantation

Thu, 10 Nov 2005 13:26:00 EST

Transmittal #: R486CP
Subject: Manualization of Carrier Claims Processing Instructions for Stem Cell Transplantation
CR #: 3684
Job Aid #: N/A

Calculating Payment-to-Cost Ratios (PCR) for Purposes of Determining Transitional Corridor Payments under the Outpatient Prospective Payment System (OPPS)

Thu, 10 Nov 2005 13:27:00 EST

Transmittal #: R485CP
Subject: Calculating Payment-to-Cost Ratios (PCR) for Purposes of Determining Transitional Corridor Payments under the Outpatient Prospective Payment System (OPPS)
CR #: 3661
Job Aid #: N/A

New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims

Thu, 10 Nov 2005 13:28:00 EST

Transmittal #: R484CP
Subject: New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims
CR #: 3679
Job Aid #: JA3679

Hospital Partial Hospitalization Services Billing Requirements

Thu, 10 Nov 2005 13:29:00 EST

Transmittal #: R483CP
Subject: Hospital Partial Hospitalization Services Billing Requirements
CR #: 3297
Job Aid #: N/A

Clarifying Manual Instructions for Coding and Payment for Drug Administration Under the Hospital Outpatient Prospective Payment System (OPPS)

Thu, 10 Nov 2005 13:31:00 EST

Transmittal #: R557CP
Subject: Clarifying Manual Instructions for Coding and Payment for Drug Administration Under the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 3848
Job Aid #: JA3848

Revision to the Health Professional Shortage Area (HPSA) and Physician Scarcity Area (PSA) Payment Rules

Thu, 10 Nov 2005 13:32:00 EST

Transmittal #: R556CP
Subject: Revision to the Health Professional Shortage Area (HPSA) and Physician Scarcity Area (PSA) Payment Rules
CR #: 3822
Job Aid #: N/A

New Healthcare Common Procedure Coding System (HCPCS) Codes and Systems Edits for Supplies and Accessories for Ventricular Assist Devices (VADs)

Thu, 10 Nov 2005 13:41:00 EST

Transmittal #: R548CP
Subject: New Healthcare Common Procedure Coding System (HCPCS) Codes and Systems Edits for Supplies and Accessories for Ventricular Assist Devices (VADs)
CR #: 3761
Job Aid #: JA3761

Revision to the Health Professional Shortage Area (HPSA) and Physician Scarcity Area (PSA) Payment Rules

Thu, 10 Nov 2005 13:42:00 EST

Transmittal #: R547CP
Subject: Revision to the Health Professional Shortage Area (HPSA) and Physician Scarcity Area (PSA) Payment Rules
CR #: 3822
Job Aid #: N/A

Modification of FISS Edits for Colorectal Cancer Screening Services (HCPCS Codes G0104, G0106, G0107, G0120, and G0328) Furnished at Skilled Nursing Facilities (SNFs)

Thu, 10 Nov 2005 13:48:00 EST

Transmittal #: R544CP
Subject: Modification of FISS Edits for Colorectal Cancer Screening Services (HCPCS Codes G0104, G0106, G0107, G0120, and G0328) Furnished at Skilled Nursing Facilities (SNFs)
CR #: 3763
Job Aid #: N/A

Healthcare Provider Taxonomy Code (HPTC) Update

Thu, 10 Nov 2005 13:49:00 EST

Transmittal #: R543CP
Subject: Healthcare Provider Taxonomy Code (HPTC) Update
CR #: 3803
Job Aid #: JA3803

Update to Current National Uniform Billing Committee (NUBC) Codes

Thu, 10 Nov 2005 13:50:00 EST

Transmittal #: R529CP
Subject: Update to Current National Uniform Billing Committee (NUBC) Codes
CR #: 3794
Job Aid #: JA3794

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

Thu, 10 Nov 2005 13:51:00 EST

Transmittal #: R528CP
Subject: July 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective July 1, 2005
CR #: 3783
Job Aid #: JA3783

New Coding for FDG PET Scans and Billing Requirements for Specific Indications of Cervical Cancer

Thu, 10 Nov 2005 13:51:00 EST

Transmittal #: R527CP
Subject: New Coding for FDG PET Scans and Billing Requirements for Specific Indications of Cervical Cancer
CR #: 3741
Job Aid #: JA3741

Updated Requirements for Autologous Stem Cell Transplantation (AuSCT)

Thu, 10 Nov 2005 13:56:00 EST

Transmittal #: R526CP
Subject: Updated Requirements for Autologous Stem Cell Transplantation (AuSCT)
CR #: 3797
Job Aid #: JA3797

Updated Manual Instructions for the Medicare Claims Processing Manual, Chapter 10

Thu, 10 Nov 2005 14:03:00 EST

Transmittal #: R481CP
Subject: Updated Manual Instructions for the Medicare Claims Processing Manual, Chapter 10
CR #: 3691
Job Aid #: N/A

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

Thu, 10 Nov 2005 14:04:00 EST

Transmittal #: R480CP
Subject: April 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective April 1, 2005, and New January 2005 Quarterly ASP File
CR #: 3667
Job Aid #: N/A

2005 Scheduled Release for April Updates to Software Programs and Pricing/Coding Files

Thu, 10 Nov 2005 14:06:00 EST

Transmittal #: R499CP
Subject: 2005 Scheduled Release for April Updates to Software Programs and Pricing/Coding Files
CR #: 3746
Job Aid #: N/A

Update to the Healthcare Provider taxonomy Codes (HPTC) Version 5.0

Thu, 10 Nov 2005 14:06:00 EST

Transmittal #: R479CP
Subject: Update to the Healthcare Provider taxonomy Codes (HPTC) Version 5.0
CR #: 3716
Job Aid #: JA3716

Billing of the Diagnosis and Treatment of Peripheral Neuropathy with Loss of Protective Sensation in People with Diabetes

Thu, 10 Nov 2005 14:08:00 EST

Transmittal #: R498CP
Subject: Billing of the Diagnosis and Treatment of Peripheral Neuropathy with Loss of Protective Sensation in People with Diabetes
CR #: 3580
Job Aid #: N/A

New Waived Tests

Thu, 10 Nov 2005 14:15:00 EST

Transmittal #: R538CP
Subject: New Waived Tests
CR #: 3804
Job Aid #: N/A

Instructions for Downloading the Medicare Zip Code File

Thu, 10 Nov 2005 14:16:00 EST

Transmittal #: R537CP
Subject: Instructions for Downloading the Medicare Zip Code File
CR #: 3731
Job Aid #: N/A

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

Thu, 10 Nov 2005 14:17:00 EST

Transmittal #: R536CP
Subject: July Quarterly Update for 2005 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule
CR #: 3779
Job Aid #: N/A

Modification to Appeals Language on Medicare Summary Notice

Thu, 10 Nov 2005 14:18:00 EST

Transmittal #: R535CP
Subject: Modification to Appeals Language on Medicare Summary Notice
CR #: 3808
Job Aid #: N/A

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2005

Thu, 10 Nov 2005 14:25:00 EST

Transmittal #: R534CP
Subject: Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2005
CR #: 3806
Job Aid #: N/A

Implementation of the Physician Scarcity Areas and Revision to the Health Professional Shortage (HPSA)

Thu, 10 Nov 2005 14:26:00 EST

Transmittal #: R523CP
Subject: Implementation of the Physician Scarcity Areas and Revision to the Health Professional Shortage (HPSA)
CR #: 3790
Job Aid #: JA3790

Modification to the Common Working File (CWF) Edit Process for Non-Assigned Medicaid Coordination of Benefits Agreement (COBA) Crossover Claims

Thu, 10 Nov 2005 14:26:00 EST

Transmittal #: R533CP
Subject: Modification to the Common Working File (CWF) Edit Process for Non-Assigned Medicaid Coordination of Benefits Agreement (COBA) Crossover Claims
CR #: 3842
Job Aid #: N/A

October 2005 Non-Outpatient Prospective Payment System Code Editor (Non-OPPS OCE) Specifications Version 21

Thu, 10 Nov 2005 14:33:00 EST

Transmittal #: R644CP
Subject: October 2005 Non-Outpatient Prospective Payment System Code Editor (Non-OPPS OCE) Specifications Version 21
CR #: 4009
Job Aid #: N/A

Update to the Inpatient Provider Specific File (PSF) and the Outpatient PSF to Retain Provider Information

Thu, 10 Nov 2005 14:33:00 EST

Transmittal #: R646CP
Subject: Update to the Inpatient Provider Specific File (PSF) and the Outpatient PSF to Retain Provider Information
CR #: 3940
Job Aid #: N/A

Update of Laboratory NCDs to Reference New Screening Benefits

Thu, 10 Nov 2005 14:53:00 EST

Transmittal #: R28NCD
Subject: Update of Laboratory NCDs to Reference New Screening Benefits
CR #: 3690
Job Aid #: N/A

Exception for Small Employers in Multi-Employer Group Health Plans (GHP)

Thu, 10 Nov 2005 14:54:00 EST

Transmittal #: R32MSP
Subject: Exception for Small Employers in Multi-Employer Group Health Plans (GHP)
CR #: 3998
Job Aid #: N/A

Full Replacement of CR3770, Expanding the Number of Source Identifiers for Common Working File (CWF) MSP Records. CR 3770 is Rescinded

Thu, 10 Nov 2005 14:56:00 EST

Transmittal #: R31MSP
Subject: Full Replacement of CR3770, Expanding the Number of Source Identifiers for Common Working File (CWF) MSP Records. CR 3770 is Rescinded
CR #: 3909
Job Aid #: N/A

Implantable Automatic Defibrillators

Thu, 10 Nov 2005 15:03:00 EST

Transmittal #: R29NCD
Subject: Implantable Automatic Defibrillators
CR #: 3604
Job Aid #: JA3604

Percutaneous Transluminal Angioplasty (PTA

Thu, 10 Nov 2005 15:04:00 EST

Transmittal #: R33NCD
Subject: Percutaneous Transluminal Angioplasty (PTA
CR #: 3811
Job Aid #: JA3811

Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials

Thu, 10 Nov 2005 15:10:00 EST

Transmittal #: R30NCD
Subject: Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials
CR #: 3742
Job Aid #: N/A

Smoking and Tobacco-Use Cessation Counseling

Thu, 10 Nov 2005 15:11:00 EST

Transmittal #: R36NCD
Subject: Smoking and Tobacco-Use Cessation Counseling
CR #: 3834
Job Aid #: JA3834

July 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.2

Thu, 10 Nov 2005 16:42:00 EST

Transmittal #: R569CP
Subject: July 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.2
CR #: 3871
Job Aid #: N/A

Common Working File (CWF): Addition of Disease Management Auxiliary File

Thu, 10 Nov 2005 16:43:00 EST

Transmittal #: R570CP
Subject: Common Working File (CWF): Addition of Disease Management Auxiliary File
CR #: 3887
Job Aid #: N/A

New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims

Thu, 10 Nov 2005 16:45:00 EST

Transmittal #: R571CP
Subject: New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims
CR #: 3679
Job Aid #: JA3679

July 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.2

Thu, 10 Nov 2005 16:45:00 EST

Transmittal #: R572CP
Subject: July 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.2
CR #: 3871
Job Aid #: N/A

Mobility Assistive Equipment (MAE)

Thu, 10 Nov 2005 16:47:00 EST

Transmittal #: R574CP
Subject: Mobility Assistive Equipment (MAE)
CR #: 3791
Job Aid #: JA3791

New Healthcare Common Procedure Coding System (HCPCS) Drug Codes

Thu, 10 Nov 2005 16:53:00 EST

Transmittal #: R580CP
Subject: New Healthcare Common Procedure Coding System (HCPCS) Drug Codes
CR #: 3847
Job Aid #: JA3847

New Location for Contractor ID Number on Medicare Summary Notices (MSNs)

Thu, 10 Nov 2005 16:54:00 EST

Transmittal #: R581CP
Subject: New Location for Contractor ID Number on Medicare Summary Notices (MSNs)
CR #: 3895
Job Aid #: N/A

New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims

Thu, 10 Nov 2005 16:55:00 EST

Transmittal #: R582CP
Subject: New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims
CR #: 3679
Job Aid #: JA3679

Access Process for HIPAA 270/271 (Extranet Only)

Thu, 10 Nov 2005 16:56:00 EST

Transmittal #: R583CP
Subject: Access Process for HIPAA 270/271 (Extranet Only)
CR #: 3883
Job Aid #: JA3883

Update of HCPCS Codes and File Names, Descriptions and Instructions for Retrieving the 2005 ASC HCPCS Additions, Deletions and Master Listing

Thu, 10 Nov 2005 16:57:00 EST

Transmittal #: R584CP
Subject: Update of HCPCS Codes and File Names, Descriptions and Instructions for Retrieving the 2005 ASC HCPCS Additions, Deletions and Master Listing
CR #: 3905
Job Aid #: JA3905

July 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)

Thu, 10 Nov 2005 16:58:00 EST

Transmittal #: R585CP
Subject: July 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 3915
Job Aid #: JA3915

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

Fri, 11 Nov 2005 09:48:00 EST

Transmittal #: R591CP
Subject: Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
CR #: 3888
Job Aid #: JA3888

Disposition of Misdirected Claims to the Carrier

Fri, 11 Nov 2005 09:50:00 EST

Transmittal #: R593CP
Subject: Disposition of Misdirected Claims to the Carrier
CR #: 3838
Job Aid #: N/A

Preliminary Instructions: Expedited Determinations/Reviews for Original Medicare

Fri, 11 Nov 2005 09:51:00 EST

Transmittal #: R594CP
Subject: Preliminary Instructions: Expedited Determinations/Reviews for Original Medicare
CR #: 3903
Job Aid #: N/A

Implementation of Carrier Guidelines for End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests (Supplemental to Change Request 2813)

Fri, 11 Nov 2005 09:52:00 EST

Transmittal #: R595CP
Subject: Implementation of Carrier Guidelines for End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests (Supplemental to Change Request 2813)
CR #: 3890
Job Aid #: JA3890

Cochlear Implantation

Fri, 11 Nov 2005 10:29:00 EST

Transmittal #: R601CP
Subject: Cochlear Implantation
CR #: 3796
Job Aid #: JA3796

Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials

Fri, 11 Nov 2005 10:38:00 EST

Transmittal #: R38NCD
Subject: Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials
CR #: 3742
Job Aid #: JA3742

Mobility Assistive Equipment (Mobility Assistive Equipment (MAE) )

Fri, 11 Nov 2005 10:54:00 EST

Transmittal #: R37NCD
Subject: Mobility Assistive Equipment (Mobility Assistive Equipment (MAE) )
CR #: 3791
Job Aid #: JA3791

Expansion of Various Alpha and Numeric Fields with in the Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE)

Fri, 11 Nov 2005 10:55:00 EST

Transmittal #: R602CP
Subject: Expansion of Various Alpha and Numeric Fields with in the Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE)
CR #: 3767
Job Aid #: JA3767

Frequency Instructions for Smoking and Tobacco-Use Cessation Counseling Services

Fri, 11 Nov 2005 10:56:00 EST

Transmittal #: R605CP
Subject: Frequency Instructions for Smoking and Tobacco-Use Cessation Counseling Services
CR #: 3929
Job Aid #: N/A

Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, and Hepatitis B Virus) and their Administration at Renal Dialysis Facilities (RDFs)

Fri, 11 Nov 2005 11:16:00 EST

Transmittal #: R610CP
Subject: Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, and Hepatitis B Virus) and their Administration at Renal Dialysis Facilities (RDFs)
CR #: 3936
Job Aid #: JA3936

Payment Methodology for Rehabilitation Services in IHS/Tribally Owned and/or Operated Hospitals and Hospital-Based Facilities

Fri, 11 Nov 2005 11:17:00 EST

Transmittal #: R611CP
Subject: Payment Methodology for Rehabilitation Services in IHS/Tribally Owned and/or Operated Hospitals and Hospital-Based Facilities
CR #: 3934
Job Aid #: JA3934

Administration of Drugs and Biologicals in a Method II Critical Access Hospital (CAH)

Fri, 11 Nov 2005 11:23:00 EST

Transmittal #: R617CP
Subject: Administration of Drugs and Biologicals in a Method II Critical Access Hospital (CAH)
CR #: 3911
Job Aid #: JA3911

Clarification for Carriers and Durable Medical Equipment Regional Carriers (DMERCs) about Correction and Recoupment of Payments for Previously Processed Claims

Fri, 11 Nov 2005 11:40:00 EST

Transmittal #: R618CP
Subject: Clarification for Carriers and Durable Medical Equipment Regional Carriers (DMERCs) about Correction and Recoupment of Payments for Previously Processed Claims
CR #: 3772
Job Aid #: JA3772

Late IRF-PAI Data Submission Penalty Protocol Within the Inpatient Rehabilitation Facility Prospective Payment System

Fri, 11 Nov 2005 11:40:00 EST

Transmittal #: R619CP
Subject: Late IRF-PAI Data Submission Penalty Protocol Within the Inpatient Rehabilitation Facility Prospective Payment System
CR #: 3885
Job Aid #: JA3885

New Fiscal Intermediary (FI) Edit to Identify Potentially Excessive Medicare Payments

Fri, 11 Nov 2005 11:41:00 EST

Transmittal #: R620CP
Subject: New Fiscal Intermediary (FI) Edit to Identify Potentially Excessive Medicare Payments
CR #: 3925
Job Aid #: N/A

Locality Codes for Purchased Diagnostic Tests

Fri, 11 Nov 2005 11:42:00 EST

Transmittal #: R621CP
Subject: Locality Codes for Purchased Diagnostic Tests
CR #: 3961
Job Aid #: N/A

Enforcement of Hospital Inpatient Bundling: Carrier Denial of Ambulance Claims during an Inpatient Stay

Fri, 11 Nov 2005 11:43:00 EST

Transmittal #: R622CP
Subject: Enforcement of Hospital Inpatient Bundling: Carrier Denial of Ambulance Claims during an Inpatient Stay
CR #: 3933
Job Aid #: JA3933

DMERC Only--Corrections to the Billing Indicator Field for Adjusted Claims

Fri, 11 Nov 2005 11:44:00 EST

Transmittal #: R623CP
Subject: DMERC Only--Corrections to the Billing Indicator Field for Adjusted Claims
CR #: 3877
Job Aid #: N/A

Certificate of Medical Necessity Claim Edits Workload Reporting

Fri, 11 Nov 2005 11:50:00 EST

Transmittal #: R629CP
Subject: Certificate of Medical Necessity Claim Edits Workload Reporting
CR #: 3699
Job Aid #: N/A

Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update and Health Insurance Prospective Payment System (HIPPS) Coding Update Effective January 1, 2006

Fri, 11 Nov 2005 11:51:00 EST

Transmittal #: R630CP
Subject: Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update and Health Insurance Prospective Payment System (HIPPS) Coding Update Effective January 1, 2006
CR #: 3962
Job Aid #: N/A

Claim Status Category Code and Claim Status Code Update

Fri, 11 Nov 2005 11:52:00 EST

Transmittal #: R631CP
Subject: Claim Status Category Code and Claim Status Code Update
CR #: 3960
Job Aid #: N/A

Billing and Claims Processing Instructions for Claims Subject to Expedited Determinations

Fri, 11 Nov 2005 11:53:00 EST

Transmittal #: R632CP
Subject: Billing and Claims Processing Instructions for Claims Subject to Expedited Determinations
CR #: 3949
Job Aid #: N/A

Cessation of Additional $50 Payment for New Technology Intraocular Lenses (NTIOLs)

Fri, 11 Nov 2005 12:00:00 EST

Transmittal #: R639CP
Subject: Cessation of Additional $50 Payment for New Technology Intraocular Lenses (NTIOLs)
CR #: 3901
Job Aid #: JA3901

Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2006

Fri, 11 Nov 2005 12:01:00 EST

Transmittal #: R640CP
Subject: Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2006
CR #: 3972
Job Aid #: N/A

October 2005 Quarterly Update to Skilled Nursing Facility (SNF) Consolidated Billing

Fri, 11 Nov 2005 12:02:00 EST

Transmittal #: R641CP
Subject: October 2005 Quarterly Update to Skilled Nursing Facility (SNF) Consolidated Billing
CR #: 4010
Job Aid #: N/A

Cost Reporting Forms and Instructions, Form CMS-265-94

Fri, 11 Nov 2005 12:07:00 EST

Transmittal #: R7P234
Subject: Cost Reporting Forms and Instructions, Form CMS-265-94
CR #: N/A
Job Aid #: N/A

Coverage of Aprepitant for Chemotherapy-Induced Emesis

Fri, 11 Nov 2005 12:08:00 EST

Transmittal #: R40NCD
Subject: Coverage of Aprepitant for Chemotherapy-Induced Emesis
CR #: 3831
Job Aid #: N/A

Cochlear Implantation

Fri, 11 Nov 2005 13:02:00 EST

Transmittal #: R39NCD
Subject: Cochlear Implantation
CR #: 3796
Job Aid #: JA3796

Automated Multi-Channel Chemistry (AMCC) for Continuous Ambulatory Peritoneal Dialysis (CAPD) and Non-CAPD Patients

Fri, 11 Nov 2005 13:03:00 EST

Transmittal #: R35BP
Subject: Automated Multi-Channel Chemistry (AMCC) for Continuous Ambulatory Peritoneal Dialysis (CAPD) and Non-CAPD Patients
CR #: 3802
Job Aid #: N/A

Pub. 100-02, Chapter 15, Sections 220 and 230 Therapy Services

Fri, 11 Nov 2005 13:04:00 EST

Transmittal #: R34BP
Subject: Pub. 100-02, Chapter 15, Sections 220 and 230 Therapy Services
CR #: 3648
Job Aid #: JA3648

List of Medicare Telehealth Services

Fri, 11 Nov 2005 13:05:00 EST

Transmittal #: R31BP
Subject: List of Medicare Telehealth Services
CR #: 3747
Job Aid #: JA3747

Policy for Repair and Replacement of Durable Medical Equipment (DME)

Fri, 11 Nov 2005 13:06:00 EST

Transmittal #: R30BP
Subject: Policy for Repair and Replacement of Durable Medical Equipment (DME)
CR #: 3693
Job Aid #: N/A

Cochlear Implantation

Fri, 11 Nov 2005 13:07:00 EST

Transmittal #: R42NCD
Subject: Cochlear Implantation
CR #: 3736
Job Aid #: JA3796

Beneficiary Enrollment and Disenrollment Requirements for Medicare Advantage Plans

Fri, 11 Nov 2005 14:03:00 EST

Transmittal #: R66MCM
Subject: Beneficiary Enrollment and Disenrollment Requirements for Medicare Advantage Plans
CR #: N/A
Job Aid #: N/A

Surveys, Contracting Strategy and Appeals

Fri, 11 Nov 2005 14:04:00 EST

Transmittal #: R65MCM
Subject: Surveys, Contracting Strategy and Appeals
CR #: N/A
Job Aid #: N/A

Revised Reporting Requirements for Contractor Reporting of Operational Workload Data (CROWD) Physician Scarcity Area (PSA) Quarterly Report (CMS Form-1565F, CROWD Form 6)

Fri, 11 Nov 2005 14:10:00 EST

Transmittal #: R65FM
Subject: Revised Reporting Requirements for Contractor Reporting of Operational Workload Data (CROWD) Physician Scarcity Area (PSA) Quarterly Report (CMS Form-1565F, CROWD Form 6)
CR #: 3673
Job Aid #: N/A

For Fiscal Intermediaries (FIs), a new Provider Type 80, Status Code CH, and Method of Recoupment codes. For Carriers and Durable Medical Equipment Regional Carriers (DMERCs) Status Code 2

Fri, 11 Nov 2005 14:11:00 EST

Transmittal #: R64FM
Subject: For Fiscal Intermediaries (FIs), a new Provider Type 80, Status Code CH, and Method of Recoupment codes. For Carriers and Durable Medical Equipment Regional Carriers (DMERCs) Status Code 2
CR #: 3641
Job Aid #: N/A

Discovery Code Indication for Recovery Audit Contractor (RAC) Non-MSP Identified Overpayments

Fri, 11 Nov 2005 14:12:00 EST

Transmittal #: R74FM
Subject: Discovery Code Indication for Recovery Audit Contractor (RAC) Non-MSP Identified Overpayments
CR #: 3938
Job Aid #: N/A

New Thresholds for 2nd Demand Letter for Physicians/Suppliers

Fri, 11 Nov 2005 14:13:00 EST

Transmittal #: R73FM
Subject: New Thresholds for 2nd Demand Letter for Physicians/Suppliers
CR #: 3932
Job Aid #: N/A

Claims Accounts Receivable Update

Fri, 11 Nov 2005 14:13:00 EST

Transmittal #: R72FM
Subject: Claims Accounts Receivable Update
CR #: 3963
Job Aid #: N/A

Debt Collection Improvement Act Backlog Non-MSP Collections from February 1998 to September 2004

Fri, 11 Nov 2005 14:15:00 EST

Transmittal #: R144OTN
Subject: Debt Collection Improvement Act Backlog Non-MSP Collections from February 1998 to September 2004
CR #: 3612
Job Aid #: N/A

Notice of New Interest Rate for Medicare Overpayment and Underpayments

Fri, 11 Nov 2005 14:15:00 EST

Transmittal #: R71FM
Subject: Notice of New Interest Rate for Medicare Overpayment and Underpayments
CR #: 3456
Job Aid #: N/A

Instructions to contractors regarding aged, pre-settlement cases and Inter-Contractor Notices (ICN)s

Fri, 11 Nov 2005 14:22:00 EST

Transmittal #: R137OTN
Subject: Instructions to contractors regarding aged, pre-settlement cases and Inter-Contractor Notices (ICN)s
CR #: 3598
Job Aid #: N/A

Medlearn Matters Article Related to the Flu Demonstration

Fri, 11 Nov 2005 14:23:00 EST

Transmittal #: R136OTN
Subject: Medlearn Matters Article Related to the Flu Demonstration
CR #: 3696
Job Aid #: JA3696

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

Fri, 11 Nov 2005 14:24:00 EST

Transmittal #: R135OTN
Subject: Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing
CR #: 3597
Job Aid #: N/A

Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File

Fri, 11 Nov 2005 14:25:00 EST

Transmittal #: R134OTN
Subject: Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File
CR #: 3695
Job Aid #: N/A

Frequent Hemodialysis Network Payment Changes for Approved Clinical Trial Costs

Fri, 11 Nov 2005 14:32:00 EST

Transmittal #: R145OTN
Subject: Frequent Hemodialysis Network Payment Changes for Approved Clinical Trial Costs
CR #: 3730
Job Aid #: N/A

Payment to Ambulatory Surgery Centers (ASCs) for New CPT Code 66711

Fri, 11 Nov 2005 14:33:00 EST

Transmittal #: R155OTN
Subject: Payment to Ambulatory Surgery Centers (ASCs) for New CPT Code 66711
CR #: 3817
Job Aid #: N/A

Correction 2005 Clinical Laboratory Travel Fee (P9603 P9604)

Fri, 11 Nov 2005 14:41:00 EST

Transmittal #: R154OTN
Subject: Correction 2005 Clinical Laboratory Travel Fee (P9603 P9604)
CR #: 3785
Job Aid #: JA3785

Analysis of Systems Improvements to Streamline POS Code Set Updates

Fri, 11 Nov 2005 14:43:00 EST

Transmittal #: R169OTN
Subject: Analysis of Systems Improvements to Streamline POS Code Set Updates
CR #: 3976
Job Aid #: N/A

Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction January 2006 Release Testing

Fri, 11 Nov 2005 14:44:00 EST

Transmittal #: R168OTN
Subject: Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction January 2006 Release Testing
CR #: 3974
Job Aid #: N/A

Overnight Oximetery Testing

Fri, 11 Nov 2005 14:45:00 EST

Transmittal #: R166OTN
Subject: Overnight Oximetery Testing
CR #: 3751
Job Aid #: N/A

Medicare HIPAA Electronic Claims Report - Third Reporting Timeframe Extension

Fri, 11 Nov 2005 14:46:00 EST

Transmittal #: R164OTN
Subject: Medicare HIPAA Electronic Claims Report - Third Reporting Timeframe Extension
CR #: 3926
Job Aid #: N/A

New Patient Status Code to Define Discharges or Transfers to a Critical Access Hospital (CAH)

Mon, 14 Nov 2005 10:17:00 EST

Transmittal #: R156OTN
Subject: New Patient Status Code to Define Discharges or Transfers to a Critical Access Hospital (CAH)
CR #: 3829
Job Aid #: JA3829

Reimbursement for ESRD and Transplant Services

Mon, 14 Nov 2005 10:25:00 EST

Transmittal #: R30PR1
Subject: Reimbursement for ESRD and Transplant Services
CR #: N/A
Job Aid #: N/A

Mandatory Assignment for MMA S630 Claims

Mon, 14 Nov 2005 10:32:00 EST

Transmittal #: R430CP
Subject: Mandatory Assignment for MMA S630 Claims
CR #: 3587
Job Aid #: N/A

October Update to the 2005 Medicare Physician Fee Schedule Database

Mon, 14 Nov 2005 10:33:00 EST

Transmittal #: R652CP
Subject: October Update to the 2005 Medicare Physician Fee Schedule Database
CR #: 4031
Job Aid #: N/A

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2005

Mon, 14 Nov 2005 10:33:00 EST

Transmittal #: R651CP
Subject: Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2005
CR #: 4005
Job Aid #: N/A

Adding an Indicator to the National Claims History (NCH) to Indicate that DMERCs, Carriers, and FIs have Reviewed a Potentially Duplicate Clai

Mon, 14 Nov 2005 10:33:00 EST

Transmittal #: R432CP
Subject: Adding an Indicator to the National Claims History (NCH) to Indicate that DMERCs, Carriers, and FIs have Reviewed a Potentially Duplicate Clai
CR #: 2965
Job Aid #: N/A

Timeframe for Continued Execution of Crossover Agreements and Updated on the Transition to the National Coordination of Benefits Agreement (COBA) Program

Mon, 14 Nov 2005 10:34:00 EST

Transmittal #: R448CP
Subject: Timeframe for Continued Execution of Crossover Agreements and Updated on the Transition to the National Coordination of Benefits Agreement (COBA) Program
CR #: 3658
Job Aid #: N/A

Manual Update on Medical Nutrition Therapy Services - Manualization

Mon, 14 Nov 2005 10:34:00 EST

Transmittal #: R650CP
Subject: Manual Update on Medical Nutrition Therapy Services - Manualization
CR #: 3955
Job Aid #: N/A

Diabetes Screening Tests

Mon, 14 Nov 2005 10:37:00 EST

Transmittal #: R446CP
Subject: Diabetes Screening Tests
CR #: 3637
Job Aid #: N/A

Further Information Related to Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)

Mon, 14 Nov 2005 10:38:00 EST

Transmittal #: R444CP
Subject: Further Information Related to Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)
CR #: 3678
Job Aid #: JA3678

October 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective October 1, 2005 and Revisions to April 2005 and July 2005 Quarterly ASP Medicare Part B Drug Pricing File

Mon, 14 Nov 2005 10:38:00 EST

Transmittal #: R653CP
Subject: October 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective October 1, 2005 and Revisions to April 2005 and July 2005 Quarterly ASP Medicare Part B Drug Pricing File
CR #: 3992
Job Aid #: N/A

Hospital Outpatient Prospective Payment System (OPPS): Use of Modifiers -52, -73 and -74 for Reduced or Discontinued Services

Mon, 14 Nov 2005 10:40:00 EST

Transmittal #: R442CP
Subject: Hospital Outpatient Prospective Payment System (OPPS): Use of Modifiers -52, -73 and -74 for Reduced or Discontinued Services
CR #: 3507
Job Aid #: JA3507

VMS Changes to DMERC Processing of Method II Home Dialysis Claims

Mon, 14 Nov 2005 10:41:00 EST

Transmittal #: R441CP
Subject: VMS Changes to DMERC Processing of Method II Home Dialysis Claims
CR #: 3546
Job Aid #: N/A

Updating the Common Working File Editing for Pap Smear (Q0091) and Adding a New Low Risk Diagnosis Code (V72.31) for Pap Smear and Pelvic Examination

Mon, 14 Nov 2005 10:42:00 EST

Transmittal #: R440CP
Subject: Updating the Common Working File Editing for Pap Smear (Q0091) and Adding a New Low Risk Diagnosis Code (V72.31) for Pap Smear and Pelvic Examination
CR #: 3659
Job Aid #: JA3659

Modification to the Fiscal Intermediary Standard System (FISS) Regarding Ambulance Services Billed on 18x and 21x Types of Bill (TOBs)

Mon, 14 Nov 2005 11:07:00 EST

Transmittal #: R439CP
Subject: Modification to the Fiscal Intermediary Standard System (FISS) Regarding Ambulance Services Billed on 18x and 21x Types of Bill (TOBs)
CR #: 3564
Job Aid #: JA3564

Fiscal Intermediary Standard Paper Remittance Advice Changes

Mon, 14 Nov 2005 11:08:00 EST

Transmittal #: R438CP
Subject: Fiscal Intermediary Standard Paper Remittance Advice Changes
CR #: 3645
Job Aid #: JA3645

Revisions and Corrections to the Medicare Claims Processing Manual, Chapter 6, Section 30 and Various Sections in Chapter 15

Mon, 14 Nov 2005 11:10:00 EST

Transmittal #: R437CP
Subject: Revisions and Corrections to the Medicare Claims Processing Manual, Chapter 6, Section 30 and Various Sections in Chapter 15
CR #: 3664
Job Aid #: JA3664

Remittance Advice Remark Code and Claim Adjustment Reason Code Update

Mon, 14 Nov 2005 11:11:00 EST

Transmittal #: R436CP
Subject: Remittance Advice Remark Code and Claim Adjustment Reason Code Update
CR #: 3636
Job Aid #: JA3636

Diabetes Screening Tests

Mon, 14 Nov 2005 11:19:00 EST

Transmittal #: R457CP
Subject: Diabetes Screening Tests
CR #: 3677
Job Aid #: N/A

Independent Laboratory Billing for the Technical Component (TC) of Physician Pathology Services Furnished to Hospital Patients (Supplemental to Change Request 3467)

Mon, 14 Nov 2005 11:20:00 EST

Transmittal #: R456CP
Subject: Independent Laboratory Billing for the Technical Component (TC) of Physician Pathology Services Furnished to Hospital Patients (Supplemental to Change Request 3467)
CR #: 3675
Job Aid #: N/A

Enforcement of Mandatory Electronic Submission of Medicare Claims.

Mon, 14 Nov 2005 11:28:00 EST

Transmittal #: R450CP
Subject: Enforcement of Mandatory Electronic Submission of Medicare Claims.
CR #: 3440
Job Aid #: JA3440

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

Mon, 14 Nov 2005 11:29:00 EST

Transmittal #: R449CP
Subject: April Quarterly Update to 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
CR #: 3683
Job Aid #: N/A

DMERC Only--Dispensing Fees for Immunosuppressive Drugs

Mon, 14 Nov 2005 11:31:00 EST

Transmittal #: R462CP
Subject: DMERC Only--Dispensing Fees for Immunosuppressive Drugs
CR #: 3682
Job Aid #: N/A

Implementation of the Abstract File for Purchased Diagnostic Tests/Interpretations (Supplemental to CR 3481)

Mon, 14 Nov 2005 11:39:00 EST

Transmittal #: R464CP
Subject: Implementation of the Abstract File for Purchased Diagnostic Tests/Interpretations (Supplemental to CR 3481)
CR #: 3694
Job Aid #: JA3694

Standard Terminology for Claims Processing Systems

Mon, 14 Nov 2005 12:08:00 EST

Transmittal #: R8GI
Subject: Standard Terminology for Claims Processing Systems
CR #: 3086
Job Aid #: N/A

Services Not Provided Within United States

Mon, 14 Nov 2005 13:00:00 EST

Transmittal #: R38BP
Subject: Services Not Provided Within United States
CR #: 3781
Job Aid #: N/A

Overnight Oximetery Testing

Mon, 14 Nov 2005 13:01:00 EST

Transmittal #: R173OTN
Subject: Overnight Oximetery Testing
CR #: 3751
Job Aid #: N/A

Conforming Changes for Change Request 3648 to Pub. 100-01

Mon, 14 Nov 2005 13:02:00 EST

Transmittal #: R28GI
Subject: Conforming Changes for Change Request 3648 to Pub. 100-01
CR #: 3912
Job Aid #: N/A

Conforming Changes for Change Request 3648 to Pub. 100-02

Mon, 14 Nov 2005 13:03:00 EST

Transmittal #: R37BP
Subject: Conforming Changes for Change Request 3648 to Pub. 100-02
CR #: 3912
Job Aid #: N/A

The Medicare Chronic Care Improvement, "Medicare Health Support," Program

Mon, 14 Nov 2005 13:04:00 EST

Transmittal #: R27DEMO
Subject: The Medicare Chronic Care Improvement, "Medicare Health Support," Program
CR #: 3953
Job Aid #: JA3953

October 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.3

Mon, 14 Nov 2005 13:04:00 EST

Transmittal #: R664CP
Subject: October 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.3
CR #: 4007
Job Aid #: N/A

Correction to Change Request (CR) 3222: Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision

Mon, 14 Nov 2005 13:09:00 EST

Transmittal #: R120PI
Subject: Correction to Change Request (CR) 3222: Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision
CR #: 3880
Job Aid #: N/A

Instructions for Downloading the Medicare Zip Code File

Mon, 14 Nov 2005 13:10:00 EST

Transmittal #: R659CP
Subject: Instructions for Downloading the Medicare Zip Code File
CR #: 3986
Job Aid #: N/A

Billing for Devices Under the Hospital Outpatient Prospective Payment System (OPPS)

Mon, 14 Nov 2005 13:15:00 EST

Transmittal #: R658CP
Subject: Billing for Devices Under the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 4017
Job Aid #: JA4017

Quarterly Update to Correct Coding Initiative (CCI) Edits, Version V11.3, Effective October 1, 2005

Mon, 14 Nov 2005 13:16:00 EST

Transmittal #: R657CP
Subject: Quarterly Update to Correct Coding Initiative (CCI) Edits, Version V11.3, Effective October 1, 2005
CR #: 3995
Job Aid #: N/A

Change of the CareFirst Part A Plan to Highmark in the State of Maryland and Washington, DC

Mon, 14 Nov 2005 13:17:00 EST

Transmittal #: R176OTN
Subject: Change of the CareFirst Part A Plan to Highmark in the State of Maryland and Washington, DC
CR #: 4043
Job Aid #: N/A

Home Care and Domiciliary Care Visits (Codes 99321 - 99350)

Mon, 14 Nov 2005 13:22:00 EST

Transmittal #: R667CP
Subject: Home Care and Domiciliary Care Visits (Codes 99321 - 99350)
CR #: 3922
Job Aid #: N/A

Updates to the Coordination of Benefits Contractor (COBC) Detailed Error Report File Layouts

Mon, 14 Nov 2005 13:23:00 EST

Transmittal #: R666CP
Subject: Updates to the Coordination of Benefits Contractor (COBC) Detailed Error Report File Layouts
CR #: 4042
Job Aid #: N/A

Updated Manual Instructions for the Medicare Claims Processing Manual, Regarding Smoking and Tobacco-Use Cessation Counseling Services

Mon, 14 Nov 2005 13:24:00 EST

Transmittal #: R671CP
Subject: Updated Manual Instructions for the Medicare Claims Processing Manual, Regarding Smoking and Tobacco-Use Cessation Counseling Services
CR #: 4045
Job Aid #: N/A

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

Mon, 14 Nov 2005 13:25:00 EST

Transmittal #: R665CP
Subject: October Quarterly Update for 2005 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule
CR #: 4026
Job Aid #: N/A

Realignment of States and Medicare Claims Processing Workload from DMERC Regions A, B, C and D to the DME MAC Jurisdictions A, B, C, and D

Mon, 14 Nov 2005 13:25:00 EST

Transmittal #: R670CP
Subject: Realignment of States and Medicare Claims Processing Workload from DMERC Regions A, B, C and D to the DME MAC Jurisdictions A, B, C, and D
CR #: 4002
Job Aid #: N/A

Enforcement of Hospital Inpatient Bundling: Carrier Denial of Ambulance Claims during an Inpatient Stay

Mon, 14 Nov 2005 13:26:00 EST

Transmittal #: R668CP
Subject: Enforcement of Hospital Inpatient Bundling: Carrier Denial of Ambulance Claims during an Inpatient Stay
CR #: 3933
Job Aid #: JA3933

Termination of Existing Crossover Agreements As Trading Partners Transition to the National Coordination of Benefits Agreement (COBA) Program

Mon, 14 Nov 2005 13:31:00 EST

Transmittal #: R177OTN
Subject: Termination of Existing Crossover Agreements As Trading Partners Transition to the National Coordination of Benefits Agreement (COBA) Program
CR #: 3980
Job Aid #: N/A

Manual Update on Medical Nutrition Therapy (MNT) Services - Manualization

Mon, 14 Nov 2005 13:32:00 EST

Transmittal #: R673CP
Subject: Manual Update on Medical Nutrition Therapy (MNT) Services - Manualization
CR #: 3955
Job Aid #: N/A

October Update to the 2005 Medicare Physician Fee Schedule Database

Mon, 14 Nov 2005 13:32:00 EST

Transmittal #: R672CP
Subject: October Update to the 2005 Medicare Physician Fee Schedule Database
CR #: 4031
Job Aid #: N/A

2006 Healthcare Common Procedure Coding System (HCPCS) Annual Update Remind

Mon, 14 Nov 2005 13:37:00 EST

Transmittal #: R676CP
Subject: 2006 Healthcare Common Procedure Coding System (HCPCS) Annual Update Remind
CR #: 4057
Job Aid #: N/A

Changes to Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Date October 1, 2005)

Mon, 14 Nov 2005 13:37:00 EST

Transmittal #: R675CP
Subject: Changes to Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Date October 1, 2005)
CR #: 3943
Job Aid #: N/A

Fiscal Year (FY) 2006 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH PPS) Changes

Mon, 14 Nov 2005 13:38:00 EST

Transmittal #: R674CP
Subject: Fiscal Year (FY) 2006 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH PPS) Changes
CR #: 4046
Job Aid #: N/A

Calculation of the Interim Payment of Indirect Medical Education (IME) Through the Inpatient PPS PRICER for Hospitals That Received an Increase to Their Full-time Equivalent Resident Caps Under Section 422 of the Medicare Modernization Act (MMA), P.L. 108-173

Mon, 14 Nov 2005 13:39:00 EST

Transmittal #: R179OTN
Subject: Calculation of the Interim Payment of Indirect Medical Education (IME) Through the Inpatient PPS PRICER for Hospitals That Received an Increase to Their Full-time Equivalent Resident Caps Under Section 422 of the Medicare Modernization Act (MMA), P.L. 108-173
CR #: 4025
Job Aid #: JA4025

Medical Review Collection Number Requirements

Mon, 14 Nov 2005 13:40:00 EST

Transmittal #: R122PI
Subject: Medical Review Collection Number Requirements
CR #: 4091
Job Aid #: N/A

October 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.3

Mon, 14 Nov 2005 13:41:00 EST

Transmittal #: R683CP
Subject: October 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.3
CR #: 4007
Job Aid #: N/A

Updates to the Group Health Plan Identification and Recovery Processes

Mon, 14 Nov 2005 13:42:00 EST

Transmittal #: R35MSP
Subject: Updates to the Group Health Plan Identification and Recovery Processes
CR #: 4015
Job Aid #: N/A

Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for FI Initial Determinations Issued on or After May 1, 2005 and Carrier Initial Determinations Issued on or After January 1, 2006)

Mon, 14 Nov 2005 13:47:00 EST

Transmittal #: R687CP
Subject: Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for FI Initial Determinations Issued on or After May 1, 2005 and Carrier Initial Determinations Issued on or After January 1, 2006)
CR #: 3939
Job Aid #: JA3939

Common Working File (CWF) Unsolicited Response Adjustments for Certain Claims Denied Due to an Open Medicare Secondary Payer (MSP) Group Health Plan (GHP) Record Where the GHP Record was Subsequently Deleted

Mon, 14 Nov 2005 13:48:00 EST

Transmittal #: R686CP
Subject: Common Working File (CWF) Unsolicited Response Adjustments for Certain Claims Denied Due to an Open Medicare Secondary Payer (MSP) Group Health Plan (GHP) Record Where the GHP Record was Subsequently Deleted
CR #: 3916
Job Aid #: N/A

Correction to Chapter 17, Section 80.2.3, MSN/ANSI X12 Denial Messages for Anti-Emetic Drugs

Mon, 14 Nov 2005 13:49:00 EST

Transmittal #: R684CP
Subject: Correction to Chapter 17, Section 80.2.3, MSN/ANSI X12 Denial Messages for Anti-Emetic Drugs
CR #: 4001
Job Aid #: JA4001

Update to the Healthcare Provider Taxonomy Codes (HPTC) Version 5.1

Mon, 14 Nov 2005 13:53:00 EST

Transmittal #: R36MSP
Subject: Update to the Healthcare Provider Taxonomy Codes (HPTC) Version 5.1
CR #: 4072
Job Aid #: N/A

The Supplemental Security Income (SSI) Medicare Beneficiary Data for Fiscal Year 2006 for the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS)

Mon, 14 Nov 2005 13:54:00 EST

Transmittal #: R698CP
Subject: The Supplemental Security Income (SSI) Medicare Beneficiary Data for Fiscal Year 2006 for the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS)
CR #: 4065
Job Aid #: JA4065

Appeals of Claims Decisions: Redeterminations and Reconsiderations (implementation date May 1, 2005).

Mon, 14 Nov 2005 13:55:00 EST

Transmittal #: R67CP
Subject: Appeals of Claims Decisions: Redeterminations and Reconsiderations (implementation date May 1, 2005).
CR #: 3942
Job Aid #: N/A

2006 Annual Update of HCPCS Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) for the Common Working File (CWF), Medicare Carriers and Fiscal Intermediaries (FIs)

Mon, 14 Nov 2005 13:56:00 EST

Transmittal #: R696CP
Subject: 2006 Annual Update of HCPCS Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) for the Common Working File (CWF), Medicare Carriers and Fiscal Intermediaries (FIs)
CR #: 4086
Job Aid #: N/A

Payment Methodology for Rehabilitation Services in IHS/Tribally Owned and/or Operated Hospitals and Hospital-Based Facil

Mon, 14 Nov 2005 14:07:00 EST

Transmittal #: R706CP
Subject: Payment Methodology for Rehabilitation Services in IHS/Tribally Owned and/or Operated Hospitals and Hospital-Based Facil
CR #: 3934
Job Aid #: JA3934

Discontinuation of Biannual Recertification List for Certified Registered Nurse Anesthetist (CRNA) Services

Mon, 14 Nov 2005 14:08:00 EST

Transmittal #: R704CP
Subject: Discontinuation of Biannual Recertification List for Certified Registered Nurse Anesthetist (CRNA) Services
CR #: 4062
Job Aid #: N/A

IPPS Outlier Reconciliation

Mon, 14 Nov 2005 14:09:00 EST

Transmittal #: R703CP
Subject: IPPS Outlier Reconciliation
CR #: 3966
Job Aid #: N/A

Changes in Manual Instructions for Intermediate Sanctions

Mon, 14 Nov 2005 14:13:00 EST

Transmittal #: R73MCM
Subject: Changes in Manual Instructions for Intermediate Sanctions
CR #: N/A
Job Aid #: N/A

Changes in Manual Instructions for Benefits and Beneficiary Protections

Mon, 14 Nov 2005 14:14:00 EST

Transmittal #: R72MCM
Subject: Changes in Manual Instructions for Benefits and Beneficiary Protections
CR #: N/A
Job Aid #: N/A

Deletion of MCM Chapter 19 - The Enrollment and Payment User's Guide, and Chapter 20 - Managed Care and MA Systems Business Requirements.

Mon, 14 Nov 2005 14:14:00 EST

Transmittal #: R71MCM
Subject: Deletion of MCM Chapter 19 - The Enrollment and Payment User's Guide, and Chapter 20 - Managed Care and MA Systems Business Requirements.
CR #: N/A
Job Aid #: N/A

Beneficiary Enrollment and Disenrollment Requirements for Medicare Advantage Plans

Mon, 14 Nov 2005 14:18:00 EST

Transmittal #: R70MCM
Subject: Beneficiary Enrollment and Disenrollment Requirements for Medicare Advantage Plans
CR #: N/A
Job Aid #: N/A

Manualizing Long-Standing Medicare Secondary Payer (MSP) Policy in Chapter 3 of the MSP Internet Only Manual (IOM)

Mon, 14 Nov 2005 14:24:00 EST

Transmittal #: R37MSP
Subject: Manualizing Long-Standing Medicare Secondary Payer (MSP) Policy in Chapter 3 of the MSP Internet Only Manual (IOM)
CR #: 4028
Job Aid #: N/A

Changes in Manual Instructions for Payment Principles for Cost Based HMO/CMPs

Mon, 14 Nov 2005 14:26:00 EST

Transmittal #: R74MCM
Subject: Changes in Manual Instructions for Payment Principles for Cost Based HMO/CMPs
CR #: N/A
Job Aid #: N/A

Disabling the Revenue/HCPCS Consistency Edit Codes in the Fiscal Intermediary Shared System (FISS)

Mon, 14 Nov 2005 14:27:00 EST

Transmittal #: R717CP
Subject: Disabling the Revenue/HCPCS Consistency Edit Codes in the Fiscal Intermediary Shared System (FISS)
CR #: 4049
Job Aid #: N/A

New G Code for Power Mobility Devices (PMDs)

Mon, 14 Nov 2005 14:27:00 EST

Transmittal #: R713CP
Subject: New G Code for Power Mobility Devices (PMDs)
CR #: 4121
Job Aid #: JA4121

Source of Admission Code 'D'

Mon, 14 Nov 2005 14:28:00 EST

Transmittal #: R718CP
Subject: Source of Admission Code 'D'
CR #: 3881
Job Aid #: JA3881

New Designated Competitive Acquisition Program (CAP)Carrier Contractor ID Numbers

Mon, 14 Nov 2005 14:29:00 EST

Transmittal #: R715CP
Subject: New Designated Competitive Acquisition Program (CAP)Carrier Contractor ID Numbers
CR #: 3985
Job Aid #: N/A

Payment Window Edit Corrections within the Common Working File (CWF)

Mon, 14 Nov 2005 14:29:00 EST

Transmittal #: R714CP
Subject: Payment Window Edit Corrections within the Common Working File (CWF)
CR #: 4089
Job Aid #: JA4089

New Waived Tests - April 1, 2005

Mon, 14 Nov 2005 14:30:00 EST

Transmittal #: R469CP
Subject: New Waived Tests - April 1, 2005
CR #: 3650
Job Aid #: N/A

Modifiers for Transportation of Portable X-rays (R0075) When Billed by Skilled Nursing Facilities (SNFs)

Mon, 14 Nov 2005 14:30:00 EST

Transmittal #: R716CP
Subject: Modifiers for Transportation of Portable X-rays (R0075) When Billed by Skilled Nursing Facilities (SNFs)
CR #: 4039
Job Aid #: N/A

Use of 12X Type of Bill (TOB) for Billing Vaccines and Their Administration

Mon, 14 Nov 2005 14:31:00 EST

Transmittal #: R473CP
Subject: Use of 12X Type of Bill (TOB) for Billing Vaccines and Their Administration
CR #: 3618
Job Aid #: N/A

Clarification and Update to Hospital Billing Instructions and Payment for Epoetin Alfa (EPO) and Darbepoetin Alfa (Aranesp) for Beneficiaries with End Stage Renal Disease (ESRD)

Mon, 14 Nov 2005 14:31:00 EST

Transmittal #: R719CP
Subject: Clarification and Update to Hospital Billing Instructions and Payment for Epoetin Alfa (EPO) and Darbepoetin Alfa (Aranesp) for Beneficiaries with End Stage Renal Disease (ESRD)
CR #: 4103
Job Aid #: JA4103

Use of Value Codes 48 and 49 on End Stage Renal Disease (ESRD) Bills

Mon, 14 Nov 2005 14:31:00 EST

Transmittal #: R721CP
Subject: Use of Value Codes 48 and 49 on End Stage Renal Disease (ESRD) Bills
CR #: 4087
Job Aid #: N/A

Infusion Pumps: C-Peptide Levels as A Criterion for Use

Mon, 14 Nov 2005 14:33:00 EST

Transmittal #: R471CP
Subject: Infusion Pumps: C-Peptide Levels as A Criterion for Use
CR #: 3705
Job Aid #: JA3705

New ICD-9-CM Code for Beneficiaries with Chronic Kidney Disease

Mon, 14 Nov 2005 14:33:00 EST

Transmittal #: R725CP
Subject: New ICD-9-CM Code for Beneficiaries with Chronic Kidney Disease
CR #: 4108
Job Aid #: N/A

2006 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments

Mon, 14 Nov 2005 14:33:00 EST

Transmittal #: R722CP
Subject: 2006 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments
CR #: 4113
Job Aid #: N/A

Smoking and Tobacco-Use Cessation Counseling Services: Common Working File (CWF) Inquiry for Providers

Mon, 14 Nov 2005 14:34:00 EST

Transmittal #: R726CP
Subject: Smoking and Tobacco-Use Cessation Counseling Services: Common Working File (CWF) Inquiry for Providers
CR #: 4104
Job Aid #: N/A

Request to Change Lead Contractor

Mon, 14 Nov 2005 14:35:00 EST

Transmittal #: R39MSP
Subject: Request to Change Lead Contractor
CR #: 4088
Job Aid #: N/A

Updates to the Group Health Plan (GHP) Demand Letters

Mon, 14 Nov 2005 14:35:00 EST

Transmittal #: R40MSP
Subject: Updates to the Group Health Plan (GHP) Demand Letters
CR #: 4012
Job Aid #: N/A

Standardization of Fiscal Intermediary Use of Group and Claim Adjustment Reason Codes and Calculation and Balancing of TS2 and TS3 Segment Data Elements

Mon, 14 Nov 2005 14:36:00 EST

Transmittal #: R470CP
Subject: Standardization of Fiscal Intermediary Use of Group and Claim Adjustment Reason Codes and Calculation and Balancing of TS2 and TS3 Segment Data Elements
CR #: 3685
Job Aid #: JA3685

Full Replacement of and Rescinding Change Request (CR) 3504--Modification to Online Medicare Secondary Payer Questionnaire

Mon, 14 Nov 2005 14:36:00 EST

Transmittal #: R41MSP
Subject: Full Replacement of and Rescinding Change Request (CR) 3504--Modification to Online Medicare Secondary Payer Questionnaire
CR #: 4098
Job Aid #: JA4098

Medicare Contractors' Monthly Cash Collections

Mon, 14 Nov 2005 14:37:00 EST

Transmittal #: R80FM
Subject: Medicare Contractors' Monthly Cash Collections
CR #: 4074
Job Aid #: N/A

Notification of New Value and Condition Codes For Medicare Demonstrations

Mon, 14 Nov 2005 14:38:00 EST

Transmittal #: R29DEMO
Subject: Notification of New Value and Condition Codes For Medicare Demonstrations
CR #: 4055
Job Aid #: N/A

Implementation of Program Safeguard Contractor (PSC) Access to the VIPS Medicare Shared System (VMS) at All Durable Medical Equipment Carriers (DMERCs)

Mon, 14 Nov 2005 14:39:00 EST

Transmittal #: R126PI
Subject: Implementation of Program Safeguard Contractor (PSC) Access to the VIPS Medicare Shared System (VMS) at All Durable Medical Equipment Carriers (DMERCs)
CR #: 3994
Job Aid #: N/A

Payment Allowances for the Influenza Virus Vaccine (CPT 90655, 90656, 90657, and 90658) and the Pneumoccocal Vaccine (CPT 90732) when Payment is Based on 95 Percent of the Average Wholesale Price (AWP)

Mon, 14 Nov 2005 14:39:00 EST

Transmittal #: R185OTN
Subject: Payment Allowances for the Influenza Virus Vaccine (CPT 90655, 90656, 90657, and 90658) and the Pneumoccocal Vaccine (CPT 90732) when Payment is Based on 95 Percent of the Average Wholesale Price (AWP)
CR #: 4109
Job Aid #: JA4109

Revisions to Chapter 2, "The Certification Process," Appendix E-- "Providers of Outpatient Physical Therapy or Outpatient Speech Language Pathology (OPT/OSP) Services," and Appendix K-- "Comprehensive Outpatient Rehabilitation Facilities"

Mon, 14 Nov 2005 14:40:00 EST

Transmittal #: R13SOM
Subject: Revisions to Chapter 2, "The Certification Process," Appendix E-- "Providers of Outpatient Physical Therapy or Outpatient Speech Language Pathology (OPT/OSP) Services," and Appendix K-- "Comprehensive Outpatient Rehabilitation Facilities"
CR #: N/A
Job Aid #: N/A

Recurring Update Notification for the Notice of New Interest Rate for Medicare Overpayments and Underpayments

Mon, 14 Nov 2005 14:40:00 EST

Transmittal #: R81FM
Subject: Recurring Update Notification for the Notice of New Interest Rate for Medicare Overpayments and Underpayments
CR #: 4066
Job Aid #: N/A

Complaint Screening Revisions

Mon, 14 Nov 2005 14:41:00 EST

Transmittal #: R127PI
Subject: Complaint Screening Revisions
CR #: 4118
Job Aid #: N/A

Annual Type Of Service (TOS)

Mon, 14 Nov 2005 14:42:00 EST

Transmittal #: R727CP
Subject: Annual Type Of Service (TOS)
CR #: 4145
Job Aid #: N/A

Installation of the January 2006 Inpatient Prospective Payment System Pricer and Hospice Pricer

Mon, 14 Nov 2005 14:43:00 EST

Transmittal #: R728CP
Subject: Installation of the January 2006 Inpatient Prospective Payment System Pricer and Hospice Pricer
CR #: 4117
Job Aid #: N/A

Initiate STC testing of the MCS for RRB and HIGLAS

Mon, 14 Nov 2005 14:44:00 EST

Transmittal #: R30GI
Subject: Initiate STC testing of the MCS for RRB and HIGLAS
CR #: 4150
Job Aid #: N/A

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

Mon, 14 Nov 2005 14:45:00 EST

Transmittal #: R729CP
Subject: Revised October 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective October 1, 2005
CR #: 4160
Job Aid #: N/A

Initial Publication of Chapter 10 - MA Organization Compliance with State Law and Preemption by Federal law

Mon, 14 Nov 2005 14:45:00 EST

Transmittal #: R76MCM
Subject: Initial Publication of Chapter 10 - MA Organization Compliance with State Law and Preemption by Federal law
CR #: N/A
Job Aid #: N/A

Reasonable Charge Update for 2006 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, Certain Intraocular Lenses and Certain HCPCS Coding Issues

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R749CP
Subject: Reasonable Charge Update for 2006 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, Certain Intraocular Lenses and Certain HCPCS Coding Issues
CR #: 4131
Job Aid #: N/A

Payment for Office or Other Outpatient Evaluation and Management (E/M ) Visits (Codes 99201 - 99215)

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R731CP
Subject: Payment for Office or Other Outpatient Evaluation and Management (E/M ) Visits (Codes 99201 - 99215)
CR #: 4032
Job Aid #: JA4032

Change of Medicare Part B contractor in the State of Utah from Regence Blue Cross and Blue Shield of Utah to Noridian Administrative Services.

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R193OTN
Subject: Change of Medicare Part B contractor in the State of Utah from Regence Blue Cross and Blue Shield of Utah to Noridian Administrative Services.
CR #: 4174
Job Aid #: N/A

New ICD-9-CM Codes for Beneficiaries with Chronic Kidney Disease and new HCPCS for reporting Epoetin Alfa and Darbepoetin Alfa

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R737CP
Subject: New ICD-9-CM Codes for Beneficiaries with Chronic Kidney Disease and new HCPCS for reporting Epoetin Alfa and Darbepoetin Alfa
CR #: 4108
Job Aid #: N/A

Repeat Tests for Automated Multi-Channel Chemistries for End Stage Renal Disease beneficiaries

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R733CP
Subject: Repeat Tests for Automated Multi-Channel Chemistries for End Stage Renal Disease beneficiaries
CR #: 4101
Job Aid #: JA4101

Calculation of the Interim Payment of Indirect Medical Education (IME) Through the Inpatient PPS PRICER for Hospitals That Received an Increase to Their Full-time Equivalent Resident Caps Under Section 422 of the Medicare Modernization Act (MMA), P.L. 108-1

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R194OTN
Subject: Calculation of the Interim Payment of Indirect Medical Education (IME) Through the Inpatient PPS PRICER for Hospitals That Received an Increase to Their Full-time Equivalent Resident Caps Under Section 422 of the Medicare Modernization Act (MMA), P.L. 108-1
CR #: 4025
Job Aid #: N/A

Noridian North Dakota/South Dakota Carrier Number Issue

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R191OTN
Subject: Noridian North Dakota/South Dakota Carrier Number Issue
CR #: 4165
Job Aid #: N/A

Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Evaluation and Management (E&M) Services Billed to Fiscal Intermediaries (FIs) by Hospitals

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R740CP
Subject: Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Evaluation and Management (E&M) Services Billed to Fiscal Intermediaries (FIs) by Hospitals
CR #: 3910
Job Aid #: N/A

Redefined Type of Bill (TOB), 14x, for Non-Patient Laboratory Specimens

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R734CP
Subject: Redefined Type of Bill (TOB), 14x, for Non-Patient Laboratory Specimens
CR #: 3835
Job Aid #: JA3835

Calendar Year 2005 Payment for Medicare Part B Radiopharmaceuticals Not Paid on a Cost or Prospective Payment Basis

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R738CP
Subject: Calendar Year 2005 Payment for Medicare Part B Radiopharmaceuticals Not Paid on a Cost or Prospective Payment Basis
CR #: 4053
Job Aid #: JA4053

Processing All Diagnosis Codes Reported on Claims Submitted to Carriers

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R735CP
Subject: Processing All Diagnosis Codes Reported on Claims Submitted to Carriers
CR #: 4097
Job Aid #: N/A

Change of Medicare Part A contractor in the State of Idaho, Oregon, and Utah from Regence Blue Cross and Blue Shield to Noridian Administrative Service

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R195OTN
Subject: Change of Medicare Part A contractor in the State of Idaho, Oregon, and Utah from Regence Blue Cross and Blue Shield to Noridian Administrative Service
CR #: 4189
Job Aid #: N/A

Coverage by Medicare Advantage (MA) Plans for Implantable Automatic Cardiac Defibrillator (ICD) Services Not Previously Included in MA Capitation Rate

Thu, 01 Dec 2005 14:50:00 EST

Transmittal #: R186OTN
Subject: Coverage by Medicare Advantage (MA) Plans for Implantable Automatic Cardiac Defibrillator (ICD) Services Not Previously Included in MA Capitation Rate
CR #: 4133
Job Aid #: JA4133

Revising the FISS Shared System

Thu, 01 Dec 2005 15:00:00 EST

Transmittal #: R111PI
Subject: Revising the FISS Shared System
CR #: 3812
Job Aid #: N/A

Replacing the Use of Unique Physician Identification Numbers (UPINs) With the National Provider Identifiers (NPIs)

Fri, 02 Dec 2005 09:43:00 EST

Transmittal #: R129PI
Subject: Replacing the Use of Unique Physician Identification Numbers (UPINs) With the National Provider Identifiers (NPIs)
CR #: 4166
Job Aid #: N/A

Payment to Ambulatory Surgery Centers (ASCs) for New CPT Code 66711

Fri, 02 Dec 2005 14:17:00 EST

Transmittal #: R153OTN
Subject: Payment to Ambulatory Surgery Centers (ASCs) for New CPT Code 66711
CR #: 3817
Job Aid #: N/A

Qualified Independent Contractor Jurisdictions

Fri, 02 Dec 2005 14:17:00 EST

Transmittal #: R163OTN
Subject: Qualified Independent Contractor Jurisdictions
CR #: 3908
Job Aid #: N/A

The Medicare Chronic Care Improvement , "Medicare Health Support," Program

Fri, 02 Dec 2005 15:35:00 EST

Transmittal #: R30DEMO
Subject: The Medicare Chronic Care Improvement , "Medicare Health Support," Program
CR #: 3953
Job Aid #: JA3953

Common Working File (CWF) Calculation of Next Eligible Date for Preventive Services

Fri, 02 Dec 2005 15:35:00 EST

Transmittal #: R175OTN
Subject: Common Working File (CWF) Calculation of Next Eligible Date for Preventive Services
CR #: 4011
Job Aid #: N/A

Update to Medicare Deductible, Coinsurance and Premium Rates for 2006

Fri, 02 Dec 2005 16:18:00 EST

Transmittal #: R31GI
Subject: Update to Medicare Deductible, Coinsurance and Premium Rates for 2006
CR #: 4132
Job Aid #: N/A

Manualization: Long-Standing MSP Policy in Chapter 1 of the Medicare Secondary Payer (MSP) Internet Only Manual (IOM)

Fri, 02 Dec 2005 16:46:00 EST

Transmittal #: R34MSP
Subject: Manualization: Long-Standing MSP Policy in Chapter 1 of the Medicare Secondary Payer (MSP) Internet Only Manual (IOM)
CR #: 4018
Job Aid #: N/A

Updates to the Electronic Correspondence Referral System (ECRS) User Guide v9.0 and Quick Reference Card v9.0

Fri, 02 Dec 2005 17:09:00 EST

Transmittal #: R44MSP
Subject: Updates to the Electronic Correspondence Referral System (ECRS) User Guide v9.0 and Quick Reference Card v9.0
CR #: 4162
Job Aid #: N/A

Hurricanes Katrina and Rita-Transportation of Evacuees with Medical Needs

Tue, 06 Dec 2005 09:50:00 EST

Transmittal #: SE0579
Subject: Hurricanes Katrina and Rita-Transportation of Evacuees with Medical Needs
CR #: N/A
Job Aid #: JA0579

Influenza/Flu Season and Available Resources for Providers

Tue, 06 Dec 2005 09:50:00 EST

Transmittal #: SE0580
Subject: Influenza/Flu Season and Available Resources for Providers
CR #: N/A
Job Aid #: JA0580

Providing Medicare with Data for Certain Implantable Cardioverter Defibrillators (ICDs)

Tue, 06 Dec 2005 09:50:00 EST

Transmittal #: SE0578
Subject: Providing Medicare with Data for Certain Implantable Cardioverter Defibrillators (ICDs)
CR #: N/A
Job Aid #: JA0578

MMA Sunset of the Provider Nomination Provision and the Policy to Assign Providers to the Local Fiscal Intermediary (FI)

Tue, 06 Dec 2005 09:50:00 EST

Transmittal #: SE0582
Subject: MMA Sunset of the Provider Nomination Provision and the Policy to Assign Providers to the Local Fiscal Intermediary (FI)
CR #: N/A
Job Aid #: JA0582

Important Message to Nursing Home Administrators About Medicare Prescription Drug Coverage - The Tenth in a Series in the Medlearn Matters Series

Tue, 06 Dec 2005 10:39:00 EST

Transmittal #: SE0575
Subject: Important Message to Nursing Home Administrators About Medicare Prescription Drug Coverage - The Tenth in a Series in the Medlearn Matters Series
CR #: N/A
Job Aid #: JA0575

Important Information about Medicare Coverage of Drugs under Part B and the New Medicare Prescription Drug Coverage(Part D), and Vaccines Administered in a Physician's Office - The Ninth in the Medlearn Matters Series on the New Prescription Drug Plans

Tue, 06 Dec 2005 10:46:00 EST

Transmittal #: SE0570
Subject: Important Information about Medicare Coverage of Drugs under Part B and the New Medicare Prescription Drug Coverage(Part D), and Vaccines Administered in a Physician's Office - The Ninth in the Medlearn Matters Series on the New Prescription Drug Plans
CR #: N/A
Job Aid #: JA0570

MMA - The Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contract (RAC) Initiative

Tue, 06 Dec 2005 10:50:00 EST

Transmittal #: SE0565
Subject: MMA - The Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contract (RAC) Initiative
CR #: N/A
Job Aid #: JA0565

Full Replacement of Change Request 3607, Payment Edits in Applicable States for DMEPOS Suppliers of Prosthetics and Certain Custom-Fabricated Orthotics. Change Request 3607 is rescinded (DMERC only)

Tue, 06 Dec 2005 11:02:00 EST

Transmittal #: R656CP
Subject: Full Replacement of Change Request 3607, Payment Edits in Applicable States for DMEPOS Suppliers of Prosthetics and Certain Custom-Fabricated Orthotics. Change Request 3607 is rescinded (DMERC only)
CR #: 3959
Job Aid #: JA3959

Appeals of Claims Decisions: Redeterminations and Reconsiderations (implementation date May 1, 2005).

Tue, 06 Dec 2005 11:16:00 EST

Transmittal #: R697CP
Subject: Appeals of Claims Decisions: Redeterminations and Reconsiderations (implementation date May 1, 2005).
CR #: 3942
Job Aid #: JA3942

File Descriptions and instructions for retrieving the 2006 fee schedules and HCPCS through CMS 's Mainframe Telecommunications system

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R744CP
Subject: File Descriptions and instructions for retrieving the 2006 fee schedules and HCPCS through CMS 's Mainframe Telecommunications system
CR #: 4084
Job Aid #: N/A

New Condition Codes 49 and 50

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R741CP
Subject: New Condition Codes 49 and 50
CR #: 4058
Job Aid #: JA4058

Update of Contact Information for the Do Not Forward Reports

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R753CP
Subject: Update of Contact Information for the Do Not Forward Reports
CR #: 4122
Job Aid #: N/A

Elimination of the DMERC Information Form (DIF)

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R745CP
Subject: Elimination of the DMERC Information Form (DIF)
CR #: 4040
Job Aid #: N/A

Resubmission of Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) Claims with Chronic Renal Failure Comorbid Condition

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R757CP
Subject: Resubmission of Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) Claims with Chronic Renal Failure Comorbid Condition
CR #: 4164
Job Aid #: JA4164

Remittance Advice Remark Code and Claim Adjustment Reason Code Update

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R743CP
Subject: Remittance Advice Remark Code and Claim Adjustment Reason Code Update
CR #: 4123
Job Aid #: JA4123

Deletion of MCM Chapter 3 - Marketing

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R75MCM
Subject: Deletion of MCM Chapter 3 - Marketing
CR #: N/A
Job Aid #: N/A

January 2006 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective January 1, 2006, and Revisions to January 2005, April 2005, July 2005, and October 2005 Quarterly ASP Medicare Part B Drug Pricing Files

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R746CP
Subject: January 2006 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective January 1, 2006, and Revisions to January 2005, April 2005, July 2005, and October 2005 Quarterly ASP Medicare Part B Drug Pricing Files
CR #: 4140
Job Aid #: N/A

Medical Review of Rural Air Ambulance Services

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R93PI
Subject: Medical Review of Rural Air Ambulance Services
CR #: 3571
Job Aid #: N/A

National Monitoring Policy for EPO and Aranesp for End Stage Renal Disease (ESRD) Patients Treated in Renal Dialysis Facilities

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R751CP
Subject: National Monitoring Policy for EPO and Aranesp for End Stage Renal Disease (ESRD) Patients Treated in Renal Dialysis Facilities
CR #: 4135
Job Aid #: N/A

Quarterly Update to Correct Coding Initiative (CCI) Edits, V12.0, Effective January 1, 2006

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R742CP
Subject: Quarterly Update to Correct Coding Initiative (CCI) Edits, V12.0, Effective January 1, 2006
CR #: 4168
Job Aid #: N/A

Reasonable Charge Update for 2006 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, Certain Intraocular Lenses and Certain HCPCS Coding Issues

Tue, 06 Dec 2005 13:24:00 EST

Update of HCPCS Codes and File Names, Descriptions and Instructions for Retrieving the 2006 ASC HCPCS Deletions, Additions, and Master Listing

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R720CP
Subject: Update of HCPCS Codes and File Names, Descriptions and Instructions for Retrieving the 2006 ASC HCPCS Deletions, Additions, and Master Listing
CR #: 4082
Job Aid #: N/A

New G Code for Power Mobility Devices (PMDs)

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R748CP
Subject: New G Code for Power Mobility Devices (PMDs)
CR #: 4121
Job Aid #: JA4121

2006 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

Tue, 06 Dec 2005 15:07:00 EST

Transmittal #: R750CP
Subject: 2006 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment
CR #: 4144
Job Aid #: JA4144

Physician's Voluntary Reporting Program (PVRP)

Tue, 06 Dec 2005 15:07:00 EST

Transmittal #: R31DEMO
Subject: Physician's Voluntary Reporting Program (PVRP)
CR #: 4183
Job Aid #: N/A

Temporary Hold of Claims with HCPCS Codes G0369 or G0370 Received on or after October 1, 2005, from Maryland Hospitals and Non-OPPS Hospitals and Dialysis Facilities

Tue, 06 Dec 2005 16:40:00 EST

Transmittal #: SE0564
Subject: Temporary Hold of Claims with HCPCS Codes G0369 or G0370 Received on or after October 1, 2005, from Maryland Hospitals and Non-OPPS Hospitals and Dialysis Facilities
CR #: N/A
Job Aid #: JA0564

Provider Notification Regarding Adjustments for Home Health Prospective Payment System (HH PPS) Claims Failing to Report Prior Inpatient Discharges

Tue, 06 Dec 2005 16:49:00 EST

Transmittal #: SE0561
Subject: Provider Notification Regarding Adjustments for Home Health Prospective Payment System (HH PPS) Claims Failing to Report Prior Inpatient Discharges
CR #: N/A
Job Aid #: JA0561

New Educational Products Available on Medicare Prescription Drug Coverage - The Eighth in the Medlearn Matters Series

Tue, 06 Dec 2005 16:49:00 EST

Transmittal #: SE0559
Subject: New Educational Products Available on Medicare Prescription Drug Coverage - The Eighth in the Medlearn Matters Series
CR #: N/A
Job Aid #: JA0559

Clarification on Part D and Fee-For-Service (FFS) Providers, New Web-based Educational Products, and the Latest Information on Medicare Prescription Drug Coverage - The Seventh in the Medlearn Matters Series

Tue, 06 Dec 2005 16:49:00 EST

Transmittal #: SE0557
Subject: Clarification on Part D and Fee-For-Service (FFS) Providers, New Web-based Educational Products, and the Latest Information on Medicare Prescription Drug Coverage - The Seventh in the Medlearn Matters Series
CR #: N/A
Job Aid #: JA0557

Hurricanes Katrina and Rita - Frequently Asked Questions - Medicare Issues

Tue, 06 Dec 2005 16:49:00 EST

Transmittal #: SE0563
Subject: Hurricanes Katrina and Rita - Frequently Asked Questions - Medicare Issues
CR #: N/A
Job Aid #: JA0563

Informational and Educational Materials for the New Preventive Services

Wed, 07 Dec 2005 07:59:00 EST

Transmittal #: SE0556
Subject: Informational and Educational Materials for the New Preventive Services
CR #: N/A
Job Aid #: N/A

Key Medicare News for 2006 for Physicians and Other Health Care Professionals

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0543
Subject: Key Medicare News for 2006 for Physicians and Other Health Care Professionals
CR #: N/A
Job Aid #: JA0543

How to Locate Specific Transmittals/Change Requests (CRs) of Interest That Are Posted on Centers for Medicare & Medicaid Services (CMS) Web Sites

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0506
Subject: How to Locate Specific Transmittals/Change Requests (CRs) of Interest That Are Posted on Centers for Medicare & Medicaid Services (CMS) Web Sites
CR #: N/A
Job Aid #: JA0506

Electronically Requesting and Receiving Information Regarding Claims Using the ASC X12N276/277 Claims Status Inquiry/Response Transactions

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0524
Subject: Electronically Requesting and Receiving Information Regarding Claims Using the ASC X12N276/277 Claims Status Inquiry/Response Transactions
CR #: N/A
Job Aid #: JA0524

New Expedited Review Process for Disputed Terminations of Medicare Covered Services in SNFs, HHAs, CORFs and Hospices

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0538
Subject: New Expedited Review Process for Disputed Terminations of Medicare Covered Services in SNFs, HHAs, CORFs and Hospices
CR #: N/A
Job Aid #: N/A

MMA - Proposed Implementation of the Physician Scarcity Bonus and Revision to the Health Professional Shortage Area (HPSA)

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0449
Subject: MMA - Proposed Implementation of the Physician Scarcity Bonus and Revision to the Health Professional Shortage Area (HPSA)
CR #: N/A
Job Aid #: N/A

MMA - The Facts for Providers Regarding the Medicare Prescription Drug Plans That Will Become Available in 2006

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0502
Subject: MMA - The Facts for Providers Regarding the Medicare Prescription Drug Plans That Will Become Available in 2006
CR #: N/A
Job Aid #: JA0502

Prosthetics and Orthotics Ordered in a Hospital or Home Prior to a Skilled Nursing Facility Admission

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0507
Subject: Prosthetics and Orthotics Ordered in a Hospital or Home Prior to a Skilled Nursing Facility Admission
CR #: N/A
Job Aid #: JA0507

The Centers for Medicare & Medicaid Services (CMS) Consolidation of the Claims Crossover Process

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0504
Subject: The Centers for Medicare & Medicaid Services (CMS) Consolidation of the Claims Crossover Process
CR #: N/A
Job Aid #: JA0504

MMA - End Stage Renal Disease (ESRD) Composite Payment Rate System Changes

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0511
Subject: MMA - End Stage Renal Disease (ESRD) Composite Payment Rate System Changes
CR #: N/A
Job Aid #: N/A

New Guidance Regarding Healthcare Common Procedure Coding System (HCPCS) Code G0297

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0553
Subject: New Guidance Regarding Healthcare Common Procedure Coding System (HCPCS) Code G0297
CR #: N/A
Job Aid #: JA0553

MMA - Medicare Prescription Drug, Improvement, and Modernization Act - Skilled Nursing Facility Consolidated Billing and Services of Rural Health Clinics and Federally Qualified Health Centers

Wed, 07 Dec 2005 08:42:00 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 #: JA0438

MMA - Expansion of Coverage for Chiropractic Services Demonstration - Information Relevant to Outpatient Hospitals and Independent Clinical Laboratories

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0521
Subject: MMA - Expansion of Coverage for Chiropractic Services Demonstration - Information Relevant to Outpatient Hospitals and Independent Clinical Laboratories
CR #: N/A
Job Aid #: JA0521

MMA - CMS' Implementation of Section 1011 of the Medicare Modernization Act - Federal Funding of Emergency Health Services Furnished to Undocumented Aliens

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0535
Subject: MMA - CMS' Implementation of Section 1011 of the Medicare Modernization Act - Federal Funding of Emergency Health Services Furnished to Undocumented Aliens
CR #: N/A
Job Aid #: JA0535

New Educational Products Available

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0537
Subject: New Educational Products Available
CR #: N/A
Job Aid #: JA0537

CMS Releases New Educational Guide on Remittance Advice (RA) Notices

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0540
Subject: CMS Releases New Educational Guide on Remittance Advice (RA) Notices
CR #: N/A
Job Aid #: JA0540

MMA - The Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contract (RAC) Initiative

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0469
Subject: MMA - The Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contract (RAC) Initiative
CR #: N/A
Job Aid #: JA0469

Reminder Regarding Medicare Billing Rules for Ambulance Services Rendered to Medicare Patients During an Inpatient Hospital Stay

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0536
Subject: Reminder Regarding Medicare Billing Rules for Ambulance Services Rendered to Medicare Patients During an Inpatient Hospital Stay
CR #: N/A
Job Aid #: JA0536

Mass Adjustment of Certain Transplant Claims

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0539
Subject: Mass Adjustment of Certain Transplant Claims
CR #: N/A
Job Aid #: JA0539

The Comprehensive Error Rate Testing (CERT) Process for Handling a Provider's Allegation of Medical Record Destruction

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0547
Subject: The Comprehensive Error Rate Testing (CERT) Process for Handling a Provider's Allegation of Medical Record Destruction
CR #: N/A
Job Aid #: JA0547

MMA - Proposed Implementation of the Physician Scarcity Bonus and Revision to the Health Professional Shortage Area (HPSA)

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0453
Subject: MMA - Proposed Implementation of the Physician Scarcity Bonus and Revision to the Health Professional Shortage Area (HPSA)
CR #: N/A
Job Aid #: JA0453

Update of Healthcare Common Procedure Coding System (HCPCS) Codes and File Names, Descriptions, and Instruction for Retrieving the 2005 Ambulatory Surgical/Surgery Center (ASC) HCPCS Deletions and Master Listing

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0463
Subject: Update of Healthcare Common Procedure Coding System (HCPCS) Codes and File Names, Descriptions, and Instruction for Retrieving the 2005 Ambulatory Surgical/Surgery Center (ASC) HCPCS Deletions and Master Listing
CR #: N/A
Job Aid #: N/A

CMS Seeks Provider Input on Satisfaction with Medicare Fee for Service Contractor Services

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0513
Subject: CMS Seeks Provider Input on Satisfaction with Medicare Fee for Service Contractor Services
CR #: N/A
Job Aid #: JA0513

Resubmission of Outpatient Prospective Payment System (OPPS) Services for Eligible Outlier Payment

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0523
Subject: Resubmission of Outpatient Prospective Payment System (OPPS) Services for Eligible Outlier Payment
CR #: N/A
Job Aid #: JA0523

More Web-based Educational Products Available on Medicare Prescription Drug Coverage - The Fifth in the Medlearn Matters Series

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0541
Subject: More Web-based Educational Products Available on Medicare Prescription Drug Coverage - The Fifth in the Medlearn Matters Series
CR #: N/A
Job Aid #: JA0541

MMA - Coming Soon - The New Medicare Prescription Drug Program

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0501
Subject: MMA - Coming Soon - The New Medicare Prescription Drug Program
CR #: N/A
Job Aid #: JA0501

MMA - Expansion of Coverage for Chiropractic Services Demonstration

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0514
Subject: MMA - Expansion of Coverage for Chiropractic Services Demonstration
CR #: N/A
Job Aid #: JA0514

MMA - Your Important Role

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0520
Subject: MMA - Your Important Role
CR #: N/A
Job Aid #: N/A

MMA - Expansion of Coverage for Chiropractic Services Demonstration - Information for Outpatient Hospitals and Radiologists

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0522
Subject: MMA - Expansion of Coverage for Chiropractic Services Demonstration - Information for Outpatient Hospitals and Radiologists
CR #: N/A
Job Aid #: JA0522

Centers for Medicare & Medicaid Services (CMS) Comprehensive Error Rate Testing (CERT) Program - The Importance of Complying with Requests for Claim Documentation

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0526
Subject: Centers for Medicare & Medicaid Services (CMS) Comprehensive Error Rate Testing (CERT) Program - The Importance of Complying with Requests for Claim Documentation
CR #: N/A
Job Aid #: JA0526

The Centers for Medicare & Medicaid Services (CMS) Doctors' Office Quality Information Technology Demonstrations: Providing Leadership in the Adoption of Electronic Health Records

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0505
Subject: The Centers for Medicare & Medicaid Services (CMS) Doctors' Office Quality Information Technology Demonstrations: Providing Leadership in the Adoption of Electronic Health Records
CR #: N/A
Job Aid #: JA0505

Revisions to Pub. 100-04, Medicare Claims Processing Manual in Preparation for the National Provider Identifier (NPI)

Thu, 08 Dec 2005 09:36:00 EST

Transmittal #: R771CP
Subject: Revisions to Pub. 100-04, Medicare Claims Processing Manual in Preparation for the National Provider Identifier (NPI)
CR #: 4181
Job Aid #: N/A

Medicare Announces Delay in Processing Certain Claims No Later Than April 18, 2005

Wed, 14 Dec 2005 08:42:00 EST

Transmittal #: SE0531
Subject: Medicare Announces Delay in Processing Certain Claims No Later Than April 18, 2005
CR #: N/A
Job Aid #: N/A

Billing for Syringes Used in the Treatment of End Stage Renal Disease (ESRD) Patients

Wed, 14 Dec 2005 08:42:00 EST

Transmittal #: SE0527
Subject: Billing for Syringes Used in the Treatment of End Stage Renal Disease (ESRD) Patients
CR #: N/A
Job Aid #: JA0527

Population - Based Disease Management - Use of Group Health Plan Payment System for Medicare Disease Management Demonstration Serving Medicare Fee For Service Beneficiaries

Wed, 14 Dec 2005 08:42:00 EST

Transmittal #: SE0519
Subject: Population - Based Disease Management - 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

Message to Nursing Home Administrators on Medicare Prescription Drug Coverage-The Sixth in the Series of Medlearn Matters Articles on the New Prescription Drug Coverage

Wed, 14 Dec 2005 08:42:00 EST

Transmittal #: SE0544
Subject: Message to Nursing Home Administrators on Medicare Prescription Drug Coverage-The Sixth in the Series of Medlearn Matters Articles on the New Prescription Drug Coverage
CR #: N/A
Job Aid #: JA0544

Skilled Nursing Facility (SNF) Consolidated Billing (CB) as It Relates to Therapy Services

Wed, 14 Dec 2005 08:42:00 EST

Transmittal #: SE0518
Subject: Skilled Nursing Facility (SNF) Consolidated Billing (CB) as It Relates to Therapy Services
CR #: N/A
Job Aid #: JA0518

Tool Available for Registering Patients with Implantable Cardioverter Defibrillators

Wed, 14 Dec 2005 08:42:00 EST

Transmittal #: SE0517
Subject: Tool Available for Registering Patients with Implantable Cardioverter Defibrillators
CR #: N/A
Job Aid #: JA0517

Announcing the New Booklet: Physician's Guide to Medicare Coverage of Kidney Dialysis and Kidney Transplant Services

Wed, 14 Dec 2005 08:42:00 EST

Transmittal #: SE0532
Subject: Announcing the New Booklet: Physician's Guide to Medicare Coverage of Kidney Dialysis and Kidney Transplant Services
CR #: N/A
Job Aid #: JA0532

Correct Coding Initiative (CCI) Edits to Apply to ALL Therapy Providers

Wed, 14 Dec 2005 08:42:00 EST

Transmittal #: SE0545
Subject: Correct Coding Initiative (CCI) Edits to Apply to ALL Therapy Providers
CR #: N/A
Job Aid #: JA0545

Review of Documentation During Medical Review

Wed, 14 Dec 2005 10:09:00 EST

Transmittal #: R100PI
Subject: Review of Documentation During Medical Review
CR #: 3644
Job Aid #: N/A

Benefit Integrity (BI) PIM Revisions

Wed, 14 Dec 2005 10:10:00 EST

Transmittal #: R101PI
Subject: Benefit Integrity (BI) PIM Revisions
CR #: 3579
Job Aid #: N/A

Medical Review of Rural Air Ambulance Services

Wed, 14 Dec 2005 10:11:00 EST

Transmittal #: R102PI
Subject: Medical Review of Rural Air Ambulance Services
CR #: 3571
Job Aid #: N/A

Updated Standard System Changes for Provider Enrollment Chain Ownership System (PECOS) and MCS

Wed, 14 Dec 2005 10:32:00 EST

Transmittal #: R109PI
Subject: Updated Standard System Changes for Provider Enrollment Chain Ownership System (PECOS) and MCS
CR #: 3725
Job Aid #: N/A

Expansion of State Codes for OSCAR Provider Numbers

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R553CP
Subject: Expansion of State Codes for OSCAR Provider Numbers
CR #: 3844
Job Aid #: N/A

Bone Mass Measurements - Procedure Coding

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R501CP
Subject: Bone Mass Measurements - Procedure Coding
CR #: 3719
Job Aid #: N/A

Cost Reporting Forms and Instructions, Form CMS-1984-99

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R6P238
Subject: Cost Reporting Forms and Instructions, Form CMS-1984-99
CR #: N/A
Job Aid #: N/A

Radiopharmaceutical Diagnostic Imaging Agents Codes Applicable to PET Scan Services Performed on or After January 28, 2005

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R628CP
Subject: Radiopharmaceutical Diagnostic Imaging Agents Codes Applicable to PET Scan Services Performed on or After January 28, 2005
CR #: 3945
Job Aid #: N/A

Abarelix for Treatment of Prostrate Cancer

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R612CP
Subject: Abarelix for Treatment of Prostrate Cancer
CR #: 3775
Job Aid #: JA3775

Inclusion of Interventional Pain Management Specialists on Carrier Advisory Committee (CAC) Membership

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R106PI
Subject: Inclusion of Interventional Pain Management Specialists on Carrier Advisory Committee (CAC) Membership
CR #: 3721
Job Aid #: N/A

Quarterly Update to Correct Coding Initiative (CCI) edits, Version 11.1, Effective April 1, 2005

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R466CP
Subject: Quarterly Update to Correct Coding Initiative (CCI) edits, Version 11.1, Effective April 1, 2005
CR #: 3688
Job Aid #: JA3688

General Appeals Process in Initial Determinations (Implementation Dates for FI Initial Determinations Issued on or After May 1, 2005, and Carrier Initial Determinations Issued on or After January 1, 2006).

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R695CP
Subject: General Appeals Process in Initial Determinations (Implementation Dates for FI Initial Determinations Issued on or After May 1, 2005, and Carrier Initial Determinations Issued on or After January 1, 2006).
CR #: 4019
Job Aid #: N/A

October 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R691CP
Subject: October 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 4035
Job Aid #: N/A

Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R140OTN
Subject: Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File
CR #: 3728
Job Aid #: N/A

Revisions to Chapter 12, "Effect of Change of Ownership," and Chapter 14, "Contract Determination and Appeals

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R69MCM
Subject: Revisions to Chapter 12, "Effect of Change of Ownership," and Chapter 14, "Contract Determination and Appeals
CR #: N/A
Job Aid #: N/A

Medicare Authorization to Disclose Personal Health Information" form and "Information to Help You Fill Out the Medicare Authorization to Disclose Personal Health Information Form

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R20GI
Subject: Medicare Authorization to Disclose Personal Health Information" form and "Information to Help You Fill Out the Medicare Authorization to Disclose Personal Health Information Form
CR #: 3485
Job Aid #: N/A

Demonstration Project for Medical Adult Day-Care Services

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R17DEMO
Subject: Demonstration Project for Medical Adult Day-Care Services
CR #: 3660
Job Aid #: JA3660

Revision of Appendix P and certain Exhibits of the State Operations Manual

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R9SOM
Subject: Revision of Appendix P and certain Exhibits of the State Operations Manual
CR #: N/A
Job Aid #: N/A

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R455CP
Subject: Number of Drug Pricing Files That Must Be Maintained Online for Medicare - DMERC Only
CR #: 3584
Job Aid #: N/A

List of Medicare Telehealth Services

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R517CP
Subject: List of Medicare Telehealth Services
CR #: 3747
Job Aid #: JA3747

Update to Repetitive Billing -- Manualization

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R711CP
Subject: Update to Repetitive Billing -- Manualization
CR #: 4047
Job Aid #: JA4047

Manualization of Payment Change for Diagnostic Mammography and Diagnostic Computer Aided Detection

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R482CP
Subject: Manualization of Payment Change for Diagnostic Mammography and Diagnostic Computer Aided Detection
CR #: 3662
Job Aid #: N/A

Development of New Report to Capture BIPA and MMA Appeals Data

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R76FM
Subject: Development of New Report to Capture BIPA and MMA Appeals Data
CR #: 3837
Job Aid #: N/A

Competitive Acquisition Program (CAP) for Part B Drugs

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R699CP
Subject: Competitive Acquisition Program (CAP) for Part B Drugs
CR #: 4064
Job Aid #: JA4064

Medical Review Additional Documentation Requests

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R125PI
Subject: Medical Review Additional Documentation Requests
CR #: 4022
Job Aid #: JA4022

Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for FI Initial Determinations Issued on or After May 1, 2005 and Carrier Initial Determinations Issued on or After January 1, 2006)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R677CP
Subject: Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for FI Initial Determinations Issued on or After May 1, 2005 and Carrier Initial Determinations Issued on or After January 1, 2006)
CR #: 3939
Job Aid #: JA3939

Coordination of Benefits Agreement (COBA) Process for Contractor Financial Staff Notification

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R78FM
Subject: Coordination of Benefits Agreement (COBA) Process for Contractor Financial Staff Notification
CR #: 4016
Job Aid #: N/A

Percutaneous Transluminal Angioplasty (PTA)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R531CP
Subject: Percutaneous Transluminal Angioplasty (PTA)
CR #: 3811
Job Aid #: JA3811

Revision of Chapter 24, EDI Support Requirements

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R615CP
Subject: Revision of Chapter 24, EDI Support Requirements
CR #: 3875
Job Aid #: N/A

Preliminary Instructions: Expedited Determinations/Reviews for Original Medicare

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R577CP
Subject: Preliminary Instructions: Expedited Determinations/Reviews for Original Medicare
CR #: 3903
Job Aid #: N/A

Abarelix for the Treatment of Abarelix for the Treatment of Prostate Cancer Cancer

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R34NCD
Subject: Abarelix for the Treatment of Abarelix for the Treatment of Prostate Cancer Cancer
CR #: 3775
Job Aid #: JA3775

Assignment of Non-Payment/Denial Code specific to the Recovery Audit Contractor (RAC) Created Group Health Plan (GHP) Occurrences

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R29MSP
Subject: Assignment of Non-Payment/Denial Code specific to the Recovery Audit Contractor (RAC) Created Group Health Plan (GHP) Occurrences
CR #: 3770
Job Aid #: N/A

Clarification of the Verification Process to be Used to Determine if the Inpatient Rehabilitation Facility (IRF) Meets The IRF Classification Criteria

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R478CP
Subject: Clarification of the Verification Process to be Used to Determine if the Inpatient Rehabilitation Facility (IRF) Meets The IRF Classification Criteria
CR #: 3704
Job Aid #: N/A

Instructions for Affiliated Contractors Involved in the Recovery Audit Contractor (RAC) Demonstrations

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R24DEMO
Subject: Instructions for Affiliated Contractors Involved in the Recovery Audit Contractor (RAC) Demonstrations
CR #: 3773
Job Aid #: N/A

Review of Contractor Implementation of Change Requests (Replacement for expired CR 944).

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R17GI
Subject: Review of Contractor Implementation of Change Requests (Replacement for expired CR 944).
CR #: 2884
Job Aid #: N/A

Procedures for Modifying Shared Systems Edits and Capturing Audit Trail Data

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R23GI
Subject: Procedures for Modifying Shared Systems Edits and Capturing Audit Trail Data
CR #: 3862
Job Aid #: N/A

Notification to Affiliated Contractors of the establishment of Medicare Secondary Payer (MSP) Recovery Audit Contractors (RACs) and the impact to the Affiliated Contractors current MSP recovery processes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R19DEMO
Subject: Notification to Affiliated Contractors of the establishment of Medicare Secondary Payer (MSP) Recovery Audit Contractors (RACs) and the impact to the Affiliated Contractors current MSP recovery processes
CR #: 3724
Job Aid #: N/A

Revise the Fiscal Intermediary Shared System (FISS) to Allow Reporting of Data for the Comprehensive Error Rate Testing (CERT) Program Resolution File at a Line Level

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R116PI
Subject: Revise the Fiscal Intermediary Shared System (FISS) to Allow Reporting of Data for the Comprehensive Error Rate Testing (CERT) Program Resolution File at a Line Level
CR #: 3997
Job Aid #: N/A

Psychotherapy Notes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R98PI
Subject: Psychotherapy Notes
CR #: 3457
Job Aid #: JA3457

Consent Settlements

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R96PI
Subject: Consent Settlements
CR #: 3626
Job Aid #: N/A

New Location for Contractor ID Number on Medicare Summary Notices (MSNs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R587CP
Subject: New Location for Contractor ID Number on Medicare Summary Notices (MSNs)
CR #: 3895
Job Aid #: N/A

Enforcement of Mandatory Electronic Submission of Medicare Claims.

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R435CP
Subject: Enforcement of Mandatory Electronic Submission of Medicare Claims.
CR #: 3440
Job Aid #: N/A

New Coding for FDG PET Scans and Billing Requirements for Specific Indications of Cervical Cancer

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R518CP
Subject: New Coding for FDG PET Scans and Billing Requirements for Specific Indications of Cervical Cancer
CR #: 3741
Job Aid #: JA3741

Flu/PPV Revisions

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R519CP
Subject: Flu/PPV Revisions
CR #: 3733
Job Aid #: N/A

Clarification to the Health Professional Shortage Area Language in the Medicare Claims Processing Manual

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R524CP
Subject: Clarification to the Health Professional Shortage Area Language in the Medicare Claims Processing Manual
CR #: 3736
Job Aid #: JA3736

Changing the Order of Medicare System Edits Affecting Hospice Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R552CP
Subject: Changing the Order of Medicare System Edits Affecting Hospice Claims
CR #: 3825
Job Aid #: N/A

April Update to the Medicare Non-OPPS Outpatient Code Editor (OCE) Specifications Version 20.2

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R503CP
Subject: April Update to the Medicare Non-OPPS Outpatient Code Editor (OCE) Specifications Version 20.2
CR #: 3750
Job Aid #: N/A

Cost Reporting Forms and Instructions, Form CMS-222-92

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R7P229
Subject: Cost Reporting Forms and Instructions, Form CMS-222-92
CR #: N/A
Job Aid #: N/A

New Waived Tests

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R642CP
Subject: New Waived Tests
CR #: 3984
Job Aid #: JA3984

Instructions for Implementation of CMS Ruling 05-01; Presbyopia-Correcting Intraocular Lens (P-C IOLs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R636CP
Subject: Instructions for Implementation of CMS Ruling 05-01; Presbyopia-Correcting Intraocular Lens (P-C IOLs)
CR #: 3927
Job Aid #: JA3927

Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, and Hepatitis B Virus) and their Administration at Renal Dialysis Facilities (RDFs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R634CP
Subject: Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, and Hepatitis B Virus) and their Administration at Renal Dialysis Facilities (RDFs)
CR #: 3936
Job Aid #: JA3936

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R606CP
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

Modification to the Appeals Language on the Medicare Summary Notice; Full Replacement of Change Request 3808

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R603CP
Subject: Modification to the Appeals Language on the Medicare Summary Notice; Full Replacement of Change Request 3808
CR #: 3924
Job Aid #: N/A

Smoking and Tobacco-Use Cessation Counseling

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R562CP
Subject: Smoking and Tobacco-Use Cessation Counseling
CR #: 3834
Job Aid #: JA3834

Update to the Evaluation Plan for the CD-ROM Initiative Used in the Mailing of the 2005 Annual Participation Enrollment Material

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R139OTN
Subject: Update to the Evaluation Plan for the CD-ROM Initiative Used in the Mailing of the 2005 Annual Participation Enrollment Material
CR #: 3700
Job Aid #: N/A

Revision to the Beneficiary Notification Process when Recovery is Sought from the Provider

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R70FM
Subject: Revision to the Beneficiary Notification Process when Recovery is Sought from the Provider
CR #: 3795
Job Aid #: N/A

Pub. 100-02, Chapter 15, Sections 220 and 230 Therapy Services

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R36BP
Subject: Pub. 100-02, Chapter 15, Sections 220 and 230 Therapy Services
CR #: 3648
Job Aid #: JA3648

1st Update to the 2005 Medicare Physician Fee Schedule Database

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R475CP
Subject: 1st Update to the 2005 Medicare Physician Fee Schedule Database
CR #: 3726
Job Aid #: N/A

Revisions to Chapter 5, Section 50 of Publication 100-01 in the IOM to Clarify Current Policy

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R19GI
Subject: Revisions to Chapter 5, Section 50 of Publication 100-01 in the IOM to Clarify Current Policy
CR #: 3698
Job Aid #: N/A

Revision of Appendix PP - Section 483.25(d) - Urinary Incontinence, Tags F315 and F316

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R8SOM
Subject: Revision of Appendix PP - Section 483.25(d) - Urinary Incontinence, Tags F315 and F316
CR #: N/A
Job Aid #: N/A

Modifications to the National Coordination of Benefits Agreement (COBA) File Transfer and Financial Reporting Processes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R586CP
Subject: Modifications to the National Coordination of Benefits Agreement (COBA) File Transfer and Financial Reporting Processes
CR #: 3906
Job Aid #: N/A

Modification of Roster Billing for Mass Immunizers Billing for Inpatient Part B Services (Type of Bills 12x and 22x)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R542CP
Subject: Modification of Roster Billing for Mass Immunizers Billing for Inpatient Part B Services (Type of Bills 12x and 22x)
CR #: 3735
Job Aid #: N/A

2005 Scheduled Release for October Updates to Software Programs and Pricing/Coding Files

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R29GI
Subject: 2005 Scheduled Release for October Updates to Software Programs and Pricing/Coding Files
CR #: 3999
Job Aid #: N/A

New Thresholds for 2nd Demand Letter for Physicians/Suppliers

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R75FM
Subject: New Thresholds for 2nd Demand Letter for Physicians/Suppliers
CR #: 3932
Job Aid #: N/A

Update to 100-04 and Therapy Code Lists

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R463CP
Subject: Update to 100-04 and Therapy Code Lists
CR #: 3647
Job Aid #: N/A

Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2006

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R680CP
Subject: Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2006
CR #: 4037
Job Aid #: N/A

Evidence of Medical Necesity: Wheelchair and Power Operated Vehicle (POV) Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R121PI
Subject: Evidence of Medical Necesity: Wheelchair and Power Operated Vehicle (POV) Claims
CR #: 3952
Job Aid #: JA3952

Update to Fiscal Year 2005 Pricer for IPPS Hospitals

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R510CP
Subject: Update to Fiscal Year 2005 Pricer for IPPS Hospitals
CR #: 3784
Job Aid #: N/A

Working Aged Exception for Small Employers in Multi-Employer Group Health Plans (GHPs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R28MSP
Subject: Working Aged Exception for Small Employers in Multi-Employer Group Health Plans (GHPs)
CR #: 3768
Job Aid #: N/A

Standard Terminology for Claims Processing Systems

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R16GI
Subject: Standard Terminology for Claims Processing Systems
CR #: 3596
Job Aid #: N/A

Provider Extract File

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R22GI
Subject: Provider Extract File
CR #: 3801
Job Aid #: N/A

Demonstration Project to Clarify the Definition of Homebound, the Home Health Independence Demonstration

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R18DEMO
Subject: Demonstration Project to Clarify the Definition of Homebound, the Home Health Independence Demonstration
CR #: 3665
Job Aid #: N/A

Additions and Corrections to Provider Inquiry and Provider Communications Program Requirements

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R9COM
Subject: Additions and Corrections to Provider Inquiry and Provider Communications Program Requirements
CR #: 3777
Job Aid #: N/A

Program Integrity Manual Modification - Changes Waivers Approved by the Regional Office (RO) by Replacing Regional Office with Central Office (CO)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R99PI
Subject: Program Integrity Manual Modification - Changes Waivers Approved by the Regional Office (RO) by Replacing Regional Office with Central Office (CO)
CR #: 3646
Job Aid #: N/A

National Modifier and Condition Code To Be Used To Identify Disaster Related Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R184OTN
Subject: National Modifier and Condition Code To Be Used To Identify Disaster Related Claims
CR #: 4106
Job Aid #: N/A

Preliminary system updates in preparation for ending the Medicare contingency plan in October 2005

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R171OTN
Subject: Preliminary system updates in preparation for ending the Medicare contingency plan in October 2005
CR #: 3956
Job Aid #: JA3956

Abarelix for the Treatment of Prostate Cancer

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R532CP
Subject: Abarelix for the Treatment of Prostate Cancer
CR #: 3775
Job Aid #: JA3775

October Update to the 2005 Medicare Physician Fee Schedule Database

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R661CP
Subject: October Update to the 2005 Medicare Physician Fee Schedule Database
CR #: 4031
Job Aid #: N/A

Common Working File (CWF) Unsolicited Response Adjustments for Certain Claims Denied Due to an Open Medicare Secondary Payer (MSP) Group Health Plan (GHP) Record Where the GHP Record was Subsequently Deleted

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R624CP
Subject: Common Working File (CWF) Unsolicited Response Adjustments for Certain Claims Denied Due to an Open Medicare Secondary Payer (MSP) Group Health Plan (GHP) Record Where the GHP Record was Subsequently Deleted
CR #: 3916
Job Aid #: N/A

Clarifying Manual Instructions for Coding and Payment for Drug Administration Under the Hospital Outpatient Prospective Payment System (OPPS)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R566CP
Subject: Clarifying Manual Instructions for Coding and Payment for Drug Administration Under the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 3848
Job Aid #: JA3848

Update to the Healthcare Provider Taxonomy Codes (HPTC) Version 5.1

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R694CP
Subject: Update to the Healthcare Provider Taxonomy Codes (HPTC) Version 5.1
CR #: 4072
Job Aid #: N/A

Fiscal Year (FY) 2006 Payment for Services Furnished in Ambulatory Surgical Centers (ASCs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R690CP
Subject: Fiscal Year (FY) 2006 Payment for Services Furnished in Ambulatory Surgical Centers (ASCs)
CR #: 4075
Job Aid #: N/A

Telehealth Originating Site Facility Fee Payment Amount Update

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R29BP
Subject: Telehealth Originating Site Facility Fee Payment Amount Update
CR #: 3713
Job Aid #: N/A

One Time Update To The NCPDP Companion Document Regarding Crossover Claims To Medicaid

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R689CP
Subject: One Time Update To The NCPDP Companion Document Regarding Crossover Claims To Medicaid
CR #: 3975
Job Aid #: N/A

The Medicare Care Management for High Cost Beneficiaries (CMHCB) Demonstration

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R28DEMO
Subject: The Medicare Care Management for High Cost Beneficiaries (CMHCB) Demonstration
CR #: 4100
Job Aid #: JA4100

Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 11.2, Effective July 1, 2005

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R563CP
Subject: Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 11.2, Effective July 1, 2005
CR #: 3823
Job Aid #: N/A

July Update to the Medicare Outpatient Code Editor (OCE) Version 20.3 for Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System (Non-OPPS)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R564CP
Subject: July Update to the Medicare Outpatient Code Editor (OCE) Version 20.3 for Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System (Non-OPPS)
CR #: 3867
Job Aid #: N/A

Requirements for Voided, Canceled, and Deleted Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R159OTN
Subject: Requirements for Voided, Canceled, and Deleted Claims
CR #: 3627
Job Aid #: N/A

Appeals Transition- BIPA Section 521 App

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R146OTN
Subject: Appeals Transition- BIPA Section 521 App
CR #: 3530
Job Aid #: JA3530

Initial Publication of Chapter 1 - General Provisions

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R68MCM
Subject: Initial Publication of Chapter 1 - General Provisions
CR #: N/A
Job Aid #: N/A

Notice of New Interest Rate for Medicare Overpayments and Underpayments

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R63FM
Subject: Notice of New Interest Rate for Medicare Overpayments and Underpayments
CR #: 3454
Job Aid #: N/A

Definitions of Electronic and Paper Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R454CP
Subject: Definitions of Electronic and Paper Claims
CR #: 3653
Job Aid #: N/A

Competitive Acquisition Program for Part B Drugs - Coding, Testing, and Implementation

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R649CP
Subject: Competitive Acquisition Program for Part B Drugs - Coding, Testing, and Implementation
CR #: 4000
Job Aid #: N/A

Revision of Change Request 2928: Implementation of Payment Safeguards for Home Health Prospective Payment System (HH PPS) Claims Failing to Report Prior Hospitalizations

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R427CP
Subject: Revision of Change Request 2928: Implementation of Payment Safeguards for Home Health Prospective Payment System (HH PPS) Claims Failing to Report Prior Hospitalizations
CR #: 3616
Job Aid #: JA3616

Update to Billing Requirements for FDG-PET Scans for Use in the Differential Diagnosis of Alzheimer's Disease (AD) and Fronto-Temporal Dementia (FTD) and Update to the FI Billing Requirements for Special Payment Procedures for ALL PET Scan Claims for Services Performed in a Critical Access Hospital (CAH)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R428CP
Subject: Update to Billing Requirements for FDG-PET Scans for Use in the Differential Diagnosis of Alzheimer's Disease (AD) and Fronto-Temporal Dementia (FTD) and Update to the FI Billing Requirements for Special Payment Procedures for ALL PET Scan Claims for Services Performed in a Critical Access Hospital (CAH)
CR #: 3640
Job Aid #: N/A

July Update to the 2005 Medicare Physician Fee Schedule Database

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R558CP
Subject: July Update to the 2005 Medicare Physician Fee Schedule Database
CR #: 3870
Job Aid #: N/A

Update To The Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer For FY 2006

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R663CP
Subject: Update To The Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer For FY 2006
CR #: 3977
Job Aid #: JA3977

Working Aged Exception for Small Employers in Multi-Employer Group Health Plans (GHPs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R33MSP
Subject: Working Aged Exception for Small Employers in Multi-Employer Group Health Plans (GHPs)
CR #: 3768
Job Aid #: N/A

Modifications to Duplicate Editing for Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Anti-Emetic, Immunosuppressive and Inhalation Drugs

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R467CP
Subject: Modifications to Duplicate Editing for Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Anti-Emetic, Immunosuppressive and Inhalation Drugs
CR #: 3666
Job Aid #: JA3666

Appeals Transition- BIPA Section 521 Appeals

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R468CP
Subject: Appeals Transition- BIPA Section 521 Appeals
CR #: 3635
Job Aid #: N/A

Discovery Code Indication for Recovery Audit Contractor (RAC) Non-MSP Identified Overpayments

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R79FM
Subject: Discovery Code Indication for Recovery Audit Contractor (RAC) Non-MSP Identified Overpayments
CR #: 3938
Job Aid #: N/A

Discontinuation of the Skilled Nursing Facility (SNF) HCPCS Help File and Notification to Fiscal Intermediaries (FIs) and Providers of the Redesigned SNF Consolidated Billing (CB) Annual Update File Posted on CMS Web Site

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R685CP
Subject: Discontinuation of the Skilled Nursing Facility (SNF) HCPCS Help File and Notification to Fiscal Intermediaries (FIs) and Providers of the Redesigned SNF Consolidated Billing (CB) Annual Update File Posted on CMS Web Site
CR #: 4044
Job Aid #: JA4044

Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for All Requests for Redetermination Received by FIs on or After May 1, 2005, And All Requests for Redetermination Received by Carriers on or After January 1, 2006)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R678CP
Subject: Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for All Requests for Redetermination Received by FIs on or After May 1, 2005, And All Requests for Redetermination Received by Carriers on or After January 1, 2006)
CR #: 3944
Job Aid #: JA3944

National Modifier and Condition Code To Be Used To Identify Disaster Related Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R183OTN
Subject: National Modifier and Condition Code To Be Used To Identify Disaster Related Claims
CR #: 4106
Job Aid #: N/A

Correction to Change Request 3949, Section 50.3.3 in IOM to Add 23x Type of Bill

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R712CP
Subject: Correction to Change Request 3949, Section 50.3.3 in IOM to Add 23x Type of Bill
CR #: 4116
Job Aid #: N/A

Override of Automated Health Professional Shortage Area (HRSA) and/or Physician Scarcity Area (PSA) Bonus Payments for Globally Billed Services

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R559CP
Subject: Override of Automated Health Professional Shortage Area (HRSA) and/or Physician Scarcity Area (PSA) Bonus Payments for Globally Billed Services
CR #: 3827
Job Aid #: N/A

Flu/PPV Revision

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R525CP
Subject: Flu/PPV Revision
CR #: 3733
Job Aid #: N/A

Number of DMEPOS Pricing Files That Must Be Maintained Online for Medicare - DMERC, FI, and RHHI Only

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R546CP
Subject: Number of DMEPOS Pricing Files That Must Be Maintained Online for Medicare - DMERC, FI, and RHHI Only
CR #: 3792
Job Aid #: N/A

Update to the Place of Service (POS) Code Set to Add a Code for Pharmacy

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R549CP
Subject: Update to the Place of Service (POS) Code Set to Add a Code for Pharmacy
CR #: 3819
Job Aid #: JA3819

Correction to Healthcare Common Procedure Coding System (HCPCS) Code A4217

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R489CP
Subject: Correction to Healthcare Common Procedure Coding System (HCPCS) Code A4217
CR #: 3714
Job Aid #: JA3714

Adding an Indicator to the National Claims History (NCH) to Indicate that DMERCs, Carriers, and FIs have Reviewed a Potentially Duplicate Claim

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R492CP
Subject: Adding an Indicator to the National Claims History (NCH) to Indicate that DMERCs, Carriers, and FIs have Reviewed a Potentially Duplicate Claim
CR #: 2965
Job Aid #: N/A

Osteogenic Stimulators

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R41NCD
Subject: Osteogenic Stimulators
CR #: 3836
Job Aid #: JA3836

Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)--Further Clarifications

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R495CP
Subject: Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)--Further Clarifications
CR #: 3752
Job Aid #: JA3752

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2005

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R500CP
Subject: Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2005
CR #: 3722
Job Aid #: N/A

Common Working File Expansion of Duplicate Claim Edit for Clinical Diagnostic Services

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R626CP
Subject: Common Working File Expansion of Duplicate Claim Edit for Clinical Diagnostic Services
CR #: 3946
Job Aid #: JA3946

New HCPCS Codes and Systems Edits for Supplies and Accessories for Ventricular Assist Devices - Full Replacement of CR 3761

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R613CP
Subject: New HCPCS Codes and Systems Edits for Supplies and Accessories for Ventricular Assist Devices - Full Replacement of CR 3761
CR #: 3931
Job Aid #: N/A

New Health Professional Shortage Area (HPSA) Modifier

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R608CP
Subject: New Health Professional Shortage Area (HPSA) Modifier
CR #: 3935
Job Aid #: JA3935

Correction to Chapter 17, Section 80.2.3, MSN/ANSI X12N Denial Messages for Anti-Emetic Drugs

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R576CP
Subject: Correction to Chapter 17, Section 80.2.3, MSN/ANSI X12N Denial Messages for Anti-Emetic Drugs
CR #: 3918
Job Aid #: N/A

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R568CP
Subject: July Quarterly Update to 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
CR #: 3873
Job Aid #: N/A

PET for Brain, Cervical, Ovarian, Pancreatic, Small Cell Lung, and Testicular Cancers

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R31NCD
Subject: PET for Brain, Cervical, Ovarian, Pancreatic, Small Cell Lung, and Testicular Cancers
CR #: 3741
Job Aid #: JA3741

Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R35NCD
Subject: Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA)
CR #: 3843
Job Aid #: N/A

New April 2005 Quarterly ASP Medicare Part B Drug Pricing File and Revisions to January 2005 Quarterly ASP Medicare Part B Drug Pricing File

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R561CP
Subject: New April 2005 Quarterly ASP Medicare Part B Drug Pricing File and Revisions to January 2005 Quarterly ASP Medicare Part B Drug Pricing File
CR #: 3846
Job Aid #: N/A

Instructions for Fiscal Intermediary Standard System (FISS) and Multi-Carrier System (MCS) Healthcare Integrated General Ledger Accounting System (HIGLAS) Changes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R162OTN
Subject: Instructions for Fiscal Intermediary Standard System (FISS) and Multi-Carrier System (MCS) Healthcare Integrated General Ledger Accounting System (HIGLAS) Changes
CR #: 3757
Job Aid #: N/A

Revised Coding Guidelines for Drug Administration Codes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R148OTN
Subject: Revised Coding Guidelines for Drug Administration Codes
CR #: 3818
Job Aid #: N/A

Common Working File (CWF) Calculation of Next Eligible Date for Preventive Services

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R151OTN
Subject: Common Working File (CWF) Calculation of Next Eligible Date for Preventive Services
CR #: 3776
Job Aid #: N/A

Shared System and CWF Renovation of Override Code Process (Phase 3)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R141OTN
Subject: Shared System and CWF Renovation of Override Code Process (Phase 3)
CR #: 3718
Job Aid #: N/A

Frequent Hemodialysis Network Payment Changes for Approved Clinical Trial Co

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R142OTN
Subject: Frequent Hemodialysis Network Payment Changes for Approved Clinical Trial Co
CR #: 3730
Job Aid #: N/A

Chapter 7, Internal Control Requirements Update

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R66FM
Subject: Chapter 7, Internal Control Requirements Update
CR #: 3655
Job Aid #: N/A

Notice of New Interest Rate for Medicare Overpayments and Underpayments

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R67FM
Subject: Notice of New Interest Rate for Medicare Overpayments and Underpayments
CR #: 3455
Job Aid #: N/A

Infusion Pumps: C-Peptide Levels as A Criterion for Use

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R513CP
Subject: Infusion Pumps: C-Peptide Levels as A Criterion for Use
CR #: 3705
Job Aid #: JA3705

Update to 100-04 and Therapy Code Lists

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R515CP
Subject: Update to 100-04 and Therapy Code Lists
CR #: 3647
Job Aid #: JA3647

Type of Service (TOS) Correctionss

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R476CP
Subject: Type of Service (TOS) Correctionss
CR #: 3717
Job Aid #: N/A

Clarification for Change Request (CR) 3267 for Change Request (CR) 3267

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R26MSP
Subject: Clarification for Change Request (CR) 3267 for Change Request (CR) 3267
CR #: 3729
Job Aid #: JA3729

The Medicare Chronic Care improvement, "Medicare Health Support," Program

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R26DEMO
Subject: The Medicare Chronic Care improvement, "Medicare Health Support," Program
CR #: 3953
Job Aid #: JA3953

Full Replacement of CR 3639, Expansion of Coverage for Chiropractic Services Demonstration

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R21DEMO
Subject: Full Replacement of CR 3639, Expansion of Coverage for Chiropractic Services Demonstration
CR #: 3758
Job Aid #: N/A

Assignment of Non-Payment/Denial Code specific to the Recovery Audit Contractor (RAC) Created Group Health Plan (GHP) Occurrences

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R22DEMO
Subject: Assignment of Non-Payment/Denial Code specific to the Recovery Audit Contractor (RAC) Created Group Health Plan (GHP) Occurrences
CR #: 3770
Job Aid #: N/A

July 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R599CP
Subject: July 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 3915
Job Aid #: JA3915

Coverage and Billing for Ultrasound Stimulation for Nounion Fracture Healing

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R597CP
Subject: Coverage and Billing for Ultrasound Stimulation for Nounion Fracture Healing
CR #: 3836
Job Aid #: JA3836

Provider Enrollment and Inpatient Rehabilitation Facility (IRF) Compliance Reviews

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R97PI
Subject: Provider Enrollment and Inpatient Rehabilitation Facility (IRF) Compliance Reviews
CR #: 3582
Job Aid #: N/A

Change in Statistical Sampling Instructions

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R114PI
Subject: Change in Statistical Sampling Instructions
CR #: 3734
Job Aid #: N/A

Cochlear Implantation

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R589CP
Subject: Cochlear Implantation
CR #: 3796
Job Aid #: JA3796

CWF Editing for Method Selection on DMERC Claims for EPO and Aranesp

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R447CP
Subject: CWF Editing for Method Selection on DMERC Claims for EPO and Aranesp
CR #: 3547
Job Aid #: JA3547

Hemophilia Blood Clotting Fact

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R521CP
Subject: Hemophilia Blood Clotting Fact
CR #: 3755
Job Aid #: JA3755

Addition to Chapter 6 of the Claims Processing Manual - Skilled Nursing Facility (SNF) Inpatient Part A Billing: SNF Prospective Payment System (PPS) Pricer Software

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R540CP
Subject: Addition to Chapter 6 of the Claims Processing Manual - Skilled Nursing Facility (SNF) Inpatient Part A Billing: SNF Prospective Payment System (PPS) Pricer Software
CR #: 3774
Job Aid #: JA3774

Full Replacement of Change Request (CR) 3427, Transmittal 342, Issued on October 29, 2004- 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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R459CP
Subject: Full Replacement of Change Request (CR) 3427, Transmittal 342, Issued on October 29, 2004- 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 #: 3676
Job Aid #: JA3676

Services Not Provided Within United States

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R654CP
Subject: Services Not Provided Within United States
CR #: 3781
Job Aid #: N/A

Guidelines For Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, And Hepatitis B Virus) and Their Administration Provided by Indian Health Service (IHS)/Tribally Owned and/or Operated Hospitals and Hospital Based Facilities

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R633CP
Subject: Guidelines For Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, And Hepatitis B Virus) and Their Administration Provided by Indian Health Service (IHS)/Tribally Owned and/or Operated Hospitals and Hospital Based Facilities
CR #: 3967
Job Aid #: N/A

Billing Requirements for Physician Services Rendered in Method II Critical Access Hospitals (CAHs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R530CP
Subject: Billing Requirements for Physician Services Rendered in Method II Critical Access Hospitals (CAHs)
CR #: 3800
Job Aid #: JA3800

October 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.3

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R660CP
Subject: October 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.3
CR #: 4007
Job Aid #: N/A

Dispensing/Supply Fee Code, Payment, and Common Working File (CWF) Editing for Immunosuppressive Drugs

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R551CP
Subject: Dispensing/Supply Fee Code, Payment, and Common Working File (CWF) Editing for Immunosuppressive Drugs
CR #: 3830
Job Aid #: N/A

Fiscal Intermediary (FI) Reporting of Add-on-Payments that do not Result in a Specific Increase or Decrease in the Amount Reported as Payable for a Claim or a Service on a Remittance Advice

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R555CP
Subject: Fiscal Intermediary (FI) Reporting of Add-on-Payments that do not Result in a Specific Increase or Decrease in the Amount Reported as Payable for a Claim or a Service on a Remittance Advice
CR #: 3866
Job Aid #: N/A

Medicare Qualifying Clinical Trials

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R487CP
Subject: Medicare Qualifying Clinical Trials
CR #: 3625
Job Aid #: N/A

Implantable Automatic Defibrillators

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R488CP
Subject: Implantable Automatic Defibrillators
CR #: 3604
Job Aid #: N/A

Claims Status Code/Claims Status Category Code Update

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R490CP
Subject: Claims Status Code/Claims Status Category Code Update
CR #: 3715
Job Aid #: JA3715

Revision to Chapter 1, and Removal of Section 70 from Chapter 25 of the Medicare Claims Processing Manual

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R493CP
Subject: Revision to Chapter 1, and Removal of Section 70 from Chapter 25 of the Medicare Claims Processing Manual
CR #: 3671
Job Aid #: N/A

April 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.1

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R494CP
Subject: April 2005 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 6.1
CR #: 3743
Job Aid #: JA3743

Revision - Appendix J - Interpretive Guidelines Intermediate Care Facilities With Mental Retardation

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R10SOM
Subject: Revision - Appendix J - Interpretive Guidelines Intermediate Care Facilities With Mental Retardation
CR #: N/A
Job Aid #: N/A

Billing for Blood and Blood Products Under the Hospital Outpatient Prospective Payment System (OPPS)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R496CP
Subject: Billing for Blood and Blood Products Under the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 3681
Job Aid #: JA3681

Cost Reporting Forms and Instructions, Form CMS-2552-96

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R14P236
Subject: Cost Reporting Forms and Instructions, Form CMS-2552-96
CR #: N/A
Job Aid #: N/A

New Low Osmolar Contrast Material (LOCM) HCPCS Codes/Payment Criteria/Payment Level

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R627CP
Subject: New Low Osmolar Contrast Material (LOCM) HCPCS Codes/Payment Criteria/Payment Level
CR #: 3902
Job Aid #: JA3902

Competitive Acquisition Program for Part B Drugs - Coding, Testing, and Implementation

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R625CP
Subject: Competitive Acquisition Program for Part B Drugs - Coding, Testing, and Implementation
CR #: 4000
Job Aid #: N/A

Certified Registered Nurse Anesthetist (CRNA) Pass-Through Payments

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R616CP
Subject: Certified Registered Nurse Anesthetist (CRNA) Pass-Through Payments
CR #: 3833
Job Aid #: JA3833

Remittance Advice Remark Code and Claim Adjustment Reason Code Update

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R609CP
Subject: Remittance Advice Remark Code and Claim Adjustment Reason Code Update
CR #: 3923
Job Aid #: N/A

Infusion Pumps: C-Peptide Levels as A Criterion for Use

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R27NCD
Subject: Infusion Pumps: C-Peptide Levels as A Criterion for Use
CR #: 3705
Job Aid #: JA3705

New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R575CP
Subject: New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims
CR #: 3679
Job Aid #: JA3679

Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R567CP
Subject: Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials
CR #: 3742
Job Aid #: N/A

Autologous Stem Cell Transplantation (AuSCT)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R32NCD
Subject: Autologous Stem Cell Transplantation (AuSCT)
CR #: 3797
Job Aid #: JA3797

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R157OTN
Subject: CD-ROM Initiative for Distribution of the Annual Disclosure, "Dear Doctor" Letter and Participation Enrollment Material
CR #: 3891
Job Aid #: N/A

Chapter 3, MMA Section 935

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R123PI
Subject: Chapter 3, MMA Section 935
CR #: 3703
Job Aid #: N/A

National Modifier and Condition Code To Be Used To Identify Disaster Related Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R181OTN
Subject: National Modifier and Condition Code To Be Used To Identify Disaster Related Claims
CR #: 4106
Job Aid #: N/A

Medicare HIPAA Electronic Claims Report - Second Reporting Timeframe Extension

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R147OTN
Subject: Medicare HIPAA Electronic Claims Report - Second Reporting Timeframe Extension
CR #: 3780
Job Aid #: N/A

Instructions for Affiliated Contractors Involved in the Recovery Audit Contractor (RAC) Demonstrations

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R68FM
Subject: Instructions for Affiliated Contractors Involved in the Recovery Audit Contractor (RAC) Demonstrations
CR #: 3773
Job Aid #: N/A

Type of Service (TOS) Corrections

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R511CP
Subject: Type of Service (TOS) Corrections
CR #: 3788
Job Aid #: N/A

Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R512CP
Subject: Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials
CR #: 3742
Job Aid #: JA3742

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R514CP
Subject: April 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes
CR #: 3756
Job Aid #: N/A

Updates to the Electronic Correspondence Referral System (ECRS) User Guide v8.0 and Quick Reference Card v8.0

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R27MSP
Subject: Updates to the Electronic Correspondence Referral System (ECRS) User Guide v8.0 and Quick Reference Card v8.0
CR #: 3787
Job Aid #: N/A

Review of Contractor Implementation of Change Requests (Replacement for expired CR 944).

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R15GI
Subject: Review of Contractor Implementation of Change Requests (Replacement for expired CR 944).
CR #: 2884
Job Aid #: N/A

Removal of Medicare Number from Reimbursement Checks

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R21GI
Subject: Removal of Medicare Number from Reimbursement Checks
CR #: 3760
Job Aid #: N/A

New Healthcare Common Procedure Coding System (HCPCS) Drug Codes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R600CP
Subject: New Healthcare Common Procedure Coding System (HCPCS) Drug Codes
CR #: 3847
Job Aid #: JA3847

Implementation of Carrier Guidelines for End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests (Supplemental to Change Request 2813)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R598CP
Subject: Implementation of Carrier Guidelines for End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests (Supplemental to Change Request 2813)
CR #: 3890
Job Aid #: JA3890

Expansion of State Codes for OSCAR Provider Numbers

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R6SOM
Subject: Expansion of State Codes for OSCAR Provider Numbers
CR #: 3844
Job Aid #: N/A

Medicare Beneficiary Call Centers Will Begin Offering Preventive Services Information

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R8COM
Subject: Medicare Beneficiary Call Centers Will Begin Offering Preventive Services Information
CR #: 3706
Job Aid #: N/A

Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R588CP
Subject: Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials
CR #: 3742
Job Aid #: JA3742

Update to the National Council for Prescription Drug Program (NCPDP) Batch Standard 1.1 Billing Request Companion Document

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R579CP
Subject: Update to the National Council for Prescription Drug Program (NCPDP) Batch Standard 1.1 Billing Request Companion Document
CR #: 3882
Job Aid #: JA3882

Payment Policy Clarification Regarding the Healthcare Common Procedure Coding System (HCPCS) Q3001 Performed in an Ambulatory Surgery Center (ASC)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R520CP
Subject: Payment Policy Clarification Regarding the Healthcare Common Procedure Coding System (HCPCS) Q3001 Performed in an Ambulatory Surgery Center (ASC)
CR #: 3789
Job Aid #: JA3789

Hospital Audit Workload Updates

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R38MSP
Subject: Hospital Audit Workload Updates
CR #: 4056
Job Aid #: N/A

2006 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R708CP
Subject: 2006 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments
CR #: 4113
Job Aid #: N/A

October 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R662CP
Subject: October 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 4035
Job Aid #: N/A

Revised Chapter 2--"The Certification Process," Sections 2180E thru 2200F, and Appendix B--"Interpretive Guidelines: Home Health Agencies"

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R11SOM
Subject: Revised Chapter 2--"The Certification Process," Sections 2180E thru 2200F, and Appendix B--"Interpretive Guidelines: Home Health Agencies"
CR #: N/A
Job Aid #: N/A

Fiscal Year (FY) 2006 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH PPS) Changes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R692CP
Subject: Fiscal Year (FY) 2006 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH PPS) Changes
CR #: 4046
Job Aid #: N/A

Evidence of Medical Necessity: Wheelchair and Power Operated Vehicle (POV) Claim

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R124PI
Subject: Evidence of Medical Necessity: Wheelchair and Power Operated Vehicle (POV) Claim
CR #: 3952
Job Aid #: JA3952

Medicare Redetermination Notice and Effect of the Redetermination

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R679CP
Subject: Medicare Redetermination Notice and Effect of the Redetermination
CR #: 4006
Job Aid #: N/A

Chapter 39, Form CMS 287-05

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R1P239
Subject: Chapter 39, Form CMS 287-05
CR #: N/A
Job Aid #: N/A

Timeframe for Continued Execution of Crossover Agreements and Updated on the Transition to the National Coordination of Benefits Agreement (COBA) Program

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R62FM
Subject: Timeframe for Continued Execution of Crossover Agreements and Updated on the Transition to the National Coordination of Benefits Agreement (COBA) Program
CR #: 3658
Job Aid #: N/A

Instructions for Downloading the Medicare Zip Code File

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R453CP
Subject: Instructions for Downloading the Medicare Zip Code File
CR #: 3593
Job Aid #: N/A

Unprocessable Unassigned Form CMS-1500 Claim

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R443CP
Subject: Unprocessable Unassigned Form CMS-1500 Claim
CR #: 3500
Job Aid #: N/A

The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2004 for Inpatient Prospective Payment System (IPPS) Hospitals

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R647CP
Subject: The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2004 for Inpatient Prospective Payment System (IPPS) Hospitals
CR #: 4003
Job Aid #: N/A

Discontinuation of Medical Review Reports -The Medicare Status Report MRS-1), the Report of Benefit Savings (RBS), the Medicare Focused Medical Review Status Report (MFSR), and the Focused Medical Review (FMR) Report

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R103PI
Subject: Discontinuation of Medical Review Reports -The Medicare Status Report MRS-1), the Report of Benefit Savings (RBS), the Medicare Focused Medical Review Status Report (MFSR), and the Focused Medical Review (FMR) Report
CR #: 3701
Job Aid #: N/A

Billing for Blood and Blood Products Under the Hospital Outpatient Prospective Payment System (OPPS)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R18GI
Subject: Billing for Blood and Blood Products Under the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 3681
Job Aid #: JA3681

Full Replacement of CR 3220, Method of Reimbursement for Inpatient Services for Rural Hospitals Participating Under Demonstration Authorized by Section 410A of the Medicare Modernization Act. CR 3220 is rescinded.

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R20DEMO
Subject: Full Replacement of CR 3220, Method of Reimbursement for Inpatient Services for Rural Hospitals Participating Under Demonstration Authorized by Section 410A of the Medicare Modernization Act. CR 3220 is rescinded.
CR #: 3707
Job Aid #: N/A

Revise the Medicare Contractor System (MCS) and the VIPS Medicare System (VMS) to Allow Update of the Comprehensive Error Rate Testing (CERT) Program Resolution File Within Five Business Days of a CERT Request

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R117PI
Subject: Revise the Medicare Contractor System (MCS) and the VIPS Medicare System (VMS) to Allow Update of the Comprehensive Error Rate Testing (CERT) Program Resolution File Within Five Business Days of a CERT Request
CR #: 3996
Job Aid #: N/A

PIM Revision

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R115PI
Subject: PIM Revision
CR #: 3786
Job Aid #: N/A

The Teaching Adjustment for Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R545CP
Subject: The Teaching Adjustment for Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)
CR #: 3809
Job Aid #: JA3809

New Contrast Agents Healthcare Common Procedure Coding System (HCPCS) Codes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R502CP
Subject: New Contrast Agents Healthcare Common Procedure Coding System (HCPCS) Codes
CR #: 3748
Job Aid #: JA3748

Update to Pub 100-04, Chapter 12, Section 200 of the Internet Only Manual

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R504CP
Subject: Update to Pub 100-04, Chapter 12, Section 200 of the Internet Only Manual
CR #: 3732
Job Aid #: N/A

Financial Liability for Services Subject to Home Health Consolidated Billing

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R635CP
Subject: Financial Liability for Services Subject to Home Health Consolidated Billing
CR #: 3948
Job Aid #: JA3948

Medicare Physician Fee Schedule Database (MPFSDB) 2006 File Layout

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R614CP
Subject: Medicare Physician Fee Schedule Database (MPFSDB) 2006 File Layout
CR #: 3889
Job Aid #: N/A

Update-Long Term Care Hospital Prospective Payment System (LTCH PPS) Rate Year 2006

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R578CP
Subject: Update-Long Term Care Hospital Prospective Payment System (LTCH PPS) Rate Year 2006
CR #: 3884
Job Aid #: N/A

Access Process for HIPAA 270/271 (Extranet Only)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R565CP
Subject: Access Process for HIPAA 270/271 (Extranet Only)
CR #: 3883
Job Aid #: JA3883

Manualization for Physician/Practitioner/Supplier Participation Agreement and Assignment Carrier Claims and Carrier Rules for Limiting Charge

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R702CP
Subject: Manualization for Physician/Practitioner/Supplier Participation Agreement and Assignment Carrier Claims and Carrier Rules for Limiting Charge
CR #: 4030
Job Aid #: N/A

Updates to the IRF and SNF Provider Specific File and Changes in Inpatient Rehabilitation Facility Prospective Payment System For FY 2006

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R693CP
Subject: Updates to the IRF and SNF Provider Specific File and Changes in Inpatient Rehabilitation Facility Prospective Payment System For FY 2006
CR #: 4099
Job Aid #: N/A

Kansas Blue Cross Blue Shield Carrier Numbering Issue

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R161OTN
Subject: Kansas Blue Cross Blue Shield Carrier Numbering Issue
CR #: 3876
Job Aid #: N/A

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R150OTN
Subject: Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing
CR #: 3821
Job Aid #: N/A

Prepayment Review of Claims for MR Purposes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R90PI
Subject: Prepayment Review of Claims for MR Purposes
CR #: 3560
Job Aid #: N/A

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R477CP
Subject: New Case-Mix Adjusted End Stage Renal Disease (ESRD) Composite Payment Rates and New Composite Rate Exceptions Window for Pediatric ESRD Facilities
CR #: 3720
Job Aid #: JA3720

Aprepitant for Chemotherapy-Induced Emesis

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R590CP
Subject: Aprepitant for Chemotherapy-Induced Emesis
CR #: 3831
Job Aid #: N/A

Processing Durable Medical Equipment (DME), Orthotics, Prosthetics, Drugs, and Surgical Dressings Claims for Indian Health Services (IHS) and Tribally Owned and Operated Hospitals or Hospital Based Facilities including Critical Access Hospitals (CAHs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R461CP
Subject: Processing Durable Medical Equipment (DME), Orthotics, Prosthetics, Drugs, and Surgical Dressings Claims for Indian Health Services (IHS) and Tribally Owned and Operated Hospitals or Hospital Based Facilities including Critical Access Hospitals (CAHs)
CR #: 3674
Job Aid #: JA3674

Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Critical Access Hospitals (CAHs) that have Elected Method II Payment Option and Bill Physician Services to their Fiscal Intermediaries (FIs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R429CP
Subject: Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Critical Access Hospitals (CAHs) that have Elected Method II Payment Option and Bill Physician Services to their Fiscal Intermediaries (FIs)
CR #: 3561
Job Aid #: JA3561

Correction to the use of Group Codes for The Enforcement of Mandatory Electronic Submission of Medicare Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R541CP
Subject: Correction to the use of Group Codes for The Enforcement of Mandatory Electronic Submission of Medicare Claims
CR #: 3815
Job Aid #: JA3815

Implantable Automatic Defibrillators

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R497CP
Subject: Implantable Automatic Defibrillators
CR #: 3604
Job Aid #: JA3604

IPPS Outlier Reconciliation

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R707CP
Subject: IPPS Outlier Reconciliation
CR #: 3966
Job Aid #: N/A

Guidelines For Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, And Hepatitis B Virus) and Their Administration Provided by Indian Health Service (IHS)/Tribally Owned and/or Operated Hospitals and Hospital Based Facilities

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R681CP
Subject: Guidelines For Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, And Hepatitis B Virus) and Their Administration Provided by Indian Health Service (IHS)/Tribally Owned and/or Operated Hospitals and Hospital Based Facilities
CR #: 3967
Job Aid #: N/A

Unprocessable Unassigned Form CMS-1500 Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R505CP
Subject: Unprocessable Unassigned Form CMS-1500 Claims
CR #: 3500
Job Aid #: JA3500

Inflation Factor

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R428PR1
Subject: Inflation Factor
CR #: N/A
Job Aid #: N/A

New Medicare Summary Notice (MSN) Messages

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R638CP
Subject: New Medicare Summary Notice (MSN) Messages
CR #: 3957
Job Aid #: N/A

Process to Address Freedom of Information and Subpoena Requests

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R30MSP
Subject: Process to Address Freedom of Information and Subpoena Requests
CR #: 3869
Job Aid #: N/A

Production of Provider Flat Files, including Taxpayer Identification Numbers (TIN), from the Fiscal Intermediary Standard System (FISS), Financial Master Files

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R138OTN
Subject: Production of Provider Flat Files, including Taxpayer Identification Numbers (TIN), from the Fiscal Intermediary Standard System (FISS), Financial Master Files
CR #: 3553
Job Aid #: N/A

Clarification for OPPS Hospitals Billing Initial Preventive Physical Exam (IPPE)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R516CP
Subject: Clarification for OPPS Hospitals Billing Initial Preventive Physical Exam (IPPE)
CR #: 3771
Job Aid #: JA3771

Update to Debt Collection System (DCS) User Guide

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R69FM
Subject: Update to Debt Collection System (DCS) User Guide
CR #: 3868
Job Aid #: N/A

Changes in Requirements for Periodic Surveys of Current and Former Enrollees, and in the CMS Method for Calculating Interest on Overpayments and Underpayments to HMOs, CMPs and HCPPS.

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R67MCM
Subject: Changes in Requirements for Periodic Surveys of Current and Former Enrollees, and in the CMS Method for Calculating Interest on Overpayments and Underpayments to HMOs, CMPs and HCPPS.
CR #: N/A
Job Aid #: N/A

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R596CP
Subject: Indian Health Service (IHS) or Tribal Hospitals Including Critical Access Hospital (CAH) Payment Methodology for Inpatient Social Admissions and Outpatient Services Occurring During Concurrent Stays
CR #: 3452
Job Aid #: JA3452

Revision of Appendix PP - Section 483.25(d) - Urinary Incontinence, Tags F315 and F316

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R7SOM
Subject: Revision of Appendix PP - Section 483.25(d) - Urinary Incontinence, Tags F315 and F316
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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R94PI
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 #: 3602
Job Aid #: N/A

Billing Requirements for Physician Services in Method II Critical Access Hospitals (CAHs)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R465CP
Subject: Billing Requirements for Physician Services in Method II Critical Access Hospitals (CAHs)
CR #: 3559
Job Aid #: N/A

New Diagnosis Code Requirements for Method II Home Dialysis Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R701CP
Subject: New Diagnosis Code Requirements for Method II Home Dialysis Claims
CR #: 4095
Job Aid #: N/A

Instructions for Fiscal Intermediaries (FIs) to Process Payment Adjustments Resulting from Data Assessment and Verification (DAVE) Program Safeguard Contractor (PSC) Medical Review

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R158OTN
Subject: Instructions for Fiscal Intermediaries (FIs) to Process Payment Adjustments Resulting from Data Assessment and Verification (DAVE) Program Safeguard Contractor (PSC) Medical Review
CR #: 3799
Job Aid #: N/A

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R77FM
Subject: Non-Medicare Secondary Payer (Non-MSP) Debt Referral and Debt Collection Improvement Act of 1996 (DCIA) Activities
CR #: 3964
Job Aid #: N/A

New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R452CP
Subject: New Remittance Advice (RA) Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims
CR #: 3679
Job Aid #: JA3679

Various Benefit Integrity (BI) Clarifications

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R118PI
Subject: Various Benefit Integrity (BI) Clarifications
CR #: 3896
Job Aid #: N/A

Expansion of Various Alpha and Numeric Fields with in the Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R539CP
Subject: Expansion of Various Alpha and Numeric Fields with in the Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE)
CR #: 3767
Job Aid #: N/A

Addition of CLIA Edits to Certain Health Care Procedure Coding System (HCPCS) Codes for Mohs Surgery

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R434CP
Subject: Addition of CLIA Edits to Certain Health Care Procedure Coding System (HCPCS) Codes for Mohs Surgery
CR #: 3458
Job Aid #: JA3458

Updated Skilled Nursing Facility (SNF) No Pay File for April 2005

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R431CP
Subject: Updated Skilled Nursing Facility (SNF) No Pay File for April 2005
CR #: 3642
Job Aid #: JA3642

Hospice Physician Recertification Requirements

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R458CP
Subject: Hospice Physician Recertification Requirements
CR #: 3686
Job Aid #: JA3686

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

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R451CP
Subject: April 2005 Quarterly Fee Schedule Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
CR #: 3669
Job Aid #: N/A

Competitive Acquisition Program (CAP) for Part B Drugs. This CR rescinds and fully replaces CR 4000

Wed, 14 Dec 2005 10:58:00 EST

Transmittal #: R761CP
Subject: Competitive Acquisition Program (CAP) for Part B Drugs. This CR rescinds and fully replaces CR 4000
CR #: 4173
Job Aid #: JA4173

Instructions for Downloading the Medicare Zip Code File

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R765CP
Subject: Instructions for Downloading the Medicare Zip Code File
CR #: 4180
Job Aid #: N/A

Therapy Caps to be Effective January 1, 2006

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R759CP
Subject: Therapy Caps to be Effective January 1, 2006
CR #: 4115
Job Aid #: JA4115

Business Partners Systems Security Manual (BPSSM)

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R6SS
Subject: Business Partners Systems Security Manual (BPSSM)
CR #: 4111
Job Aid #: N/A

Competitive Acquisition Program (CAP) for Part B Drugs

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R777CP
Subject: Competitive Acquisition Program (CAP) for Part B Drugs
CR #: 4064
Job Aid #: JA4064

Ambulance Inflation Factor for CY 2006

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R762CP
Subject: Ambulance Inflation Factor for CY 2006
CR #: 4061
Job Aid #: JA4061

Surrogate UPINs Reported on IDTF Claims

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R769CP
Subject: Surrogate UPINs Reported on IDTF Claims
CR #: 4096
Job Aid #: JA4096

Update to Repetitive Billing -- Manualization

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R763CP
Subject: Update to Repetitive Billing -- Manualization
CR #: 4047
Job Aid #: N/A

Update to the Prospective Payment System (PPS) for Home Health Agencies for Calendar Year (CY) 2006

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R764CP
Subject: Update to the Prospective Payment System (PPS) for Home Health Agencies for Calendar Year (CY) 2006
CR #: 4186
Job Aid #: JA4186

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2006

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R758CP
Subject: Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2006
CR #: 4161
Job Aid #: JA4161

Updates to MSP Accounts Receivable (AR) Write Off Procedures

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R42MSP
Subject: Updates to MSP Accounts Receivable (AR) Write Off Procedures
CR #: 4027
Job Aid #: N/A

Correction/Clarification of Chapter 11 Medicare Auditors.

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R130PI
Subject: Correction/Clarification of Chapter 11 Medicare Auditors.
CR #: 4020
Job Aid #: N/A

Implementation of Changes in End Stage Renal Disease (ESRD) Payment for Calendar Year 2006

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R774CP
Subject: Implementation of Changes in End Stage Renal Disease (ESRD) Payment for Calendar Year 2006
CR #: 4196
Job Aid #: JA4196

Changes in MCM Chapter 17, Subchapter F - Benefits and Beneficiary Protections

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R77MCM
Subject: Changes in MCM Chapter 17, Subchapter F - Benefits and Beneficiary Protections
CR #: N/A
Job Aid #: N/A

Scheduled Release for January 2006 Software Programs and Pricing/Coding Files

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R32GI
Subject: Scheduled Release for January 2006 Software Programs and Pricing/Coding Files
CR #: 4179
Job Aid #: N/A

Expansion of Form 5 of the Contractor Reporting of Operational and Workload Data (CROWD) Report

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R82FM
Subject: Expansion of Form 5 of the Contractor Reporting of Operational and Workload Data (CROWD) Report
CR #: 3864
Job Aid #: N/A

Skilled Nursing Facility Prospective Payment System

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R40BP
Subject: Skilled Nursing Facility Prospective Payment System
CR #: 4079
Job Aid #: JA4079

Eliminate the Use of Surrogate UPINs OTH000) on Medicare Claims

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R752CP
Subject: Eliminate the Use of Surrogate UPINs OTH000) on Medicare Claims
CR #: 4177
Job Aid #: JA4177

Revised Instructions on Contractor Procedures for Provider Audit, and Clarification of CET Requirements for Medicare Auditors.

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R83FM
Subject: Revised Instructions on Contractor Procedures for Provider Audit, and Clarification of CET Requirements for Medicare Auditors.
CR #: 4060
Job Aid #: N/A

Evidence of Medical Necessity: Wheelchair and Power Operated Vehicle (POV) Claims

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R128PI
Subject: Evidence of Medical Necessity: Wheelchair and Power Operated Vehicle (POV) Claims
CR #: 3952
Job Aid #: JA3952

Expanding the Voluntary Data Sharing Agreement (VDSA) Coordination of Benefit (COB) Contractor Numbers for the Common Working File (CWF).

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R43MSP
Subject: Expanding the Voluntary Data Sharing Agreement (VDSA) Coordination of Benefit (COB) Contractor Numbers for the Common Working File (CWF).
CR #: 3826
Job Aid #: N/A

Provider Customer Service Program

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R15COM
Subject: Provider Customer Service Program
CR #: 4137
Job Aid #: N/A

New Process for Web Maintenance of Provider Enrollment Contractor Contact Information

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R132PI
Subject: New Process for Web Maintenance of Provider Enrollment Contractor Contact Information
CR #: 4141
Job Aid #: N/A

Lung Volume Reduction Surgery

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R44NCD
Subject: Lung Volume Reduction Surgery
CR #: 4149
Job Aid #: N/A

CWF Updates for Carrying National Provider Identifier (NPI)

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R755CP
Subject: CWF Updates for Carrying National Provider Identifier (NPI)
CR #: 4175
Job Aid #: N/A

Medical Review Matching of Electronic Claims and Additional Documentation in the Medical Review Proces

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R131PI
Subject: Medical Review Matching of Electronic Claims and Additional Documentation in the Medical Review Proces
CR #: 4052
Job Aid #: JA4052

Development of New Report to Capture BIPA and MMA Appeals Data.

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R86FM
Subject: Development of New Report to Capture BIPA and MMA Appeals Data.
CR #: 4148
Job Aid #: N/A

Organ Procurement Organization and Tissue Typing Laboratory Cost Report

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R4P233
Subject: Organ Procurement Organization and Tissue Typing Laboratory Cost Report
CR #: N/A
Job Aid #: N/A

Fact Sheet Available on "Inpatient Rehabilitation Facility Classification Requirements"

Wed, 14 Dec 2005 16:12:00 EST

Transmittal #: SE0509
Subject: Fact Sheet Available on "Inpatient Rehabilitation Facility Classification Requirements"
CR #: N/A
Job Aid #: JA0509

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

Wed, 14 Dec 2005 17:05:00 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

SNF PPS Revisions to IOM 100-4--Manualization

Thu, 15 Dec 2005 11:45:00 EST

Transmittal #: R767CP
Subject: SNF PPS Revisions to IOM 100-4--Manualization
CR #: 4080
Job Aid #: N/A

Common Working File (CWF) Database Extract into Next Generation Desktop (NGD) Data Mart

Fri, 16 Dec 2005 12:31:00 EST

Transmittal #: R780CP
Subject: Common Working File (CWF) Database Extract into Next Generation Desktop (NGD) Data Mart
CR #: 4207
Job Aid #: N/A

Interest on MSP Debts

Fri, 16 Dec 2005 12:31:00 EST

Transmittal #: R45MSP
Subject: Interest on MSP Debts
CR #: 4125
Job Aid #: N/A

Updated Chapter 1 to Reflect Changes in Program Requirements

Fri, 16 Dec 2005 13:24:00 EST

Transmittal #: R107PI
Subject: Updated Chapter 1 to Reflect Changes in Program Requirements
CR #: 3754
Job Aid #: N/A

Updates to the Coordination of Benefits Agreement Insurance File (COIF) For Use in the National Claims Crossover Program

Fri, 16 Dec 2005 15:28:00 EST

Transmittal #: R170OTN
Subject: Updates to the Coordination of Benefits Agreement Insurance File (COIF) For Use in the National Claims Crossover Program
CR #: 3976
Job Aid #: N/A

Fiscal Intermediary Shared System (FISS) Modification

Fri, 16 Dec 2005 15:33:00 EST

Transmittal #: R174OTN
Subject: Fiscal Intermediary Shared System (FISS) Modification
CR #: 3970
Job Aid #: JA3970

Consultation Services (Codes 99241 - 99255)

Fri, 16 Dec 2005 16:24:00 EST

Transmittal #: R782CP
Subject: Consultation Services (Codes 99241 - 99255)
CR #: 4215
Job Aid #: JA4215

Supplying Fee and Inhalation Drug Dispensing Fee Revisions and Clarifications

Mon, 19 Dec 2005 13:24:00 EST

Transmittal #: R754CP
Subject: Supplying Fee and Inhalation Drug Dispensing Fee Revisions and Clarifications
CR #: 3990
Job Aid #: JA3990

2006 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments

Wed, 21 Dec 2005 10:02:00 EST

Transmittal #: R722CP
Subject: 2006 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments
CR #: 4113
Job Aid #: N/A

Lung Volume Reduction Surgery

Wed, 21 Dec 2005 11:45:00 EST

Transmittal #: R768CP
Subject: Lung Volume Reduction Surgery
CR #: 4149
Job Aid #: JA4149

Stem Cell Transplantation

Wed, 21 Dec 2005 11:45:00 EST

Transmittal #: R766CP
Subject: Stem Cell Transplantation
CR #: 4173
Job Aid #: JA4173

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

Wed, 21 Dec 2005 14:21:00 EST

Transmittal #: R710CP
Subject: Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement
CR #: 4114
Job Aid #: JA4114

Home Care and Domiciliary Care Visits Codes 99324 - 99350)

Wed, 21 Dec 2005 14:27:00 EST

Transmittal #: R775CP
Subject: Home Care and Domiciliary Care Visits Codes 99324 - 99350)
CR #: 4212
Job Aid #: N/A

Multiple Procedure Reduction of the Technical Component (TC) of Certain Diagnostic Imaging Procedures

Thu, 22 Dec 2005 09:12:00 EST

Transmittal #: SE0587
Subject: Multiple Procedure Reduction of the Technical Component (TC) of Certain Diagnostic Imaging Procedures
CR #: N/A
Job Aid #: JA0587

Islet Cell Transplantation

Thu, 22 Dec 2005 09:54:00 EST

Transmittal #: R18NCD
Subject: Islet Cell Transplantation
CR #: 3385
Job Aid #: N/A

Fee Schedule Update for 2006 for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)

Thu, 22 Dec 2005 11:45:00 EST

Transmittal #: R770CP
Subject: Fee Schedule Update for 2006 for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
CR #: 4194
Job Aid #: N/A

January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS) Manual Instruction: Changes to Coding and Payment for Drug Administration -- MANUALIZATION

Fri, 23 Dec 2005 10:10:00 EST

Transmittal #: R785CP
Subject: January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS) Manual Instruction: Changes to Coding and Payment for Drug Administration -- MANUALIZATION
CR #: 4258
Job Aid #: N/A

January 2006 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 7.0

Fri, 23 Dec 2005 10:10:00 EST

Transmittal #: R784CP
Subject: January 2006 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 7.0
CR #: 4238
Job Aid #: JA4238

Consultation Services (Codes 99241 - 99255)

Fri, 23 Dec 2005 10:10:00 EST

Transmittal #: R788CP
Subject: Consultation Services (Codes 99241 - 99255)
CR #: 4215
Job Aid #: JA4215

January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS) Manual Instruction: Changes to Coding and Payment for Observation

Fri, 23 Dec 2005 10:10:00 EST

Transmittal #: R42BP
Subject: January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS) Manual Instruction: Changes to Coding and Payment for Observation
CR #: 4259
Job Aid #: JA4259

January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS) Manual Instruction: Changes to Coding and Payment for Observation

Fri, 23 Dec 2005 10:10:00 EST

Transmittal #: R787CP
Subject: January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS) Manual Instruction: Changes to Coding and Payment for Observation
CR #: 4259
Job Aid #: JA4259

January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes, OPPS PRICER Logic Changes, and Instructions for Updating the Outpatient Provider Specific File (OPSF

Fri, 23 Dec 2005 10:10:00 EST

Transmittal #: R786CP
Subject: January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes, OPPS PRICER Logic Changes, and Instructions for Updating the Outpatient Provider Specific File (OPSF
CR #: 4250
Job Aid #: N/A

Updates to the Electronic Correspondence Referral System (ECRS) User Guide v9.0 and Quick Reference Card v9.0

Fri, 23 Dec 2005 10:47:00 EST

Transmittal #: R46MSP
Subject: Updates to the Electronic Correspondence Referral System (ECRS) User Guide v9.0 and Quick Reference Card v9.0
CR #: 4162
Job Aid #: N/A

Physician's Voluntary Reporting Program (PVRP)

Tue, 27 Dec 2005 11:02:00 EST

Transmittal #: R35DEMO
Subject: Physician's Voluntary Reporting Program (PVRP)
CR #: 4183
Job Aid #: JA4183

PRM, Provider Reimbursement Manual - Part 1, Rev. 429 Section 2231, Regional Swing Bed Rates

Tue, 27 Dec 2005 11:02:00 EST

Transmittal #: R429PR1
Subject: PRM, Provider Reimbursement Manual - Part 1, Rev. 429 Section 2231, Regional Swing Bed Rates
CR #: N/A
Job Aid #: N/A

Nursing Facility Services (Codes 99304 - 99318)

Tue, 27 Dec 2005 11:02:00 EST

Transmittal #: R792CP
Subject: Nursing Facility Services (Codes 99304 - 99318)
CR #: 4246
Job Aid #: JA4246

Ambulance Fee Schedule - Medical Conditions List: Manualization

Tue, 27 Dec 2005 11:02:00 EST

Transmittal #: R789CP
Subject: Ambulance Fee Schedule - Medical Conditions List: Manualization
CR #: 4221
Job Aid #: N/A

Fiscal Intermediary Shared System (FISS) Edit Updates for Epoetin Alfa and Darbepoetin Alfa HCPCS Changes Effective January 1, 2006

Thu, 29 Dec 2005 09:36:00 EST

Transmittal #: R772CP
Subject: Fiscal Intermediary Shared System (FISS) Edit Updates for Epoetin Alfa and Darbepoetin Alfa HCPCS Changes Effective January 1, 2006
CR #: 4206
Job Aid #: N/A

New Waived Tests

Thu, 29 Dec 2005 12:31:00 EST

Transmittal #: R779CP
Subject: New Waived Tests
CR #: 4136
Job Aid #: N/A

2006 Oncology Demonstration Project

Thu, 29 Dec 2005 13:42:00 EST

Transmittal #: r34demo
Subject: 2006 Oncology Demonstration Project
CR #: 4219
Job Aid #: JA4219

Revised Manual Instructions for Processing End Stage Renal Disease (ESRD) Exceptions Under the Composite Rate Reimbursement System

Thu, 29 Dec 2005 13:42:00 EST

Transmittal #: R781CP
Subject: Revised Manual Instructions for Processing End Stage Renal Disease (ESRD) Exceptions Under the Composite Rate Reimbursement System
CR #: 4188
Job Aid #: JA4188

Documentation and Coding Guidelines for Medicare's 2006 Oncology Demonstration

Thu, 29 Dec 2005 14:12:00 EST

Transmittal #: SE0588
Subject: Documentation and Coding Guidelines for Medicare's 2006 Oncology Demonstration
CR #: 4219
Job Aid #: JA0588

2006 Oncology Demonstration Project

Thu, 29 Dec 2005 14:14:00 EST

Transmittal #: SE0589
Subject: 2006 Oncology Demonstration Project
CR #: N/A
Job Aid #: JA0589

January 2006 Non-Outpatient Prospective Payment System Outpatient Code Editor (Non-OPPS OCE) Specifications Version 21.1

Thu, 29 Dec 2005 16:24:00 EST

Transmittal #: R783CP
Subject: January 2006 Non-Outpatient Prospective Payment System Outpatient Code Editor (Non-OPPS OCE) Specifications Version 21.1
CR #: 4236
Job Aid #: N/A

Announcement of Medicare Supplemental Payments to Federally Qualified Health Centers (FQHCs) Under Contract with Medicare Advantage (MA) Plans

Fri, 30 Dec 2005 10:05:00 EST

Transmittal #: R794cp
Subject: Announcement of Medicare Supplemental Payments to Federally Qualified Health Centers (FQHCs) Under Contract with Medicare Advantage (MA) Plans
CR #: 3886
Job Aid #: JA3886

Redefined Type of Bill (TOB) 14X for Non-Patient Laboratory Specimens-CR 3835 Manualization

Fri, 30 Dec 2005 10:05:00 EST

Transmittal #: R795CP
Subject: Redefined Type of Bill (TOB) 14X for Non-Patient Laboratory Specimens-CR 3835 Manualization
CR #: 4208
Job Aid #: N/A

Renal Dialysis Facility for Cost Reporting Form CMS-265-94

Fri, 30 Dec 2005 13:19:00 EST

Transmittal #: R8P234
Subject: Renal Dialysis Facility for Cost Reporting Form CMS-265-94
CR #: N/A
Job Aid #: N/A

Clinical Diagnostic Laboratory Date of Service (DOS) for Archived Specimens

Fri, 30 Dec 2005 13:23:00 EST

Transmittal #: R800CP
Subject: Clinical Diagnostic Laboratory Date of Service (DOS) for Archived Specimens
CR #: 4156
Job Aid #: JA4156

New Medicare Summary Notice (MSN) Message Used for the Physician's Voluntary Reporting Program (PVRP)

Fri, 30 Dec 2005 13:23:00 EST

Transmittal #: R199OTN
Subject: New Medicare Summary Notice (MSN) Message Used for the Physician's Voluntary Reporting Program (PVRP)
CR #: 4230
Job Aid #: N/A

Emergency Update to the 2006 Medicare Physician Fee Schedule Database

Fri, 30 Dec 2005 13:23:00 EST

Transmittal #: R798CP
Subject: Emergency Update to the 2006 Medicare Physician Fee Schedule Database
CR #: 4268
Job Aid #: JA4268

Change Management Process -- Electronic Change Information Management Portal (eChimp)

Tue, 03 Jan 2006 17:27:00 EST

Transmittal #: R33GI
Subject: Change Management Process -- Electronic Change Information Management Portal (eChimp)
CR #: 4092
Job Aid #: N/A

Update to Carrier Demand Letter Appeals Language

Tue, 03 Jan 2006 17:27:00 EST

Transmittal #: R87FM
Subject: Update to Carrier Demand Letter Appeals Language
CR #: 4211
Job Aid #: N/A

Termination of the Medicare HIPAA Incoming Claim Contingency Plan, Addition of a Self-Assessable Unusual Circumstance, Modification of the OTAF Exception, and Modification of ASCA Exhibit Letters A, B and C

Tue, 03 Jan 2006 17:27:00 EST

Transmittal #: R802CP.pdf
Subject: Termination of the Medicare HIPAA Incoming Claim Contingency Plan, Addition of a Self-Assessable Unusual Circumstance, Modification of the OTAF Exception, and Modification of ASCA Exhibit Letters A, B and C
CR #: 4119
Job Aid #: JA4119

January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes, OPPS PRICER Logic Changes, and Instructions for Updating the Outpatient Provider Specific File (OPSF)

Tue, 03 Jan 2006 17:44:00 EST

Transmittal #: R804CP
Subject: January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes, OPPS PRICER Logic Changes, and Instructions for Updating the Outpatient Provider Specific File (OPSF)
CR #: 4250
Job Aid #: N/A

Administration of Drugs and Biologicals in a Method II Critical Access Hospital (CAH) - RESCINDS AND REPLACES Change Request (CR) 3911

Tue, 03 Jan 2006 17:44:00 EST

Transmittal #: R803CP
Subject: Administration of Drugs and Biologicals in a Method II Critical Access Hospital (CAH) - RESCINDS AND REPLACES Change Request (CR) 3911
CR #: 4234
Job Aid #: JA4234

Revision to Chapter 31 - Addition of Hospice Data HIPAA 270/271 Eligibility

Wed, 04 Jan 2006 15:28:00 EST

Transmittal #: R791CP
Subject: Revision to Chapter 31 - Addition of Hospice Data HIPAA 270/271 Eligibility
CR #: 4193
Job Aid #: JA4193

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

Wed, 04 Jan 2006 15:37:00 EST

Transmittal #: R796CP
Subject: Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increase
CR #: 4232
Job Aid #: JA4232

Low Vision Rehabilitation Demonstration

Wed, 04 Jan 2006 15:43:00 EST

Transmittal #: R25DEMO
Subject: Low Vision Rehabilitation Demonstration
CR #: 3816
Job Aid #: JA3816

Reminder Notice of the Implementation of Ambulance Transition Schedule

Wed, 04 Jan 2006 15:46:00 EST

Transmittal #: R799CP
Subject: Reminder Notice of the Implementation of Ambulance Transition Schedule
CR #: 4217
Job Aid #: JA4217

Revision to Chapter 31 - Addition of Hospice Data HIPAA 270/271 Eligibility

Thu, 05 Jan 2006 07:12:00 EST

Transmittal #: R793CP
Subject: Revision to Chapter 31 - Addition of Hospice Data HIPAA 270/271 Eligibility
CR #: 4193
Job Aid #: JA4193

Clarification and Update to Hospital Billing Instructions and Payment for Epoetin Alfa (EPO) and Darbepoetin Alfa (Aranesp) for Beneficiaries with End Stage Renal Disease (ESRD)

Fri, 06 Jan 2006 13:26:00 EST

Transmittal #: R736CP
Subject: Clarification and Update to Hospital Billing Instructions and Payment for Epoetin Alfa (EPO) and Darbepoetin Alfa (Aranesp) for Beneficiaries with End Stage Renal Disease (ESRD)
CR #: 4103
Job Aid #: JA4103

Low Vision Rehabilitation Demonstration

Mon, 09 Jan 2006 08:14:00 EST

Transmittal #: R23DEMO
Subject: Low Vision Rehabilitation Demonstration
CR #: 3816
Job Aid #: JA3816

Auditory Osseointegrated and Auditory Brainstem Devices

Thu, 12 Jan 2006 08:33:00 EST

Transmittal #: R39BP
Subject: Auditory Osseointegrated and Auditory Brainstem Devices
CR #: 4038
Job Aid #: JA4038

Update to Repetitive Billing -- Manualization

Thu, 12 Jan 2006 12:20:00 EST

Transmittal #: R763CP
Subject: Update to Repetitive Billing -- Manualization
CR #: 4047
Job Aid #: N/A

List of Medicare Telehealth Services

Thu, 12 Jan 2006 14:42:00 EST

Transmittal #: R790CP
Subject: List of Medicare Telehealth Services
CR #: 4204
Job Aid #: JA4204

List of Medicare Telehealth Services

Thu, 12 Jan 2006 14:43:00 EST

Transmittal #: R43BP
Subject: List of Medicare Telehealth Services
CR #: 4204
Job Aid #: JA4204

Stem Cell Transplantation

Thu, 12 Jan 2006 14:48:00 EST

Transmittal #: R776CP
Subject: Stem Cell Transplantation
CR #: 4173
Job Aid #: JA4173

Stem Cell Transplantation

Thu, 12 Jan 2006 14:49:00 EST

Transmittal #: R45NCD
Subject: Stem Cell Transplantation
CR #: 4173
Job Aid #: JA4173

Instructions for Reporting New HCPCS Code V2788 for Presbyopia-Correcting Intraocular Lenses (P-C IOLs)

Thu, 12 Jan 2006 14:51:00 EST

Transmittal #: R801CP
Subject: Instructions for Reporting New HCPCS Code V2788 for Presbyopia-Correcting Intraocular Lenses (P-C IOLs)
CR #: 4184
Job Aid #: JA4184

Renal Dialysis Facility for Cost Reporting Form CMS-265-94

Thu, 12 Jan 2006 15:16:00 EST

Transmittal #: R9P234
Subject: Renal Dialysis Facility for Cost Reporting Form CMS-265-94
CR #: N/A
Job Aid #: N/A

Full Replacement of CR 4095, Diagnosis Code Requirements for Method II Home Dialysis Claims. CR 4095 is Rescinded.

Thu, 12 Jan 2006 15:23:00 EST

Transmittal #: R797CP
Subject: Full Replacement of CR 4095, Diagnosis Code Requirements for Method II Home Dialysis Claims. CR 4095 is Rescinded.
CR #: 4227
Job Aid #: N/A

Medical Director Guidance

Fri, 27 Jan 2006 15:30:00 EST

Transmittal #: R15SOMA
Subject: Medical Director Guidance
CR #: N/A
Job Aid #: N/A

Expansion of Form 5 of the Contractor Reporting of Operational and Workload Data (CROWD)

Fri, 27 Jan 2006 15:59:00 EST

Transmittal #: R85FM
Subject: Expansion of Form 5 of the Contractor Reporting of Operational and Workload Data (CROWD)
CR #: 3864
Job Aid #: N/A

Revised Instructions on Contractor Procedures for Provider Audit, and Clarification of CET Requirements for Medicare Auditors.

Fri, 27 Jan 2006 15:59:00 EST

Transmittal #: R84FM
Subject: Revised Instructions on Contractor Procedures for Provider Audit, and Clarification of CET Requirements for Medicare Auditors.
CR #: 4060
Job Aid #: N/A

SOM Appendix PP - Guidance to Surveyors for Long Term Care Facilities

Tue, 27 Mar 2007 10:27:00 EST

Transmittal #: R12SOM
Subject: SOM Appendix PP - Guidance to Surveyors for Long Term Care Facilities
CR #: N/A
Job Aid #: N/A

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

Tue, 21 Aug 2007 07:14:00 EST

Transmittal #: R509CP
Subject: Number of Drug Pricing Files That Must Be Maintained Online for Medicare - DMERC Only
CR #: 3584
Job Aid #: JA3584

Enrolling Indian Health Service (IHS) Facilities as Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers

Tue, 21 Aug 2007 07:14:00 EST

Transmittal #: R133PI
Subject: Enrolling Indian Health Service (IHS) Facilities as Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers
CR #: 3845
Job Aid #: JA3845

Erroneous Guidance - Basis to Waive Penalty

Tue, 21 Aug 2007 07:15:00 EST

Transmittal #: R739CP
Subject: Erroneous Guidance - Basis to Waive Penalty
CR #: 3898
Job Aid #: JA3898

Modification to Reporting of Diagnosis Codes for Screening Mammography Claims

Tue, 28 Aug 2007 07:47:00 EST

Transmittal #: R426CP
Subject: Modification to Reporting of Diagnosis Codes for Screening Mammography Claims
CR #: 3562
Job Aid #: JA3562

Modification to Reporting of Diagnosis Codes for Screening Mammography Claims

Tue, 28 Aug 2007 07:47:00 EST

Transmittal #: R705CP
Subject: Modification to Reporting of Diagnosis Codes for Screening Mammography Claims
CR #: 3562
Job Aid #: JA3562

Change in Provider Enrollment Timeliness Standards

Fri, 31 Aug 2007 10:34:00 EST

Transmittal #: R134PI
Subject: Change in Provider Enrollment Timeliness Standards
CR #: 4213
Job Aid #: N/A

Provider Contact Centers Training Program

Fri, 07 Sep 2007 14:25:00 EST

Transmittal #: R13COM
Subject: Provider Contact Centers Training Program
CR #: 3951
Job Aid #: N/A

Provider Inquiry Reporting Standardization

Fri, 07 Sep 2007 14:35:00 EST

Transmittal #: R14COM
Subject: Provider Inquiry Reporting Standardization
CR #: 4048
Job Aid #: N/A

Stage 2 Requirements for Use and Editing of National Provider Identifier (NPI) Numbers Received in Electronic Data Interchange (EDI) Transactions, via Direct Data Entry (DDE) Screens, or Paper Claim Forms

Thu, 02 Jul 2009 07:21:00 EST

Transmittal #: R190OTN
Subject: Stage 2 Requirements for Use and Editing of National Provider Identifier (NPI) Numbers Received in Electronic Data Interchange (EDI) Transactions, via Direct Data Entry (DDE) Screens, or Paper Claim Forms
CR #: 4023
Job Aid #: JA4023

CMS Announces the National Provider Identifier (NPI) Enumerator Contractor and Information on Obtaining NPIs

Wed, 22 Jul 2009 07:36:00 EST

Transmittal #: SE0528
Subject: CMS Announces the National Provider Identifier (NPI) Enumerator Contractor and Information on Obtaining NPIs
CR #: N/A
Job Aid #: JA0528

Calendar Year (CY) 2006 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures

Tue, 28 Jul 2009 13:19:00 EST

Transmittal #: R730CP
Subject: Calendar Year (CY) 2006 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures
CR #: 4051
Job Aid #: N/A

Clarifying Manual Instructions for Coding and Payment for Drug Administration Under the Hospital Outpatient Prospective Payment System (OPPS)

Fri, 07 Aug 2009 10:37:00 EST

Transmittal #: R573CP
Subject: Clarifying Manual Instructions for Coding and Payment for Drug Administration Under the Hospital Outpatient Prospective Payment System (OPPS)
CR #: 3848
Job Aid #: JA3848

Medicare's Implementation of the National Provider Identifier (NPI): The Second in the Series of Special Edition Medlearn Matters Articles on NPI- Related Activities

Tue, 22 Sep 2009 07:10:00 EST

Transmittal #: SE0555
Subject: Medicare's Implementation of the National Provider Identifier (NPI): The Second in the Series of Special Edition Medlearn Matters Articles on NPI- Related Activities
CR #: N/A
Job Aid #: JA0555

Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for FI Initial Determinations Issued on or After May 1, 2005 and Carrier Initial Determinations Issued on or After January 1, 2006).

Wed, 21 Oct 2009 15:29:00 EST

Transmittal #: R724CP
Subject: Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for FI Initial Determinations Issued on or After May 1, 2005 and Carrier Initial Determinations Issued on or After January 1, 2006).
CR #: 3939
Job Aid #: JA3939

Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for All Requests for Redetermination Received by FIs on or After May 1, 2005, And All Requests for Redetermination Received by Carriers on or After January 1, 2006)

Wed, 21 Oct 2009 15:30:00 EST

Transmittal #: R688CP
Subject: Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for All Requests for Redetermination Received by FIs on or After May 1, 2005, And All Requests for Redetermination Received by Carriers on or After January 1, 2006)
CR #: 3944
Job Aid #: JA3944

Update To The Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer For FY 2006

Wed, 21 Oct 2009 15:57:00 EST

Transmittal #: R655CP
Subject: Update To The Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer For FY 2006
CR #: 3977
Job Aid #: N/A

Schedule for Completing the Calendar Year 2006 Fee Updates and the Participating Physician Enrollment Procedures.

Mon, 02 Nov 2009 13:34:00 EST

Transmittal #: R669CP
Subject: Schedule for Completing the Calendar Year 2006 Fee Updates and the Participating Physician Enrollment Procedures.
CR #: 4013
Job Aid #: N/A

Importance of Supplying Correct Provider Identification Information Required in Items 17, 17a, 24K, and 33 of the Form CMS-1500, and the Electronic Equivalent

Fri, 20 Nov 2009 08:04:00 EST

Transmittal #: SE0529
Subject: Importance of Supplying Correct Provider Identification Information Required in Items 17, 17a, 24K, and 33 of the Form CMS-1500, and the Electronic Equivalent
CR #: N/A
Job Aid #: JA0529