2005 MLN Matters Articles

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
MM Article #: MM3628
MM Article Release Date: 02/15/2005

The Medically Unbelievable Edits

Thu, 10 Nov 2005 10:25:00 EST

Transmittal #: R105PI
Subject: The Medically Unbelievable Edits
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Change in Statistical Sampling Instructions

Thu, 10 Nov 2005 10:28:00 EST

Transmittal #: R108PI
Subject: Change in Statistical Sampling Instructions
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Provider Extract File

Thu, 10 Nov 2005 11:20:00 EST

Transmittal #: R27GI
Subject: Provider Extract File
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3709
MM Article Release Date: 02/24/2005

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
MM Article #: MM3756
MM Article Release Date: 04/08/2005

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)
MM Article #: MM3745
MM Article Release Date: 04/08/2005

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
MM Article #: MM3753
MM Article Release Date: 03/21/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3679
MM Article Release Date: 06/13/2005

Hospital Partial Hospitalization Services Billing Requirements

Thu, 10 Nov 2005 13:29:00 EST

Transmittal #: R483CP
Subject: Hospital Partial Hospitalization Services Billing Requirements
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3848
MM Article Release Date: 06/06/2005

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
MM Article #: MM3822
MM Article Release Date: 05/18/2005

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)
MM Article #: N/A
MM Article Release Date: N/A

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3763
MM Article Release Date: 06/29/2005

Healthcare Provider Taxonomy Code (HPTC) Update

Thu, 10 Nov 2005 13:49:00 EST

Transmittal #: R543CP
Subject: Healthcare Provider Taxonomy Code (HPTC) Update
MM Article #: MM3803
MM Article Release Date: 05/04/2005

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
MM Article #: MM3794
MM Article Release Date: 04/29/2005

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
MM Article #: MM3783
MM Article Release Date: 04/29/2005

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
MM Article #: MM3741
MM Article Release Date: 04/20/2005

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)
MM Article #: MM3797
MM Article Release Date: 05/18/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3667
MM Article Release Date: 03/17/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3716
MM Article Release Date: 03/09/2005

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
MM Article #: N/A
MM Article Release Date: N/A

New Waived Tests

Thu, 10 Nov 2005 14:15:00 EST

Transmittal #: R538CP
Subject: New Waived Tests
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3779
MM Article Release Date: 05/11/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3806
MM Article Release Date: 05/12/2005

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)
MM Article #: MM3790
MM Article Release Date: 04/22/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4009
MM Article Release Date: 09/14/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Implantable Automatic Defibrillators

Thu, 10 Nov 2005 15:03:00 EST

Transmittal #: R29NCD
Subject: Implantable Automatic Defibrillators
MM Article #: MM3604
MM Article Release Date: 03/21/2005

Percutaneous Transluminal Angioplasty (PTA

Thu, 10 Nov 2005 15:04:00 EST

Transmittal #: R33NCD
Subject: Percutaneous Transluminal Angioplasty (PTA
MM Article #: MM3811
MM Article Release Date: 12/02/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3834
MM Article Release Date: N/A

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
MM Article #: MM3871
MM Article Release Date: 06/03/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3679
MM Article Release Date: 06/13/2005

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
MM Article #: MM3871
MM Article Release Date: 06/03/2005

Mobility Assistive Equipment (MAE)

Thu, 10 Nov 2005 16:47:00 EST

Transmittal #: R574CP
Subject: Mobility Assistive Equipment (MAE)
MM Article #: MM3791
MM Article Release Date: 10/19/2005

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
MM Article #: MM3847
MM Article Release Date: 07/01/2005

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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3679
MM Article Release Date: 06/13/2005

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)
MM Article #: MM3883
MM Article Release Date: N/A

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
MM Article #: MM3905
MM Article Release Date: 06/23/2005

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)
MM Article #: MM3915
MM Article Release Date: 07/06/2005

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)
MM Article #: MM3888
MM Article Release Date: N/A

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3890
MM Article Release Date: 08/23/2005

Cochlear Implantation

Fri, 11 Nov 2005 10:29:00 EST

Transmittal #: R601CP
Subject: Cochlear Implantation
MM Article #: MM3796
MM Article Release Date: 07/06/2005

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
MM Article #: MM3742
MM Article Release Date: 06/23/2005

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) )
MM Article #: MM3791
MM Article Release Date: 10/19/2005

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)
MM Article #: MM3767
MM Article Release Date: 07/13/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3936
MM Article Release Date: 08/04/2005

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
MM Article #: MM3934
MM Article Release Date: 10/11/2005

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)
MM Article #: MM3911
MM Article Release Date: 11/08/2005

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
MM Article #: MM3772
MM Article Release Date: 07/26/2005

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
MM Article #: MM3885
MM Article Release Date: 08/04/2005

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
MM Article #: MM3925
MM Article Release Date: 08/03/2005

Locality Codes for Purchased Diagnostic Tests

Fri, 11 Nov 2005 11:42:00 EST

Transmittal #: R621CP
Subject: Locality Codes for Purchased Diagnostic Tests
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3933
MM Article Release Date: N/A

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3962
MM Article Release Date: 08/03/2005

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
MM Article #: MM3960
MM Article Release Date: 08/03/2005

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
MM Article #: MM3949
MM Article Release Date: 10/07/2005

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)
MM Article #: MM3901
MM Article Release Date: 09/13/2005

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
MM Article #: MM3972
MM Article Release Date: 08/11/2005

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
MM Article #: MM4010
MM Article Release Date: 08/16/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3831
MM Article Release Date: 07/05/2005

Cochlear Implantation

Fri, 11 Nov 2005 13:02:00 EST

Transmittal #: R39NCD
Subject: Cochlear Implantation
MM Article #: MM3796
MM Article Release Date: 07/06/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3648
MM Article Release Date: 06/24/2005

List of Medicare Telehealth Services

Fri, 11 Nov 2005 13:05:00 EST

Transmittal #: R31BP
Subject: List of Medicare Telehealth Services
MM Article #: MM3747
MM Article Release Date: 05/17/2005

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)
MM Article #: N/A
MM Article Release Date: N/A

Cochlear Implantation

Fri, 11 Nov 2005 13:07:00 EST

Transmittal #: R42NCD
Subject: Cochlear Implantation
MM Article #: MM3796
MM Article Release Date: 07/06/2005

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
MM Article #: N/A
MM Article Release Date: N/A

Surveys, Contracting Strategy and Appeals

Fri, 11 Nov 2005 14:04:00 EST

Transmittal #: R65MCM
Subject: Surveys, Contracting Strategy and Appeals
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Claims Accounts Receivable Update

Fri, 11 Nov 2005 14:13:00 EST

Transmittal #: R72FM
Subject: Claims Accounts Receivable Update
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3696
MM Article Release Date: 01/21/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3695
MM Article Release Date: 01/24/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3817
MM Article Release Date: 05/11/2005

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)
MM Article #: MM3785
MM Article Release Date: 05/10/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Overnight Oximetery Testing

Fri, 11 Nov 2005 14:45:00 EST

Transmittal #: R166OTN
Subject: Overnight Oximetery Testing
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3829
MM Article Release Date: 05/18/2005

Reimbursement for ESRD and Transplant Services

Mon, 14 Nov 2005 10:25:00 EST

Transmittal #: R30PR1
Subject: Reimbursement for ESRD and Transplant Services
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3587
MM Article Release Date: 01/20/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4005
MM Article Release Date: 08/23/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Diabetes Screening Tests

Mon, 14 Nov 2005 10:37:00 EST

Transmittal #: R446CP
Subject: Diabetes Screening Tests
MM Article #: MM3637
MM Article Release Date: 01/24/2005

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)
MM Article #: MM3678
MM Article Release Date: 03/17/2005

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
MM Article #: MM3992
MM Article Release Date: 09/19/2005

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
MM Article #: MM3507
MM Article Release Date: 01/28/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3659
MM Article Release Date: 01/25/2005

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)
MM Article #: MM3564
MM Article Release Date: 03/28/2005

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
MM Article #: MM3645
MM Article Release Date: 01/25/2005

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
MM Article #: MM3664
MM Article Release Date: 01/25/2005

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
MM Article #: MM3636
MM Article Release Date: 01/25/2005

Diabetes Screening Tests

Mon, 14 Nov 2005 11:19:00 EST

Transmittal #: R457CP
Subject: Diabetes Screening Tests
MM Article #: MM3677
MM Article Release Date: 03/10/2005

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)
MM Article #: N/A
MM Article Release Date: 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.
MM Article #: MM3440
MM Article Release Date: 02/02/2005

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
MM Article #: MM3683
MM Article Release Date: 02/10/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3694
MM Article Release Date: 03/18/2005

Standard Terminology for Claims Processing Systems

Mon, 14 Nov 2005 12:08:00 EST

Transmittal #: R8GI
Subject: Standard Terminology for Claims Processing Systems
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3781
MM Article Release Date: 09/21/2005

Overnight Oximetery Testing

Mon, 14 Nov 2005 13:01:00 EST

Transmittal #: R173OTN
Subject: Overnight Oximetery Testing
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3953
MM Article Release Date: 10/28/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM4017
MM Article Release Date: 09/08/2005

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
MM Article #: MM3995
MM Article Release Date: 09/01/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3922
MM Article Release Date: 09/14/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4026
MM Article Release Date: 09/07/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3933
MM Article Release Date: N/A

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4025
MM Article Release Date: 11/07/2005

Medical Review Collection Number Requirements

Mon, 14 Nov 2005 13:40:00 EST

Transmittal #: R122PI
Subject: Medical Review Collection Number Requirements
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4007
MM Article Release Date: 09/23/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4001
MM Article Release Date: 01/19/2006

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
MM Article #: MM4072
MM Article Release Date: 10/04/2005

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)
MM Article #: MM4065
MM Article Release Date: 10/13/2005

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).
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM4086
MM Article Release Date: 10/13/2005

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
MM Article #: MM3934
MM Article Release Date: 10/11/2005

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
MM Article #: N/A
MM Article Release Date: N/A

IPPS Outlier Reconciliation

Mon, 14 Nov 2005 14:09:00 EST

Transmittal #: R703CP
Subject: IPPS Outlier Reconciliation
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: N/A

Source of Admission Code 'D'

Mon, 14 Nov 2005 14:28:00 EST

Transmittal #: R718CP
Subject: Source of Admission Code 'D'
MM Article #: MM3881
MM Article Release Date: 04/06/2006

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM4089
MM Article Release Date: 10/26/2005

New Waived Tests - April 1, 2005

Mon, 14 Nov 2005 14:30:00 EST

Transmittal #: R469CP
Subject: New Waived Tests - April 1, 2005
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM4039
MM Article Release Date: 11/02/2005

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
MM Article #: MM3618
MM Article Release Date: 02/18/2005

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)
MM Article #: MM4103
MM Article Release Date: 11/02/2005

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
MM Article #: MM4087
MM Article Release Date: 11/03/2005

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
MM Article #: MM3705
MM Article Release Date: 04/29/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4113
MM Article Release Date: 10/26/2005

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
MM Article #: MM4104
MM Article Release Date: 10/26/2005

Request to Change Lead Contractor

Mon, 14 Nov 2005 14:35:00 EST

Transmittal #: R39MSP
Subject: Request to Change Lead Contractor
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3685
MM Article Release Date: 02/07/2005

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
MM Article #: MM4098
MM Article Release Date: 11/14/2005

Medicare Contractors' Monthly Cash Collections

Mon, 14 Nov 2005 14:37:00 EST

Transmittal #: R80FM
Subject: Medicare Contractors' Monthly Cash Collections
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM4109
MM Article Release Date: 11/18/2005

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"
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Complaint Screening Revisions

Mon, 14 Nov 2005 14:41:00 EST

Transmittal #: R127PI
Subject: Complaint Screening Revisions
MM Article #: N/A
MM Article Release Date: N/A

Annual Type Of Service (TOS)

Mon, 14 Nov 2005 14:42:00 EST

Transmittal #: R727CP
Subject: Annual Type Of Service (TOS)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4160
MM Article Release Date: 11/03/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4131
MM Article Release Date: 11/14/2005

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)
MM Article #: MM4032
MM Article Release Date: 11/14/2005

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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4108
MM Article Release Date: 11/08/2005

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
MM Article #: MM4101
MM Article Release Date: 03/15/2006

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3910
MM Article Release Date: 11/08/2005

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
MM Article #: MM3835
MM Article Release Date: 11/09/2005

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
MM Article #: MM4053
MM Article Release Date: 11/03/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4133
MM Article Release Date: 11/08/2005

Revising the FISS Shared System

Thu, 01 Dec 2005 15:00:00 EST

Transmittal #: R111PI
Subject: Revising the FISS Shared System
MM Article #: MM3812
MM Article Release Date: 05/06/2005

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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3817
MM Article Release Date: 05/11/2005

Qualified Independent Contractor Jurisdictions

Fri, 02 Dec 2005 14:17:00 EST

Transmittal #: R163OTN
Subject: Qualified Independent Contractor Jurisdictions
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3953
MM Article Release Date: 10/28/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4132
MM Article Release Date: 11/14/2005

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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: SE0579
MM Article Release Date: 11/23/2005

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
MM Article #: SE0580
MM Article Release Date: 11/23/2005

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)
MM Article #: SE0578
MM Article Release Date: 11/18/2005

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)
MM Article #: SE0582
MM Article Release Date: 12/05/2005

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
MM Article #: SE0575
MM Article Release Date: 11/23/2005

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
MM Article #: SE0570
MM Article Release Date: 11/08/2005

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
MM Article #: SE0565
MM Article Release Date: 10/24/2005

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)
MM Article #: MM3959
MM Article Release Date: 08/29/2005

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).
MM Article #: MM3942
MM Article Release Date: 10/13/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4058
MM Article Release Date: 11/14/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

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
MM Article #: MM4123
MM Article Release Date: 11/14/2005

Deletion of MCM Chapter 3 - Marketing

Tue, 06 Dec 2005 13:24:00 EST

Transmittal #: R75MCM
Subject: Deletion of MCM Chapter 3 - Marketing
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4140
MM Article Release Date: 11/17/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4135
MM Article Release Date: 11/14/2005

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
MM Article #: MM4168
MM Article Release Date: 11/14/2005

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
MM Article #: MM4082
MM Article Release Date: 11/14/2005

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)
MM Article #: MM4121
MM Article Release Date: 11/06/2005

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
MM Article #: MM4144
MM Article Release Date: 11/18/2005

Physician's Voluntary Reporting Program (PVRP)

Tue, 06 Dec 2005 15:07:00 EST

Transmittal #: R31DEMO
Subject: Physician's Voluntary Reporting Program (PVRP)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: SE0564
MM Article Release Date: 11/08/2005

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
MM Article #: SE0561
MM Article Release Date: 09/28/2005

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
MM Article #: SE0559
MM Article Release Date: 10/26/2005

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
MM Article #: SE0557
MM Article Release Date: 08/23/2005

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
MM Article #: SE0563
MM Article Release Date: 10/06/2005

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
MM Article #: SE0556
MM Article Release Date: 10/12/2005

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
MM Article #: SE0543
MM Article Release Date: 11/14/2005

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
MM Article #: SE0506
MM Article Release Date: 01/25/2005

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
MM Article #: SE0524
MM Article Release Date: 04/29/2005

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
MM Article #: SE0538
MM Article Release Date: 06/29/2005

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)
MM Article #: SE0449
MM Article Release Date: 09/02/2004

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
MM Article #: SE0502
MM Article Release Date: 02/25/2005

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
MM Article #: SE0507
MM Article Release Date: 02/02/2005

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
MM Article #: SE0504
MM Article Release Date: 02/02/2005

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
MM Article #: SE0511
MM Article Release Date: 03/21/2005

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
MM Article #: SE0553
MM Article Release Date: 08/12/2005

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
MM Article #: SE0438
MM Article Release Date: 02/18/2004

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
MM Article #: SE0521
MM Article Release Date: 03/11/2005

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
MM Article #: SE0535
MM Article Release Date: 05/20/2005

New Educational Products Available

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0537
Subject: New Educational Products Available
MM Article #: SE0537
MM Article Release Date: 06/03/2005

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
MM Article #: SE0540
MM Article Release Date: 06/24/2005

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
MM Article #: SE0469
MM Article Release Date: 01/10/2005

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
MM Article #: SE0536
MM Article Release Date: 06/15/2005

Mass Adjustment of Certain Transplant Claims

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0539
Subject: Mass Adjustment of Certain Transplant Claims
MM Article #: SE0539
MM Article Release Date: 06/20/2005

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
MM Article #: SE0547
MM Article Release Date: 08/10/2005

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)
MM Article #: SE0453
MM Article Release Date: 10/04/2004

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
MM Article #: SE0463
MM Article Release Date: 11/04/2004

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
MM Article #: SE0513
MM Article Release Date: 02/07/2005

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
MM Article #: SE0523
MM Article Release Date: 03/21/2005

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
MM Article #: SE0541
MM Article Release Date: 07/01/2005

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
MM Article #: SE0501
MM Article Release Date: 02/26/2005

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
MM Article #: SE0514
MM Article Release Date: 03/11/2005

MMA - Your Important Role

Wed, 07 Dec 2005 08:42:00 EST

Transmittal #: SE0520
Subject: MMA - Your Important Role
MM Article #: SE0520
MM Article Release Date: 03/28/2005

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
MM Article #: SE0522
MM Article Release Date: 03/14/2005

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
MM Article #: SE0526
MM Article Release Date: 04/29/2005

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
MM Article #: SE0505
MM Article Release Date: 01/12/2005

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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: SE0531
MM Article Release Date: 04/07/2005

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
MM Article #: SE0527
MM Article Release Date: 04/22/2005

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
MM Article #: SE0519
MM Article Release Date: 03/18/2005

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
MM Article #: SE0544
MM Article Release Date: 07/21/2005

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
MM Article #: SE0518
MM Article Release Date: 03/14/2005

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
MM Article #: SE0517
MM Article Release Date: 02/18/2005

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
MM Article #: SE0532
MM Article Release Date: 08/03/2005

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
MM Article #: SE0545
MM Article Release Date: 08/08/2005

Review of Documentation During Medical Review

Wed, 14 Dec 2005 10:09:00 EST

Transmittal #: R100PI
Subject: Review of Documentation During Medical Review
MM Article #: N/A
MM Article Release Date: N/A

Benefit Integrity (BI) PIM Revisions

Wed, 14 Dec 2005 10:10:00 EST

Transmittal #: R101PI
Subject: Benefit Integrity (BI) PIM Revisions
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Bone Mass Measurements - Procedure Coding

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R501CP
Subject: Bone Mass Measurements - Procedure Coding
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3775
MM Article Release Date: 07/26/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3688
MM Article Release Date: 02/10/2005

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).
MM Article #: MM4019
MM Article Release Date: 10/13/2005

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)
MM Article #: MM4035
MM Article Release Date: 10/03/2005

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
MM Article #: MM3728
MM Article Release Date: 02/11/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3660
MM Article Release Date: 02/04/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

List of Medicare Telehealth Services

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R517CP
Subject: List of Medicare Telehealth Services
MM Article #: MM3747
MM Article Release Date: 05/17/2005

Update to Repetitive Billing -- Manualization

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R711CP
Subject: Update to Repetitive Billing -- Manualization
MM Article #: MM4047
MM Article Release Date: 12/08/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Medical Review Additional Documentation Requests

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R125PI
Subject: Medical Review Additional Documentation Requests
MM Article #: MM4022
MM Article Release Date: 10/04/2005

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)
MM Article #: MM3939
MM Article Release Date: 11/25/2005

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
MM Article #: N/A
MM Article Release Date: N/A

Percutaneous Transluminal Angioplasty (PTA)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R531CP
Subject: Percutaneous Transluminal Angioplasty (PTA)
MM Article #: MM3811
MM Article Release Date: 12/02/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3775
MM Article Release Date: 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 #: R29MSP
Subject: Assignment of Non-Payment/Denial Code specific to the Recovery Audit Contractor (RAC) Created Group Health Plan (GHP) Occurrences
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3704
MM Article Release Date: 04/20/2005

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
MM Article #: N/A
MM Article Release Date: 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).
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Psychotherapy Notes

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R98PI
Subject: Psychotherapy Notes
MM Article #: MM3457
MM Article Release Date: 01/25/2005

Consent Settlements

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R96PI
Subject: Consent Settlements
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3741
MM Article Release Date: 04/20/2005

Flu/PPV Revisions

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R519CP
Subject: Flu/PPV Revisions
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3736
MM Article Release Date: 04/20/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3750
MM Article Release Date: 03/15/2005

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
MM Article #: N/A
MM Article Release Date: N/A

New Waived Tests

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R642CP
Subject: New Waived Tests
MM Article #: MM3984
MM Article Release Date: 08/23/2005

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)
MM Article #: MM3927
MM Article Release Date: 08/08/2005

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)
MM Article #: MM3936
MM Article Release Date: 08/04/2005

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
MM Article #: MM3386
MM Article Release Date: 07/20/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3834
MM Article Release Date: 07/20/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3648
MM Article Release Date: 06/30/2005

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
MM Article #: MM3726
MM Article Release Date: 02/25/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3735
MM Article Release Date: 05/05/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3647
MM Article Release Date: 02/07/2005

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
MM Article #: MM4037
MM Article Release Date: 10/18/2005

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
MM Article #: N/A
MM Article Release Date: N/A

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
MM Article #: MM3784
MM Article Release Date: 03/28/2005

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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Provider Extract File

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R22GI
Subject: Provider Extract File
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4106
MM Article Release Date: 10/18/2005

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
MM Article #: MM3956
MM Article Release Date: 08/08/2005

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
MM Article #: MM3775
MM Article Release Date: 07/26/2005

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
MM Article #: MM4031
MM Article Release Date: 09/09/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3848
MM Article Release Date: 06/06/2005

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
MM Article #: MM4082
MM Article Release Date: 10/04/2005

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)
MM Article #: MM4075
MM Article Release Date: 10/04/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4100
MM Article Release Date: 09/28/2005

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
MM Article #: MM3823
MM Article Release Date: 05/26/2005

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)
MM Article #: MM3867
MM Article Release Date: 06/29/2005

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
MM Article #: MM3627
MM Article Release Date: 10/04/2005

Appeals Transition- BIPA Section 521 App

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R146OTN
Subject: Appeals Transition- BIPA Section 521 App
MM Article #: MM3530
MM Article Release Date: 04/12/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3616
MM Article Release Date: 01/21/2005

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)
MM Article #: MM3640
MM Article Release Date: 01/20/2005

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
MM Article #: MM3870
MM Article Release Date: 05/11/2005

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
MM Article #: MM3977
MM Article Release Date: 09/15/2005

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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3666
MM Article Release Date: 02/10/2005

Appeals Transition- BIPA Section 521 Appeals

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R468CP
Subject: Appeals Transition- BIPA Section 521 Appeals
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4044
MM Article Release Date: 09/28/2005

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)
MM Article #: MM3944
MM Article Release Date: 11/25/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4116
MM Article Release Date: 10/19/2005

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
MM Article #: MM3827
MM Article Release Date: 05/18/2005

Flu/PPV Revision

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R525CP
Subject: Flu/PPV Revision
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3792
MM Article Release Date: 06/29/2005

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
MM Article #: MM3819
MM Article Release Date: 07/06/2005

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
MM Article #: MM3714
MM Article Release Date: 03/08/2005

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
MM Article #: N/A
MM Article Release Date: N/A

Osteogenic Stimulators

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R41NCD
Subject: Osteogenic Stimulators
MM Article #: MM3836
MM Article Release Date: 07/20/2005

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
MM Article #: MM3752
MM Article Release Date: 03/17/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3946
MM Article Release Date: N/A

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
MM Article #: MM3931
MM Article Release Date: 07/26/2005

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
MM Article #: MM3935
MM Article Release Date: 07/29/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3873
MM Article Release Date: 06/01/2005

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
MM Article #: MM3741
MM Article Release Date: 04/20/2005

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)
MM Article #: MM3843
MM Article Release Date: 05/12/2005

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
MM Article #: MM3846
MM Article Release Date: 05/18/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3818
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3705
MM Article Release Date: 04/29/2005

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
MM Article #: MM3647
MM Article Release Date: 02/07/2005

Type of Service (TOS) Correctionss

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R476CP
Subject: Type of Service (TOS) Correctionss
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3729
MM Article Release Date: 03/08/2005

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
MM Article #: MM3953
MM Article Release Date: 10/28/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3915
MM Article Release Date: 07/06/2005

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
MM Article #: MM3836
MM Article Release Date: 07/20/2005

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
MM Article #: N/A
MM Article Release Date: N/A

Change in Statistical Sampling Instructions

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R114PI
Subject: Change in Statistical Sampling Instructions
MM Article #: N/A
MM Article Release Date: N/A

Cochlear Implantation

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R589CP
Subject: Cochlear Implantation
MM Article #: MM3796
MM Article Release Date: 07/06/2005

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
MM Article #: MM3547
MM Article Release Date: 01/25/2005

Hemophilia Blood Clotting Fact

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R521CP
Subject: Hemophilia Blood Clotting Fact
MM Article #: MM3755
MM Article Release Date: 04/12/2005

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
MM Article #: MM3774
MM Article Release Date: 05/04/2005

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
MM Article #: MM3676
MM Article Release Date: 02/07/2005

Services Not Provided Within United States

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R654CP
Subject: Services Not Provided Within United States
MM Article #: MM3781
MM Article Release Date: 09/21/2005

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
MM Article #: MM3967
MM Article Release Date: 09/21/2005

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)
MM Article #: MM3800
MM Article Release Date: 04/29/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3830
MM Article Release Date: 05/06/2005

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
MM Article #: MM3866
MM Article Release Date: 05/06/2005

Medicare Qualifying Clinical Trials

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R487CP
Subject: Medicare Qualifying Clinical Trials
MM Article #: N/A
MM Article Release Date: N/A

Implantable Automatic Defibrillators

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R488CP
Subject: Implantable Automatic Defibrillators
MM Article #: MM3604
MM Article Release Date: 03/21/2005

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
MM Article #: MM3715
MM Article Release Date: 03/08/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3743
MM Article Release Date: 03/08/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3681
MM Article Release Date: 03/14/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3902
MM Article Release Date: 08/03/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3833
MM Article Release Date: 08/03/2005

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
MM Article #: MM3923
MM Article Release Date: 07/26/2005

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
MM Article #: MM3705
MM Article Release Date: 04/29/2005

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
MM Article #: MM3679
MM Article Release Date: N/A

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
MM Article #: N/A
MM Article Release Date: N/A

Autologous Stem Cell Transplantation (AuSCT)

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R32NCD
Subject: Autologous Stem Cell Transplantation (AuSCT)
MM Article #: MM3797
MM Article Release Date: 05/18/2005

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
MM Article #: N/A
MM Article Release Date: N/A

Chapter 3, MMA Section 935

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R123PI
Subject: Chapter 3, MMA Section 935
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Type of Service (TOS) Corrections

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R511CP
Subject: Type of Service (TOS) Corrections
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3742
MM Article Release Date: 06/23/2005

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
MM Article #: MM3756
MM Article Release Date: 04/08/2005

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
MM Article #: N/A
MM Article Release Date: 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).
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3847
MM Article Release Date: 07/01/2005

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)
MM Article #: MM3890
MM Article Release Date: 08/23/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3742
MM Article Release Date: 06/23/2005

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
MM Article #: MM3882
MM Article Release Date: 06/20/2005

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)
MM Article #: MM3789
MM Article Release Date: 04/22/2005

Hospital Audit Workload Updates

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R38MSP
Subject: Hospital Audit Workload Updates
MM Article #: MM4056
MM Article Release Date: 10/18/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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"
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4046
MM Article Release Date: 10/03/2005

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
MM Article #: N/A
MM Article Release Date: N/A

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3681
MM Article Release Date: 03/14/2005

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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

PIM Revision

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R115PI
Subject: PIM Revision
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3809
MM Article Release Date: 05/06/2005

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
MM Article #: MM3748
MM Article Release Date: 03/24/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3948
MM Article Release Date: 09/13/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3884
MM Article Release Date: 06/15/2005

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)
MM Article #: MM3883
MM Article Release Date: N/A

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4099
MM Article Release Date: 10/18/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3720
MM Article Release Date: 03/10/2005

Aprepitant for Chemotherapy-Induced Emesis

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R590CP
Subject: Aprepitant for Chemotherapy-Induced Emesis
MM Article #: MM3831
MM Article Release Date: 07/05/2005

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)
MM Article #: MM3674
MM Article Release Date: 02/10/2005

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)
MM Article #: MM3561
MM Article Release Date: 01/26/2005

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
MM Article #: MM3815
MM Article Release Date: 05/04/2005

Implantable Automatic Defibrillators

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R497CP
Subject: Implantable Automatic Defibrillators
MM Article #: MM3604
MM Article Release Date: N/A

IPPS Outlier Reconciliation

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R707CP
Subject: IPPS Outlier Reconciliation
MM Article #: MM3966
MM Article Release Date: 10/13/2005

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
MM Article #: MM3967
MM Article Release Date: 09/21/2005

Unprocessable Unassigned Form CMS-1500 Claims

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R505CP
Subject: Unprocessable Unassigned Form CMS-1500 Claims
MM Article #: MM3500
MM Article Release Date: 03/21/2005

Inflation Factor

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R428PR1
Subject: Inflation Factor
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3771
MM Article Release Date: 04/08/2005

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
MM Article #: N/A
MM Article Release Date: 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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3452
MM Article Release Date: 02/02/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3679
MM Article Release Date: 06/13/2005

Various Benefit Integrity (BI) Clarifications

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R118PI
Subject: Various Benefit Integrity (BI) Clarifications
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM3767
MM Article Release Date: 07/13/2005

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
MM Article #: MM3458
MM Article Release Date: 01/20/2005

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
MM Article #: MM3642
MM Article Release Date: 01/20/2005

Hospice Physician Recertification Requirements

Wed, 14 Dec 2005 10:40:00 EST

Transmittal #: R458CP
Subject: Hospice Physician Recertification Requirements
MM Article #: MM3686
MM Article Release Date: 01/04/2005

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)
MM Article #: MM3669
MM Article Release Date: 02/01/2005

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
MM Article #: N/A
MM Article Release Date: N/A

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4115
MM Article Release Date: 12/08/2005

Business Partners Systems Security Manual (BPSSM)

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R6SS
Subject: Business Partners Systems Security Manual (BPSSM)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4064
MM Article Release Date: 02/10/2006

Ambulance Inflation Factor for CY 2006

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R762CP
Subject: Ambulance Inflation Factor for CY 2006
MM Article #: MM4061
MM Article Release Date: 12/02/2005

Surrogate UPINs Reported on IDTF Claims

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R769CP
Subject: Surrogate UPINs Reported on IDTF Claims
MM Article #: MM4096
MM Article Release Date: 12/28/2005

Update to Repetitive Billing -- Manualization

Wed, 14 Dec 2005 11:45:00 EST

Transmittal #: R763CP
Subject: Update to Repetitive Billing -- Manualization
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4186
MM Article Release Date: 12/02/2005

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
MM Article #: MM4161
MM Article Release Date: 11/23/2005

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
MM Article #: N/A
MM Article Release Date: 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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4196
MM Article Release Date: 01/19/2006

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4079
MM Article Release Date: 02/10/2006

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
MM Article #: MM4177
MM Article Release Date: 12/02/2005

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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3952
MM Article Release Date: 11/03/2005

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).
MM Article #: N/A
MM Article Release Date: N/A

Provider Customer Service Program

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R15COM
Subject: Provider Customer Service Program
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: N/A

Lung Volume Reduction Surgery

Wed, 14 Dec 2005 14:27:00 EST

Transmittal #: R44NCD
Subject: Lung Volume Reduction Surgery
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4052
MM Article Release Date: 11/25/2005

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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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"
MM Article #: SE0509
MM Article Release Date: 01/25/2005

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
MM Article #: MM3632
MM Article Release Date: 01/12/2005

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
MM Article #: MM4164
MM Article Release Date: 11/28/2005

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
MM Article #: N/A
MM Article Release Date: N/A

Interest on MSP Debts

Fri, 16 Dec 2005 12:31:00 EST

Transmittal #: R45MSP
Subject: Interest on MSP Debts
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3970
MM Article Release Date: 01/12/2006

Consultation Services (Codes 99241 - 99255)

Fri, 16 Dec 2005 16:24:00 EST

Transmittal #: R782CP
Subject: Consultation Services (Codes 99241 - 99255)
MM Article #: MM4215
MM Article Release Date: 01/06/2006

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
MM Article #: MM3990
MM Article Release Date: 12/08/2005

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
MM Article #: MM4113
MM Article Release Date: 10/26/2005

Lung Volume Reduction Surgery

Wed, 21 Dec 2005 11:45:00 EST

Transmittal #: R768CP
Subject: Lung Volume Reduction Surgery
MM Article #: MM4149
MM Article Release Date: 12/22/2005

Stem Cell Transplantation

Wed, 21 Dec 2005 11:45:00 EST

Transmittal #: R766CP
Subject: Stem Cell Transplantation
MM Article #: MM4173
MM Article Release Date: 12/21/2005

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
MM Article #: MM4114
MM Article Release Date: 12/22/2005

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)
MM Article #: MM4212
MM Article Release Date: 12/22/2005

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
MM Article #: SE0587
MM Article Release Date: 12/22/2005

Islet Cell Transplantation

Thu, 22 Dec 2005 09:54:00 EST

Transmittal #: R18NCD
Subject: Islet Cell Transplantation
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM4194
MM Article Release Date: 12/21/2005

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4238
MM Article Release Date: 01/23/2006

Consultation Services (Codes 99241 - 99255)

Fri, 23 Dec 2005 10:10:00 EST

Transmittal #: R788CP
Subject: Consultation Services (Codes 99241 - 99255)
MM Article #: MM4215
MM Article Release Date: 01/05/2006

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
MM Article #: N/A
MM Article Release Date: N/A

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
MM Article #: MM4259
MM Article Release Date: 01/20/2006

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: MM4183
MM Article Release Date: 11/02/2005

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
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: N/A

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4206
MM Article Release Date: 12/22/2005

New Waived Tests

Thu, 29 Dec 2005 12:31:00 EST

Transmittal #: R779CP
Subject: New Waived Tests
MM Article #: MM4136
MM Article Release Date: 12/22/2005

2006 Oncology Demonstration Project

Thu, 29 Dec 2005 13:42:00 EST

Transmittal #: r34demo
Subject: 2006 Oncology Demonstration Project
MM Article #: N/A
MM Article Release Date: N/A

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
MM Article #: MM4188
MM Article Release Date: 01/19/2006

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
MM Article #: SE0588
MM Article Release Date: 12/29/2005

2006 Oncology Demonstration Project

Thu, 29 Dec 2005 14:14:00 EST

Transmittal #: SE0589
Subject: 2006 Oncology Demonstration Project
MM Article #: SE0589
MM Article Release Date: 12/29/2005

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
MM Article #: MM4236
MM Article Release Date: 12/22/2005

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
MM Article #: MM3886
MM Article Release Date: 01/11/2006

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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4156
MM Article Release Date: 01/05/2006

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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4268
MM Article Release Date: 01/06/2006

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)
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4119
MM Article Release Date: 01/04/2006

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)
MM Article #: MM4250
MM Article Release Date: 01/25/2006

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
MM Article #: MM4234
MM Article Release Date: 01/18/2006

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
MM Article #: MM4193
MM Article Release Date: 01/04/2006

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
MM Article #: MM4232
MM Article Release Date: 01/04/2006

Low Vision Rehabilitation Demonstration

Wed, 04 Jan 2006 15:43:00 EST

Transmittal #: R25DEMO
Subject: Low Vision Rehabilitation Demonstration
MM Article #: MM3816
MM Article Release Date: 01/04/2006

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
MM Article #: MM4217
MM Article Release Date: 01/04/2006

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
MM Article #: MM4193
MM Article Release Date: 01/04/2006

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)
MM Article #: MM4103
MM Article Release Date: 11/02/2005

Low Vision Rehabilitation Demonstration

Mon, 09 Jan 2006 08:14:00 EST

Transmittal #: R23DEMO
Subject: Low Vision Rehabilitation Demonstration
MM Article #: MM3816
MM Article Release Date: 06/21/2005

Auditory Osseointegrated and Auditory Brainstem Devices

Thu, 12 Jan 2006 08:33:00 EST

Transmittal #: R39BP
Subject: Auditory Osseointegrated and Auditory Brainstem Devices
MM Article #: MM4038
MM Article Release Date: 11/18/2005

Update to Repetitive Billing -- Manualization

Thu, 12 Jan 2006 12:20:00 EST

Transmittal #: R763CP
Subject: Update to Repetitive Billing -- Manualization
MM Article #: N/A
MM Article Release Date: N/A

List of Medicare Telehealth Services

Thu, 12 Jan 2006 14:42:00 EST

Transmittal #: R790CP
Subject: List of Medicare Telehealth Services
MM Article #: MM4204
MM Article Release Date: 01/12/2006

List of Medicare Telehealth Services

Thu, 12 Jan 2006 14:43:00 EST

Transmittal #: R43BP
Subject: List of Medicare Telehealth Services
MM Article #: MM4204
MM Article Release Date: 01/12/2006

Stem Cell Transplantation

Thu, 12 Jan 2006 14:48:00 EST

Transmittal #: R776CP
Subject: Stem Cell Transplantation
MM Article #: MM4173
MM Article Release Date: 12/21/2005

Stem Cell Transplantation

Thu, 12 Jan 2006 14:49:00 EST

Transmittal #: R45NCD
Subject: Stem Cell Transplantation
MM Article #: MM4173
MM Article Release Date: 12/21/2005

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)
MM Article #: MM4184
MM Article Release Date: 01/12/2006

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
MM Article #: N/A
MM Article Release Date: 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.
MM Article #: N/A
MM Article Release Date: N/A

Medical Director Guidance

Fri, 27 Jan 2006 15:30:00 EST

Transmittal #: R15SOMA
Subject: Medical Director Guidance
MM Article #: N/A
MM Article Release Date: 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)
MM Article #: N/A
MM Article Release Date: 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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM3584
MM Article Release Date: 03/28/2005

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
MM Article #: MM3845
MM Article Release Date: 11/23/2005

Erroneous Guidance - Basis to Waive Penalty

Tue, 21 Aug 2007 07:15:00 EST

Transmittal #: R739CP
Subject: Erroneous Guidance - Basis to Waive Penalty
MM Article #: MM3898
MM Article Release Date: 11/08/2005

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
MM Article #: MM3562
MM Article Release Date: 10/13/2005

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
MM Article #: N/A
MM Article Release Date: N/A

Change in Provider Enrollment Timeliness Standards

Fri, 31 Aug 2007 10:34:00 EST

Transmittal #: R134PI
Subject: Change in Provider Enrollment Timeliness Standards
MM Article #: N/A
MM Article Release Date: N/A

Provider Contact Centers Training Program

Fri, 07 Sep 2007 14:25:00 EST

Transmittal #: R13COM
Subject: Provider Contact Centers Training Program
MM Article #: N/A
MM Article Release Date: N/A

Provider Inquiry Reporting Standardization

Fri, 07 Sep 2007 14:35:00 EST

Transmittal #: R14COM
Subject: Provider Inquiry Reporting Standardization
MM Article #: N/A
MM Article Release Date: 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
MM Article #: MM4023
MM Article Release Date: 11/29/2005

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
MM Article #: SE0528
MM Article Release Date: 05/12/2005

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
MM Article #: MM4051
MM Article Release Date: 08/11/2005

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)
MM Article #: MM3848
MM Article Release Date: 06/06/2005

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
MM Article #: SE0555
MM Article Release Date: 10/03/2005

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).
MM Article #: MM3939
MM Article Release Date: 11/25/2005

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)
MM Article #: MM3944
MM Article Release Date: 11/25/2005

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
MM Article #: N/A
MM Article Release Date: 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.
MM Article #: N/A
MM Article Release Date: 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
MM Article #: SE0529
MM Article Release Date: 04/12/2005