The following update has been posted to the Palmetto/J1MAC website.
NHIC Customers (Segment 3): The J1 Part B Go Live date is September 2,
2008!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NHIC%20Customers%20(Segment%203)%3A%20The%20J1%20Part%20B%20Go%20Live%20date%20is%20September%202%2C%202008!?opendocument
Attention NHIC Customers (Segment 3): 7 days and counting. Are you ready
?!? If you currently receive electronic payments from your current
contractor and have not submitted an updated CMS-588 Form to Palmetto GBA,
please do so immediately.
Applies to:
Part B Transition: EDI
Wednesday, August 27, 2008
Tuesday, August 26, 2008
THIS WEEK AT ACCC: AUGUST 25-29, 2008
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published today and may be found online at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCC_aug25_08.html. ANCO is an Institutional Member of ACCC. ANCO is an Institutional Member of ACCC.
This edition features:
New Survey Released About Off-Label Drug Use by Practices
Tell Your Pharmacists: An ACCC Meeting Just For Them
Still Time to Register for ACCC's 25th National Oncology Economics Conference
Sneak Peek: ACCC Meeting to Showcase Exhibitors
FDA Approves Nplate for Long-Term Treatment of Adult Chronic ITP
Strengthened Oncology Safety Information for Epogen/Procrit and Aranesp
Survey Still Open: ACCC Delegate Reps Please Take Notice
Q&A on ACCC's Listserv: Financial Counselors
NCI Issues New Tobacco Control Monograph
ACCC's CE Blackboard: New Continuing Education Programs for You
State Medical Oncology Societies Host Upcoming Meetings
This edition features:
New Survey Released About Off-Label Drug Use by Practices
Tell Your Pharmacists: An ACCC Meeting Just For Them
Still Time to Register for ACCC's 25th National Oncology Economics Conference
Sneak Peek: ACCC Meeting to Showcase Exhibitors
FDA Approves Nplate for Long-Term Treatment of Adult Chronic ITP
Strengthened Oncology Safety Information for Epogen/Procrit and Aranesp
Survey Still Open: ACCC Delegate Reps Please Take Notice
Q&A on ACCC's Listserv: Financial Counselors
NCI Issues New Tobacco Control Monograph
ACCC's CE Blackboard: New Continuing Education Programs for You
State Medical Oncology Societies Host Upcoming Meetings
UCSF Clinical Trials Update
he following information is provided by UCSF, an ANCO Institutional Member.
We would like to call your attention to the following two new clinical trials for peripheral T-cell Lymphoma and CLL at UCSF:
First-line Treatment of Peripheral T-cell Lymphoma
This multi-center trial uses the combination of gemcitabine/vinorelbine/doxil and augmented CHOP / high-dose methotrexate as induction therapy followed by stem cell mobilization/consolidation with high-dose cytarabine, etoposide and denileukin diftitox (Ontak) as in vivo purge. This is followed by high-dose chemotherapy and auto-transplant. A short course of post-transplant maintenance Ontak is then administered. Most patients with untreated alk-1-negative peripheral T-cell lymphomas are eligible.
Phase II study of Flavoperidol for refractory CLL
Requires brief hospital stay in ICU for prevention and monitoring of tumor lysis syndrome. This is a highly active drug and one of the few agents active in patients with 17p deletions. Most patients with relapsed / refractory CLL who have received one or more prior therapies will be eligible. Patients must have received prior alkylating agents and be fludarabine refractory.
If you have a patient who might be helped by one of these protocols, please call:
Lawry Kaplan, MD
415-443-9188 (pager)
415-353-2661 (office VM)
or
Beth Davis, Research Office Manager
415-502-3176
We would like to call your attention to the following two new clinical trials for peripheral T-cell Lymphoma and CLL at UCSF:
First-line Treatment of Peripheral T-cell Lymphoma
This multi-center trial uses the combination of gemcitabine/vinorelbine/doxil and augmented CHOP / high-dose methotrexate as induction therapy followed by stem cell mobilization/consolidation with high-dose cytarabine, etoposide and denileukin diftitox (Ontak) as in vivo purge. This is followed by high-dose chemotherapy and auto-transplant. A short course of post-transplant maintenance Ontak is then administered. Most patients with untreated alk-1-negative peripheral T-cell lymphomas are eligible.
Phase II study of Flavoperidol for refractory CLL
Requires brief hospital stay in ICU for prevention and monitoring of tumor lysis syndrome. This is a highly active drug and one of the few agents active in patients with 17p deletions. Most patients with relapsed / refractory CLL who have received one or more prior therapies will be eligible. Patients must have received prior alkylating agents and be fludarabine refractory.
If you have a patient who might be helped by one of these protocols, please call:
Lawry Kaplan, MD
415-443-9188 (pager)
415-353-2661 (office VM)
or
Beth Davis, Research Office Manager
415-502-3176
Monday, August 25, 2008
CMS/Medicare: Information for Eligible Professionals Who Participated in the 2007 Physician Quality Reporting Initiative (PQRI)
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that 2007 PQRI Final Feedback Reports are available on a secure website. Two MLN Matters articles on accessing the reports are now available that can assist individual eligible professionals and group practices that reported valid 2007 PQRI quality measures data to Medicare. The reports are organized by Tax Identification Number (TIN). For eligible professionals reporting measures for 2007 PQRI under a group practice TIN, the group practice determines who can access the Feedback Report for the group practice or organization.
The first article, “Steps for Individual Eligible Professionals to Access Their 2007 PQRI Feedback Reports Personally”, SE0830, can be accessed at (http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf)
The second article, “Steps for Organizations to Access Their 2007 PQRI Feedback Reports”, SE0831, is available at (http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf).
Once you are registered in the Individuals Authorized Access to CMS Computer Services (IACS) system and have access to the PQRI feedback report application, any questions about the Feedback Report should be directed to the Report Delivery System Help Desk referenced at the end of the end of the MLN Matters articles. Additional educational resources and information about the PQRI program is available at http://www.cms.hhs.gov/PQRI/.
The first article, “Steps for Individual Eligible Professionals to Access Their 2007 PQRI Feedback Reports Personally”, SE0830, can be accessed at (http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf)
The second article, “Steps for Organizations to Access Their 2007 PQRI Feedback Reports”, SE0831, is available at (http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf).
Once you are registered in the Individuals Authorized Access to CMS Computer Services (IACS) system and have access to the PQRI feedback report application, any questions about the Feedback Report should be directed to the Report Delivery System Help Desk referenced at the end of the end of the MLN Matters articles. Additional educational resources and information about the PQRI program is available at http://www.cms.hhs.gov/PQRI/.
DHCS/MediCal 10% Rate Cut Injunction
A federal judge has ordered a temporary halt in the state's 10 percent reduction in Medi-Cal reimbursement rates, improving access to care for 6.5 million low-income patients but throwing a new wrench in already difficult budget negotiations.
The U.S. District Court decision forces the state to reimburse most Medi-Cal providers at rates prior to the 10 percent cut, which lawmakers and Gov. Arnold Schwarzenegger made effective July 1 as a cost-cutting measure to help resolve a $15.2 billion budget shortfall this year.
The move increases reimbursement rates the state pays to doctors, dentists, pharmacists, adult day-care centers and other providers who serve Medi-Cal patients. It excludes some hospitals who do not contract with the state and do not provide emergency care.
"There's no question this is good news," said Anthony Wright, executive director of Health Access California, a consumer group. "We already have more than half of doctors not taking Medi-Cal patients because of low reimbursement rates, so the additional rate cut was going to further reduce access to care for millions of children, parents, seniors and people with disabilities."
But the injunction comes as lawmakers remain divided because they cannot agree whether to bridge the budget spending gap with new taxes, borrowing or spending cuts. If the state ultimately loses the Medi-Cal reimbursement case, it could face an additional $575 million hole on top of the $15.2 billion deficit, according to Schwarzenegger's Department of Finance.
"We've always said these are difficult but necessary cuts in order for the state to close its $15 billion budget deficit," said Schwarzenegger spokeswoman Lisa Page. She said the Governor's Office is reviewing the ruling and determining what its next step will be.
The state is now 51 days into the new fiscal year without a budget, and some Medi-Cal providers stopped receiving payments in late July because the state does not have a spending plan in place.
Lawmakers and Schwarzenegger in February enacted emergency spending cuts that reduced Medi-Cal reimbursements starting July 1. Groups representing providers filed lawsuits against the state charging that the reduction violated federal law and would cause irreparable harm to Medi-Cal patients because it would reduce access to care.
Democrats agreed to the Medi–Cal cuts in February but said Tuesday their proposed budget, which includes higher taxes on high-income earners, would rescind the cuts if enacted.
"I think all the way along, many of us have thought this was not a good idea because reimbursement rates already are very low, and a cut could be the straw that breaks the camel's back in physicians and nursing homes deciding not to cover Medi-Cal patients," said Assemblyman John Laird, D-Santa Cruz.
But Laird also said that "right now we have such a big budget hole that we are at loggerheads in resolving that it's always difficult when somebody makes the hole bigger."
Sen. Sam Aanestad, R-Grass Valley, an oral surgeon and one of the few GOP legislators to oppose the cuts in February, applauded the judge's decision.
"It looks like the judge recognized that these people have no access, and certainly not equal access to services, at least not the way the (federal) program was envisioned."
Aanestad said the Senate GOP caucus identified $9 billion in cuts in "nonessential services" without touching reimbursement rates.
But Wright said the decision means lawmakers must become that much more open to new revenues, such as tax increases proposed by Democrats. Without new revenues, he feared the state would reduce Medi-Cal eligibility or benefits.
The U.S. District Court decision forces the state to reimburse most Medi-Cal providers at rates prior to the 10 percent cut, which lawmakers and Gov. Arnold Schwarzenegger made effective July 1 as a cost-cutting measure to help resolve a $15.2 billion budget shortfall this year.
The move increases reimbursement rates the state pays to doctors, dentists, pharmacists, adult day-care centers and other providers who serve Medi-Cal patients. It excludes some hospitals who do not contract with the state and do not provide emergency care.
"There's no question this is good news," said Anthony Wright, executive director of Health Access California, a consumer group. "We already have more than half of doctors not taking Medi-Cal patients because of low reimbursement rates, so the additional rate cut was going to further reduce access to care for millions of children, parents, seniors and people with disabilities."
But the injunction comes as lawmakers remain divided because they cannot agree whether to bridge the budget spending gap with new taxes, borrowing or spending cuts. If the state ultimately loses the Medi-Cal reimbursement case, it could face an additional $575 million hole on top of the $15.2 billion deficit, according to Schwarzenegger's Department of Finance.
"We've always said these are difficult but necessary cuts in order for the state to close its $15 billion budget deficit," said Schwarzenegger spokeswoman Lisa Page. She said the Governor's Office is reviewing the ruling and determining what its next step will be.
The state is now 51 days into the new fiscal year without a budget, and some Medi-Cal providers stopped receiving payments in late July because the state does not have a spending plan in place.
Lawmakers and Schwarzenegger in February enacted emergency spending cuts that reduced Medi-Cal reimbursements starting July 1. Groups representing providers filed lawsuits against the state charging that the reduction violated federal law and would cause irreparable harm to Medi-Cal patients because it would reduce access to care.
Democrats agreed to the Medi–Cal cuts in February but said Tuesday their proposed budget, which includes higher taxes on high-income earners, would rescind the cuts if enacted.
"I think all the way along, many of us have thought this was not a good idea because reimbursement rates already are very low, and a cut could be the straw that breaks the camel's back in physicians and nursing homes deciding not to cover Medi-Cal patients," said Assemblyman John Laird, D-Santa Cruz.
But Laird also said that "right now we have such a big budget hole that we are at loggerheads in resolving that it's always difficult when somebody makes the hole bigger."
Sen. Sam Aanestad, R-Grass Valley, an oral surgeon and one of the few GOP legislators to oppose the cuts in February, applauded the judge's decision.
"It looks like the judge recognized that these people have no access, and certainly not equal access to services, at least not the way the (federal) program was envisioned."
Aanestad said the Senate GOP caucus identified $9 billion in cuts in "nonessential services" without touching reimbursement rates.
But Wright said the decision means lawmakers must become that much more open to new revenues, such as tax increases proposed by Democrats. Without new revenues, he feared the state would reduce Medi-Cal eligibility or benefits.
Palmetto/J1MAC Website Updates
The following updates have been posted to the Palmetto/J1MAC Website.
Batch Detail Control Listing (BCL) Update
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Batch%20Detail%20Control%20Listing%20(BCL)%20Update?opendocument
Palmetto GBA has been forwarding the MCS Batch Control Listing (BCL) report
during early boarding from the outgoing Part B contractors. GPNet, our EDI
front-end, generates a similar response report that includes the acceptance
or rejection status of claim files. Since the information on the BCL report
is duplicated in the GPNet Response Report, Palmetto GBA will no longer
forward BCL reports after cutover verification has been completed.
Applies to:
Part B Transition: EDI
----------
Jurisdiction 1 Submitters: Avoid EDI Busy Times with these Tips!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Jurisdiction%201%20Submitters%3A%20Avoid%20EDI%20Busy%20Times%20with%20these%20Tips!?opendocument
The Palmetto GBA EDI Technology Support Center (TSC) is open for support
calls between 8:00 a.m. - 5:00 p.m. PST. Call analysis reveals that the
hours between noon and 3:00 p.m. PST are the busiest times—times during
which response times and wait times are the longest. The low volume times
are between 3:00 p.m. and 5:00 p.m. PST.
Applies to:
Part A Transition: EDI
Part B Transition: General
----------
NHIC Customers (Segment 3): The J1 Part B Go Live date is September 2,
2008!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NHIC%20Customers%20(Segment%203)%3A%20The%20J1%20Part%20B%20Go%20Live%20date%20is%20September%202%2C%202008!?opendocument
Attention NHIC Customers (Segment 3): 13 days and counting. Are you
ready ?!? If you currently receive electronic payments from your current
contractor and have not submitted an updated CMS-588 Form to Palmetto GBA,
please do so immediately.
Applies to:
Part B Transition: EDI
----------
Part B
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B?opendocument
********NOTE: IF you are unable to access article through the link below,
go to www.palmettogba.com/j1, click on Learning and Education, click on
Policies and Procedures, then click on the Part B link in the middle of the
page.******** Palmetto GBA has posted articles outlining Part B claims
processing changes and/or reminders. The information contained in these
articles is applicable after the transition to the MAC contractor. Billing
and submission processes used by the current contractor remains in effect
until after the transition.
New articles added 8/20/2008: *ASC - SG Modifier Reminder*
Applies to:
Part B Transition: General
Batch Detail Control Listing (BCL) Update
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Batch%20Detail%20Control%20Listing%20(BCL)%20Update?opendocument
Palmetto GBA has been forwarding the MCS Batch Control Listing (BCL) report
during early boarding from the outgoing Part B contractors. GPNet, our EDI
front-end, generates a similar response report that includes the acceptance
or rejection status of claim files. Since the information on the BCL report
is duplicated in the GPNet Response Report, Palmetto GBA will no longer
forward BCL reports after cutover verification has been completed.
Applies to:
Part B Transition: EDI
----------
Jurisdiction 1 Submitters: Avoid EDI Busy Times with these Tips!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Jurisdiction%201%20Submitters%3A%20Avoid%20EDI%20Busy%20Times%20with%20these%20Tips!?opendocument
The Palmetto GBA EDI Technology Support Center (TSC) is open for support
calls between 8:00 a.m. - 5:00 p.m. PST. Call analysis reveals that the
hours between noon and 3:00 p.m. PST are the busiest times—times during
which response times and wait times are the longest. The low volume times
are between 3:00 p.m. and 5:00 p.m. PST.
Applies to:
Part A Transition: EDI
Part B Transition: General
----------
NHIC Customers (Segment 3): The J1 Part B Go Live date is September 2,
2008!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NHIC%20Customers%20(Segment%203)%3A%20The%20J1%20Part%20B%20Go%20Live%20date%20is%20September%202%2C%202008!?opendocument
Attention NHIC Customers (Segment 3): 13 days and counting. Are you
ready ?!? If you currently receive electronic payments from your current
contractor and have not submitted an updated CMS-588 Form to Palmetto GBA,
please do so immediately.
Applies to:
Part B Transition: EDI
----------
Part B
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B?opendocument
********NOTE: IF you are unable to access article through the link below,
go to www.palmettogba.com/j1, click on Learning and Education, click on
Policies and Procedures, then click on the Part B link in the middle of the
page.******** Palmetto GBA has posted articles outlining Part B claims
processing changes and/or reminders. The information contained in these
articles is applicable after the transition to the MAC contractor. Billing
and submission processes used by the current contractor remains in effect
until after the transition.
New articles added 8/20/2008: *ASC - SG Modifier Reminder*
Applies to:
Part B Transition: General
NHIC/Medicare Website Updates
Important Transition Information for California Part B Providers Only
Effective September 2, 2008, the new J1 Contractor will assume full responsibility for Northern and Southern California Part B providers. Additional transition information for Medicare Part B providers in California is available here.
Last Medicare payments made by NHIC August 25, 2008
From Aug 28, 2008 through Sept 1, 2008, the system will experience 'dark days'. There will not be any online access, current claim information will not be provided via the IVR or Provider Contact Center, and claims will not be processed.
California Website Shutdown
This applies only to the NHIC, Corp. Medicare Part B California website. Other NHIC, Corp. Medicare sites will still be accessible from http://www.medicarenhic.com.
Effective September 2, 2008, the new J1 Contractor will assume full responsibility for Northern and Southern California Part B providers. Additional transition information for Medicare Part B providers in California is available here.
Last Medicare payments made by NHIC August 25, 2008
From Aug 28, 2008 through Sept 1, 2008, the system will experience 'dark days'. There will not be any online access, current claim information will not be provided via the IVR or Provider Contact Center, and claims will not be processed.
California Website Shutdown
This applies only to the NHIC, Corp. Medicare Part B California website. Other NHIC, Corp. Medicare sites will still be accessible from http://www.medicarenhic.com.
ASCO's Cancer Policy Today Published
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available at http://view.exacttarget.com/?j=fe63157777640c797116&m=ff311d707460&ls=fe0112707160057f72157377&l=fea516737564057975&s=fe1f15797d620479731d75&ju=fe3416707661057e721270. ANCO is a state/regional affiliate of ASCO.
This edition features:
ASCO Launches Electronic Health Record Podcasts
Dr. John V. Cox Named New Editor-in-Chief of ASCO's Journal of Oncology Practice
FDA Releases Guidance on Advisory Committee Process
Your Participation Need for the Physician Practice Information Survey
This edition features:
ASCO Launches Electronic Health Record Podcasts
Dr. John V. Cox Named New Editor-in-Chief of ASCO's Journal of Oncology Practice
FDA Releases Guidance on Advisory Committee Process
Your Participation Need for the Physician Practice Information Survey
CMA Alert: Budget Gridlock in Sacramento
The California Medical Association (CMA) Alert was published today and is available at http://www.calphys.org/html/news.asp.
It features:
Budget Gridlock in Sacramento – Fate of Healthcare Cuts Uncertain
CMA Legislative Victory – Physicians Removed From Costly and Burdensome Reporting Legislation
CMA Publishes New Silent PPO Guide
Blue Shield Clarifies Contract Amendment
Switch to New Medicare Contractor Is September 2
Have You Updated Your Medicare Enrollment Information?
Is Your Practice Experiencing Medicare Payment Stoppage?
Medi-Cal Will Reject Claims with Legacy IDs on October 1
Member Benefit of the Week: Free Portfolio Checkup
It features:
Budget Gridlock in Sacramento – Fate of Healthcare Cuts Uncertain
CMA Legislative Victory – Physicians Removed From Costly and Burdensome Reporting Legislation
CMA Publishes New Silent PPO Guide
Blue Shield Clarifies Contract Amendment
Switch to New Medicare Contractor Is September 2
Have You Updated Your Medicare Enrollment Information?
Is Your Practice Experiencing Medicare Payment Stoppage?
Medi-Cal Will Reject Claims with Legacy IDs on October 1
Member Benefit of the Week: Free Portfolio Checkup
PLAYBACK of MOASC/Palmetto GBA General Transition Updates and Part B Claims Update Teleconference of 08212008
ANCO members are invited to take advantage of this playback opportunity.
The playback recording of MOASC’s Teleconference with Palmetto GBA J1 MAC of August 21, 2008 is now available.
Please call: 866-212-0875
Enter pass code: 737194#
Press *3 to enter the Recording Playback menu
The system will prompt you for the file number: 062180#
The system will confirm the file number entered
The system will prompt you to enter the number of minutes you wish to skip from the beginning of the recording, followed by the # key. If you do not wish to skip any minutes, press 0 followed by the # key, or stay on the line.
A confirmation message will be heard and the playback will begin.
If you have any questions, please do not hesitate to contact the MOASC office by replying to this message or call 800-310-3553.
The playback recording of MOASC’s Teleconference with Palmetto GBA J1 MAC of August 21, 2008 is now available.
Please call: 866-212-0875
Enter pass code: 737194#
Press *3 to enter the Recording Playback menu
The system will prompt you for the file number: 062180#
The system will confirm the file number entered
The system will prompt you to enter the number of minutes you wish to skip from the beginning of the recording, followed by the # key. If you do not wish to skip any minutes, press 0 followed by the # key, or stay on the line.
A confirmation message will be heard and the playback will begin.
If you have any questions, please do not hesitate to contact the MOASC office by replying to this message or call 800-310-3553.
Wednesday, August 20, 2008
CMS/Medicare Website Updates--PQRI Reports (2007)
The following updates have been posted to the CMS/Medicare website.
MM6109 – Remittance Advice Remark Code and Claim Adjustment Reason Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6109.pdf
MM6158 – Part B Drug Competitive Acquisition Program (CAP) Quarterly Drug Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6158.pdf
MM6131 – Implementation of a New Claim Adjustment Reason Code (CARC) No.213. "Non-compliance with the physician self-referral prohibition legislation or payer policy"
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6131.pdf
MM6124 – Revisions to the Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6124.pdf
MM6109 – Remittance Advice Remark Code and Claim Adjustment Reason Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6109.pdf
MM6158 – Part B Drug Competitive Acquisition Program (CAP) Quarterly Drug Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6158.pdf
MM6131 – Implementation of a New Claim Adjustment Reason Code (CARC) No.213. "Non-compliance with the physician self-referral prohibition legislation or payer policy"
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6131.pdf
MM6124 – Revisions to the Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6124.pdf
DHCS/MediCal Program Update - NDC Reporting
Beginning September 1, 2008, providers are encouraged to begin using the National Drug Code (NDC) for physician-administered drugs, in conjunction with the customary Healthcare Common Procedure Coding System (HCPCS) Level I, II, or III code, on all Medi-Cal claims. Claims submitted for dates of service September 1, 2008 through March 31, 2009 without an NDC will not be denied. However, claims with dates of service on or after April 1, 2009 that do not meet the NDC reporting requirements to include a valid NDC present with a HCPCS code, will result in that claim being denied. [FPACT only] HCPCS codes X1500 and Z7610 used by the Family PACT (Planning, Access, Care and Treatment) Program do not require an NDC.
The Deficit Reduction Act of 2005 (DRA) requires all state Medicaid Agencies to collect rebates from drug manufacturers for physician-administered or dispensed drugs. This requirement also applies to Medicare crossover claims. Only those products manufactured by companies participating in the federal Medicaid rebate program are reimbursable under Medi-Cal. A list of manufacturers participating in the rebate program, which changes periodically, is available in the Medi-Cal pharmacy manual under Drugs: Contract Drugs List Part 5 – Authorized Manufacturer Labeler Codes (drugs cdl p5) or on the Medi-Cal website at: http://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/part2/drugscdlp5_p00.doc
This email is advance notice that the Department of Healthcare Services (DHCS) will soon be publishing the details regarding NDC reporting requirements. All documentation, such as Medi-Cal Updates and Companion Guides, are currently being updated, therefore, we are providing an attachment (below) for you and your members that includes the details of this announcement. Those details include: NDC and physician-administered drug definitions; billing descriptions and examples for CMS 1500 and UB-04 paper claim forms, as well as both 837 Institutional and Professional electronic formats; and Section 340B information.
Should you have any questions or need additional information, please call the Telephone Service Center (TSC) at 1-800-541-5555 or visit the Medi-Cal Web site at the address listed above.
National Drug Code (NDC) Description
The NDC is the number that identifies a drug. The NDC number consists of 11 digits in a 5-4-2 format. NDCs printed on packages often have fewer than 11 digits, with hyphens (-) separating the number into three segments. For a complete 11-digit number, the first segment must have five digits, the second segment four digits and the third segment two digits. The first 5 digits identify the manufacturer of the drug and are assigned by the Food and Drug Administration (FDA). The remaining digits are assigned by the manufacturer and identify the specific product and package size. Add leading zeros wherever they are needed to complete a segment with the correct number of digits.
For example:
Package Number Zero Fill 11-digit NDC
1234-1234-12 (01234-1234-12) 01234123412
12345-123-12 (12345-0123-12) 12345012312
2-22-2 (00002-0022-02) 00002002202
The NDC is found on the drug container: vial, bottle, tube. The NDC submitted to Medi-Cal must be the actual NDC number on the package or container from which the medication was administered. Do not bill for one manufacturer’s product and dispense another. It is considered a fraudulent billing practice to bill using an NDC other than the one administered.
Physician-administered drugs
A physician-administered drug includes any covered outpatient drug provided or administered to a beneficiary, which is billed by a provider other than a pharmacy. Such providers would include, but not be limited to: physician offices, clinics and hospitals. A covered outpatient drug is broadly defined as a drug which may be dispensed only upon prescription and which is approved for safety and effectiveness as a prescription drug under the Federal Food, Drug and Cosmetic Act. Physician-administered drugs are not restricted to injectable drugs only; physician-administered drugs include any drug regardless of the route of administration.
Drug Identification Guidelines
There are three items to look for that will identify whether or not a product is a drug:
1. National Drug Code or NDC: the vial or the box which held the drug will have an NDC which will be used for the claim.
2. Lot and Expiration date: all drugs have both a Lot Number and Expiration Date somewhere on the vial or box.
3. Legend: This refers to the statement “Caution: federal law prohibits dispensing without prescription,” “Rx only” or similar words. All prescription drugs will have this statement.
Claims processing
Claims will continue to be priced based on the HCPCS code, with the NDC and corresponding units being used for drug rebate processing. Medicare primary claims will also require NDCs with HCPCS codes.
Reporting Quantities
Reporting instructions apply to both paper claims and electronic transactions. At this time, Medi-Cal will use only the HCPCS quantities/units for payment and rebate purposes. Sometimes it may be necessary for providers to bill multiple NDCs for a single procedure code. This may happen when two different strengths of the same drug are needed in order to administer the appropriate dose. This will also be necessary when multiple vials of the same drug are used to administer the appropriate dose and the vials are manufactured by different manufacturers. When a provider uses more than one NDC for a drug, the provider must include all NDCs on the claim. The quantity for each NDC must be reported separately by repeating the HCPCS code.
Paper claims
CMS 1500
For paper claims submitted on the CMS 1500 claim form, the NDC is reported in the shaded area above field 24a.
Box 24A (shaded area) – This area will have a combination of two values entered there: Bytes 1 and 2 will include the Product ID Qualifier. This qualifier identifies the type of number that is being provided, which is an NDC, with a qualifier of ‘N4’. Bytes 3 - 21 will consist of the entry of the appropriate number for the qualifier entered in the first two digits. The length of this additional information will vary dependent upon the type of number being provided (as identified by the previous 2 byte Product ID Qualifier).
Example: N4 as the Product ID Qualifier, followed by the 11 digit NDC - N412345678901
Box 24D – The HCPCS code will continue to be entered in 24D, with the charges in Box 24F and units in Box 24G.
Box 24D (shaded area) – In this area, enter the NDC unit of measure (two positions) immediately followed by the numeric quantity administered to the patient, which is a full ten-digit number. The ten digits consist of seven digits for the whole number, followed by the three-digit decimal portion of the number.
Note: The quantity field should be entered from left to right; do not enter a decimal. Valid Unit of Measurement Qualifiers are:
F2 = international unit
GR = gram
ML = milliliter
UN = unit
Examples: UN0000012000 for a quantity of 12 units (UN)
ML0000124540 for a quantity of 124.54 milliliters (ML)
UB-04
For paper claims submitted on the UB-04 claim form, the NDC is reported in the Description field (Box 43).
Box 43 – Enter the two-digit Product ID Qualifier ‘N4’ in the first two positions, immediately followed by the 11-digit NDC (no hyphens). Directly following the last digit of the NDC (no delimiter), enter the two-digit Unit of Measurement Qualifier as noted above. Immediately following the Unit of Measurement Qualifier, enter the nine-digit quantity. The nine digits consist of six digits for the whole number, followed by the three-digit decimal portion of the number.
Note: The quantity field should be entered from left to right; do not enter a decimal.
The Revenue Description field on the UB-04 form is 24 characters in length
Example: Unit quantity of 30 for NDC 12345678901: N412345678901UN000030000
Box 44 – Using the HCPCS/RATE/HIPPS Code field, enter the five-character HCPCS code.
Box 46 – Using the Serv. Units field, enter the corresponding service units for the HCPCS reported.
Direct Data Entry
The Point of Service (POS) device and Internet Professional Claim Submission (IPCS) system have not been updated yet. In the interim, providers using these means of claims submission shall continue to provide the HCPCS code only. These applications will be remediated and HCPCS/NDC pairing will be required beginning with dates of service April 1, 2009 and after. Please watch for more detailed information in future Medi-Cal Updates.
Electronic claims
HIPAA 837 Professional Transaction
For HIPAA-compliant ASC X12N 837 Professional electronic claim transactions, the HCPCS code is reported in Loop ID 2400.
Loop 2400:
Field SV1 – enter HCPCS code
Field SV101 – 3 – enter the UD modifier if you obtained the drug under the 340B program
The NDC is reported in Loop ID 2410.
Loop 2410:
Field CTP04 – enter quantity
Field CTP05 – enter unit of measurement
Field LIN02 – enter qualifier ‘N4’
Field LIN03 – enter NDC without hyphens
Examples: CTP****2*UN~
LIN**N4*12345678901~
HIPAA 837 Institutional Transactions
For HIPAA-compliant ASC X12N 837 Institutional electronic claim transactions, the HCPCS code is reported in Loop ID 2400.
Loop 2400:
Field SV201 – Enter the revenue code
Field SV202-1 – Enter qualifier ‘HC’
Field SV202-2 – Enter the HCPCS code
Field SV202-3 – Enter the UD modifier if you obtained the drug under the 340B program
Field SV204 – Enter qualifier ‘UN’
Field SV205 – Enter the quantity
Example: SV2*250*HC*Jxxxx**UN*1~
Loop 2410:
Field LIN02 – Enter qualifier ‘N4’
Field LIN03 – Enter NDC without hyphens
Example: LIN**N4*12345678901~
Field CTP04 – Enter quantity
Field CTP05 – Enter unit of measure
Example: CTP****2*ML~
For more detailed information, please refer to the billing instructions for electronic claim transactions found in the 837 Transaction Companion Guides (ASC X12N Version 4010A1 Companion Guides) located on the Medi-Cal Web site at: ASC X12N Version 4010A1 Companion Guides
Section 340B of the Public Health Service Act
The 340B Drug Pricing Program resulted from enactment of Public Law 102-585, the Veterans Health Care Act of 1992, which is codified as Section 340B of the Public Health Service Act. Section 340B limits the cost of covered outpatient drugs to certain federal grantees, federally-qualified health center look-alikes and qualified disproportionate share hospitals. Significant savings on pharmaceuticals may be seen by those entities that participate in this program.
Section 340B of the Public Health Service Act provides that a manufacturer who sells covered outpatient drugs to eligible entities must sign a pharmaceutical pricing agreement with the Secretary of Health and Human Services in which the manufacturer agrees to charge a price for covered outpatient drugs that will not exceed the average manufacturer price ("AMP") decreased by a rebate percentage. Section 340B also requires eligible entities to charge the Medicaid program no more than the actual acquisition cost of the drug plus the state allowed dispensing/administration fee and also requires the state Medicaid program to exclude these claims from the collection of rebates.
In order for providers to identify 340B outpatient drugs which have been dispensed, the National Medicaid EDI Healthcare (NMEH) has recommended use of the ‘UD’ modifier. This will allow Medicaids to identify those claims which are from 340B entities and exclude them from the rebate collection process. The ‘UD’ modifier should be billed on the CMS 1500 & 837 Professional and the UB-04 & 837 Institutional claims forms, associated with the applicable HCPCS code and NDC, to properly identify 340B drugs. The UD modifier is to be used only in this circumstance. All non-340B drugs are billed using the applicable HCPCS and NDC pair without a modifier.
The Deficit Reduction Act of 2005 (DRA) requires all state Medicaid Agencies to collect rebates from drug manufacturers for physician-administered or dispensed drugs. This requirement also applies to Medicare crossover claims. Only those products manufactured by companies participating in the federal Medicaid rebate program are reimbursable under Medi-Cal. A list of manufacturers participating in the rebate program, which changes periodically, is available in the Medi-Cal pharmacy manual under Drugs: Contract Drugs List Part 5 – Authorized Manufacturer Labeler Codes (drugs cdl p5) or on the Medi-Cal website at: http://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/part2/drugscdlp5_p00.doc
This email is advance notice that the Department of Healthcare Services (DHCS) will soon be publishing the details regarding NDC reporting requirements. All documentation, such as Medi-Cal Updates and Companion Guides, are currently being updated, therefore, we are providing an attachment (below) for you and your members that includes the details of this announcement. Those details include: NDC and physician-administered drug definitions; billing descriptions and examples for CMS 1500 and UB-04 paper claim forms, as well as both 837 Institutional and Professional electronic formats; and Section 340B information.
Should you have any questions or need additional information, please call the Telephone Service Center (TSC) at 1-800-541-5555 or visit the Medi-Cal Web site at the address listed above.
National Drug Code (NDC) Description
The NDC is the number that identifies a drug. The NDC number consists of 11 digits in a 5-4-2 format. NDCs printed on packages often have fewer than 11 digits, with hyphens (-) separating the number into three segments. For a complete 11-digit number, the first segment must have five digits, the second segment four digits and the third segment two digits. The first 5 digits identify the manufacturer of the drug and are assigned by the Food and Drug Administration (FDA). The remaining digits are assigned by the manufacturer and identify the specific product and package size. Add leading zeros wherever they are needed to complete a segment with the correct number of digits.
For example:
Package Number Zero Fill 11-digit NDC
1234-1234-12 (01234-1234-12) 01234123412
12345-123-12 (12345-0123-12) 12345012312
2-22-2 (00002-0022-02) 00002002202
The NDC is found on the drug container: vial, bottle, tube. The NDC submitted to Medi-Cal must be the actual NDC number on the package or container from which the medication was administered. Do not bill for one manufacturer’s product and dispense another. It is considered a fraudulent billing practice to bill using an NDC other than the one administered.
Physician-administered drugs
A physician-administered drug includes any covered outpatient drug provided or administered to a beneficiary, which is billed by a provider other than a pharmacy. Such providers would include, but not be limited to: physician offices, clinics and hospitals. A covered outpatient drug is broadly defined as a drug which may be dispensed only upon prescription and which is approved for safety and effectiveness as a prescription drug under the Federal Food, Drug and Cosmetic Act. Physician-administered drugs are not restricted to injectable drugs only; physician-administered drugs include any drug regardless of the route of administration.
Drug Identification Guidelines
There are three items to look for that will identify whether or not a product is a drug:
1. National Drug Code or NDC: the vial or the box which held the drug will have an NDC which will be used for the claim.
2. Lot and Expiration date: all drugs have both a Lot Number and Expiration Date somewhere on the vial or box.
3. Legend: This refers to the statement “Caution: federal law prohibits dispensing without prescription,” “Rx only” or similar words. All prescription drugs will have this statement.
Claims processing
Claims will continue to be priced based on the HCPCS code, with the NDC and corresponding units being used for drug rebate processing. Medicare primary claims will also require NDCs with HCPCS codes.
Reporting Quantities
Reporting instructions apply to both paper claims and electronic transactions. At this time, Medi-Cal will use only the HCPCS quantities/units for payment and rebate purposes. Sometimes it may be necessary for providers to bill multiple NDCs for a single procedure code. This may happen when two different strengths of the same drug are needed in order to administer the appropriate dose. This will also be necessary when multiple vials of the same drug are used to administer the appropriate dose and the vials are manufactured by different manufacturers. When a provider uses more than one NDC for a drug, the provider must include all NDCs on the claim. The quantity for each NDC must be reported separately by repeating the HCPCS code.
Paper claims
CMS 1500
For paper claims submitted on the CMS 1500 claim form, the NDC is reported in the shaded area above field 24a.
Box 24A (shaded area) – This area will have a combination of two values entered there: Bytes 1 and 2 will include the Product ID Qualifier. This qualifier identifies the type of number that is being provided, which is an NDC, with a qualifier of ‘N4’. Bytes 3 - 21 will consist of the entry of the appropriate number for the qualifier entered in the first two digits. The length of this additional information will vary dependent upon the type of number being provided (as identified by the previous 2 byte Product ID Qualifier).
Example: N4 as the Product ID Qualifier, followed by the 11 digit NDC - N412345678901
Box 24D – The HCPCS code will continue to be entered in 24D, with the charges in Box 24F and units in Box 24G.
Box 24D (shaded area) – In this area, enter the NDC unit of measure (two positions) immediately followed by the numeric quantity administered to the patient, which is a full ten-digit number. The ten digits consist of seven digits for the whole number, followed by the three-digit decimal portion of the number.
Note: The quantity field should be entered from left to right; do not enter a decimal. Valid Unit of Measurement Qualifiers are:
F2 = international unit
GR = gram
ML = milliliter
UN = unit
Examples: UN0000012000 for a quantity of 12 units (UN)
ML0000124540 for a quantity of 124.54 milliliters (ML)
UB-04
For paper claims submitted on the UB-04 claim form, the NDC is reported in the Description field (Box 43).
Box 43 – Enter the two-digit Product ID Qualifier ‘N4’ in the first two positions, immediately followed by the 11-digit NDC (no hyphens). Directly following the last digit of the NDC (no delimiter), enter the two-digit Unit of Measurement Qualifier as noted above. Immediately following the Unit of Measurement Qualifier, enter the nine-digit quantity. The nine digits consist of six digits for the whole number, followed by the three-digit decimal portion of the number.
Note: The quantity field should be entered from left to right; do not enter a decimal.
The Revenue Description field on the UB-04 form is 24 characters in length
Example: Unit quantity of 30 for NDC 12345678901: N412345678901UN000030000
Box 44 – Using the HCPCS/RATE/HIPPS Code field, enter the five-character HCPCS code.
Box 46 – Using the Serv. Units field, enter the corresponding service units for the HCPCS reported.
Direct Data Entry
The Point of Service (POS) device and Internet Professional Claim Submission (IPCS) system have not been updated yet. In the interim, providers using these means of claims submission shall continue to provide the HCPCS code only. These applications will be remediated and HCPCS/NDC pairing will be required beginning with dates of service April 1, 2009 and after. Please watch for more detailed information in future Medi-Cal Updates.
Electronic claims
HIPAA 837 Professional Transaction
For HIPAA-compliant ASC X12N 837 Professional electronic claim transactions, the HCPCS code is reported in Loop ID 2400.
Loop 2400:
Field SV1 – enter HCPCS code
Field SV101 – 3 – enter the UD modifier if you obtained the drug under the 340B program
The NDC is reported in Loop ID 2410.
Loop 2410:
Field CTP04 – enter quantity
Field CTP05 – enter unit of measurement
Field LIN02 – enter qualifier ‘N4’
Field LIN03 – enter NDC without hyphens
Examples: CTP****2*UN~
LIN**N4*12345678901~
HIPAA 837 Institutional Transactions
For HIPAA-compliant ASC X12N 837 Institutional electronic claim transactions, the HCPCS code is reported in Loop ID 2400.
Loop 2400:
Field SV201 – Enter the revenue code
Field SV202-1 – Enter qualifier ‘HC’
Field SV202-2 – Enter the HCPCS code
Field SV202-3 – Enter the UD modifier if you obtained the drug under the 340B program
Field SV204 – Enter qualifier ‘UN’
Field SV205 – Enter the quantity
Example: SV2*250*HC*Jxxxx**UN*1~
Loop 2410:
Field LIN02 – Enter qualifier ‘N4’
Field LIN03 – Enter NDC without hyphens
Example: LIN**N4*12345678901~
Field CTP04 – Enter quantity
Field CTP05 – Enter unit of measure
Example: CTP****2*ML~
For more detailed information, please refer to the billing instructions for electronic claim transactions found in the 837 Transaction Companion Guides (ASC X12N Version 4010A1 Companion Guides) located on the Medi-Cal Web site at: ASC X12N Version 4010A1 Companion Guides
Section 340B of the Public Health Service Act
The 340B Drug Pricing Program resulted from enactment of Public Law 102-585, the Veterans Health Care Act of 1992, which is codified as Section 340B of the Public Health Service Act. Section 340B limits the cost of covered outpatient drugs to certain federal grantees, federally-qualified health center look-alikes and qualified disproportionate share hospitals. Significant savings on pharmaceuticals may be seen by those entities that participate in this program.
Section 340B of the Public Health Service Act provides that a manufacturer who sells covered outpatient drugs to eligible entities must sign a pharmaceutical pricing agreement with the Secretary of Health and Human Services in which the manufacturer agrees to charge a price for covered outpatient drugs that will not exceed the average manufacturer price ("AMP") decreased by a rebate percentage. Section 340B also requires eligible entities to charge the Medicaid program no more than the actual acquisition cost of the drug plus the state allowed dispensing/administration fee and also requires the state Medicaid program to exclude these claims from the collection of rebates.
In order for providers to identify 340B outpatient drugs which have been dispensed, the National Medicaid EDI Healthcare (NMEH) has recommended use of the ‘UD’ modifier. This will allow Medicaids to identify those claims which are from 340B entities and exclude them from the rebate collection process. The ‘UD’ modifier should be billed on the CMS 1500 & 837 Professional and the UB-04 & 837 Institutional claims forms, associated with the applicable HCPCS code and NDC, to properly identify 340B drugs. The UD modifier is to be used only in this circumstance. All non-340B drugs are billed using the applicable HCPCS and NDC pair without a modifier.
Palmetto/J1MAC Website Updates
The following updates have been posted to the Palmetto/J1MAC website.
Part B LCD Update
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B%20LCD%20Update?opendocument
Physical Medicine and Rehabilitation Policy, J1B-08-0062-L - Under
Indications and Limitations of Coverage and/or Medical Necessity- A.
General PM&R Guidelines #8 corrected spelling errors. Under Documentation
Requirements #5 changed "30 days" to now read "90 days" to support manual
instruction. This revision becomes effective 09/02/2008.
Applies to:
Part B Transition: General
Part B LCD Update
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B%20LCD%20Update?opendocument
Physical Medicine and Rehabilitation Policy, J1B-08-0062-L - Under
Indications and Limitations of Coverage and/or Medical Necessity- A.
General PM&R Guidelines #8 corrected spelling errors. Under Documentation
Requirements #5 changed "30 days" to now read "90 days" to support manual
instruction. This revision becomes effective 09/02/2008.
Applies to:
Part B Transition: General
Tuesday, August 19, 2008
Palmetto/J1MAC Website Updates
The following update has been posted to the Palmetto/J1MAC website.
California Part B Payment Floor Release for MAC J1 Transition
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/California%20Part%20B%20Payment%20Floor%20Release%20for%20MAC%20J1%20Transition?opendocument
Attention NHIC Customers (Segment 3). Important information from NHIC
regarding the payment floor release for the J1 MAC transition.
Applies to:
Part B Transition: General
----------
Segment 3 Reminders
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Segment%203%20Reminders?opendocument
Part B California Providers: Palmetto GBA has put together a list of
important Segment 3 transition reminders. Please read the article in order
to stay informed of important transition information.
Applies to:
Part B Transition: General
----------
California Part B Payment Floor Release for MAC J1 Transition
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/California%20Part%20B%20Payment%20Floor%20Release%20for%20MAC%20J1%20Transition?opendocument
Attention NHIC Customers (Segment 3). Important information from NHIC
regarding the payment floor release for the J1 MAC transition.
Applies to:
Part B Transition: General
----------
Segment 3 Reminders
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Segment%203%20Reminders?opendocument
Part B California Providers: Palmetto GBA has put together a list of
important Segment 3 transition reminders. Please read the article in order
to stay informed of important transition information.
Applies to:
Part B Transition: General
----------
ASCO e-News Published
The American Society of Clinical Oncology's (ASCO) e-News was published today and is available at http://view.exacttarget.com/?j=fe60157774620d797517&m=ff2d16787160&ls=fdf812757561077972107276&l=fe5b15747c60077a7017&s=fdf2157972640d79751d7073&ju=fe3b16707665007c771675. ANCO is a state/regional affiliate of ASCO.
This edition features:
RSVP for Cancer Advances: A Public Forum on Breast Cancer
ASCO Joins Frosted Pink with A Twist and Mary Lou Retton to Raise Awareness of Cancer
Submit an Abstract for 2009 Gastrointestinal Cancers Symposium
Submit an Abstract for 2009 Genitourinary Cancers Symposium
Register for 2008 Clinical Trials Workshop
Spotlight on State Affiliates: Georgia Society of Clinical Oncology
ASCO Launches Electronic Health Record (EHR) Podcasts
Applications for the 2009 ASCO Cancer Foundation Grants Program Now Being Accepted
Editors Sought for ASCO Daily News and ASCO News & Forum
Attend 2008 UICC World Cancer Congress
Cancer Policy Alert: Senate Appropriations Committee Details Second Economic Stimulus Package, FDA Orders Label Change for ESAs, New Advances on E-Prescribing Adoption
For Your Patients: Latest Cancer.Net Podcast Explores Medical Abstracts
For Your Patients: New Cancer.Net Features on Coping with Fatigue, Appearance after Cancer Treatment
JCO Early Release Articles Examine Preoperative Staging of Large Primary Breast Cancer with [18F]FDG-PET/CT Compared with Conventional Imaging Procedures; Monosomal Karyotype in Acute Myeloid Leukemia; Suicidal Thoughts, Actions, and Incidence in Patients with Cancer
Future JCO Table of Contents
This edition features:
RSVP for Cancer Advances: A Public Forum on Breast Cancer
ASCO Joins Frosted Pink with A Twist and Mary Lou Retton to Raise Awareness of Cancer
Submit an Abstract for 2009 Gastrointestinal Cancers Symposium
Submit an Abstract for 2009 Genitourinary Cancers Symposium
Register for 2008 Clinical Trials Workshop
Spotlight on State Affiliates: Georgia Society of Clinical Oncology
ASCO Launches Electronic Health Record (EHR) Podcasts
Applications for the 2009 ASCO Cancer Foundation Grants Program Now Being Accepted
Editors Sought for ASCO Daily News and ASCO News & Forum
Attend 2008 UICC World Cancer Congress
Cancer Policy Alert: Senate Appropriations Committee Details Second Economic Stimulus Package, FDA Orders Label Change for ESAs, New Advances on E-Prescribing Adoption
For Your Patients: Latest Cancer.Net Podcast Explores Medical Abstracts
For Your Patients: New Cancer.Net Features on Coping with Fatigue, Appearance after Cancer Treatment
JCO Early Release Articles Examine Preoperative Staging of Large Primary Breast Cancer with [18F]FDG-PET/CT Compared with Conventional Imaging Procedures; Monosomal Karyotype in Acute Myeloid Leukemia; Suicidal Thoughts, Actions, and Incidence in Patients with Cancer
Future JCO Table of Contents
THIS WEEK AT ACCC: AUGUST 18-22, 2008
The Association of Community Cancer Center's (ACCC) This Week at ACCC was published today and is available at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCC_aug18_08.html. ANCO is an Institutional Member of ACCC.
This week's edition features:
ACCC's Fall Conference—Still Time to Register!
Attention Pharmacists: ACCC Meeting Just for You
E&M Services Guide Available from CMS
Patient Navigation Services—Tell Us Your Story
CMS Releases ICD-10, Transaction Standard Rules
ACCC's CE Blackboard: New Continuing Education Programs for You
State Medical Oncology Societies Host Upcoming Meetings
On ACCC's Website: Updated, Searchable Oncology Buyers Guide
This week's edition features:
ACCC's Fall Conference—Still Time to Register!
Attention Pharmacists: ACCC Meeting Just for You
E&M Services Guide Available from CMS
Patient Navigation Services—Tell Us Your Story
CMS Releases ICD-10, Transaction Standard Rules
ACCC's CE Blackboard: New Continuing Education Programs for You
State Medical Oncology Societies Host Upcoming Meetings
On ACCC's Website: Updated, Searchable Oncology Buyers Guide
Monday, August 18, 2008
MOASC sponsored Palmetto GBA General Transition Updates and Part B Claims Update
The following information is provided by MOASC and ANCO members are invited to participate in this teleconference.
Below is the outline of discussion for the Thursday, August 21 teleconference at 10:30am – 12:00pm.
Please do not hesitate to bring your questions to this conference call.
The call in information is:
866-212-0875
Passcode: 469922
PLEASE PRESS *6 TO MUTE AND UN-MUTE YOUR LINE DURING THE CALL.
If you have any questions, please do not hesitate to contact the MOASC office.
Thanks!
Phone: (909) 985-9061
Fax: (909) 985-8581
P.O. Box 161
Upland, California 91785-0161
moasc@moasc.org
Palmetto GBA General Transition Updates and Part B Claims Update
Presented by:
Pat Boardley
Palmetto GBA, J1 Manager Provider Customer Service
And
Margo Simpson
Palmetto GBA, Provider Outreach and Education
Regardless of the date of service, all claims processing, customer services and payments will be handled by Palmetto GBA as the J1 MAC, beginning September 2, 2008. NHIC will transfer all pending and in-process operations, all history previously on file with NHIC and pending work, to Palmetto GBA at that time.
On Thursday, August 28, 2008, Segment 3 of the Medicare Part B workload will begin its transition from NHIC, Corp (NHIC) to Palmetto GBA. The transition of Segment 3 affects Part B providers in California.
Discussion regarding important transition information for Medicare Part B providers in California will be addressed.
DATE: Thursday, August 21, 2008
TIME: 10:30 A.M. - 12:00 P.M.
Please RSVP to moasc@moasc.org by August 20 to receive call-in information and handouts.
Palmetto GBA Jurisdiction 1 MAC Part B Transition Update Agenda
Medical Oncology Association of Southern California
August 21, 2008
California Transition Updates
Implementation Schedule for Segment 3
California Part B
Contractor Workload Operational Date
NHIC California
Part B 9/2/08
Regardless of the date of service, all claims processing, customer services and payments will be handled by Palmetto GBA as the J1 MAC beginning September 2, 2008.
NHIC will transfer all pending and in-process operations, all history previously on file with NHIC and pending work to Palmetto GBA at that time.
Inquiries or Appeals - Effective September 2, 2008, if you have an inquiry or want to request an appeal on a claim processed prior to September 2, 2008, you will contact Palmetto GBA.
Provider Enrollment - All provider enrollment applications currently in process with NHIC will be transferred to Palmetto GBA at cutover for completion.
“Dark Days” - In order to complete the transition of the Medicare Part B workload for California, NHIC and Palmetto GBA will need to observe “dark days”. A “dark day” is defined as a day in which the Medicare claims processing system is not available for normal business operations. There will be no online access, current claim information will not be provided via the IVR or Provider Contact Center, and claims will not be processed.
“Dark days” for NHIC will be Thursday, August 28, 2008 and Friday, August 29, 2008, and for Palmetto GBA on Monday, September 1, 2008. Claims processing systems will not be available during the cutover weekend. Tuesday, September 2, 2008, will be the first day for all operations for Palmetto GBA, to include the Provider Contact Center and
Customer service
Interactive Voice Response (IVR) - The Palmetto GBA’s IVR system should be provider’s first point of contact for customer service. You are able to check claim status, eligibility, information for redetermination, the reason for denials, and check status. There is a voice message to provide options for each region. The IVR option for California is ready for service however there is a message letting providers know this region will transition Sept. 2nd.
IVR job aids – Are located through links on the J1 web site’s home page.
Part B IVR: (866) 931-3903
Customer Service Representative: (866) 931-3901
TTY: (866) 931-3902
Call Center Hours: 7 a.m. – 5 p.m. Pacific Time
Providers will need to have their NPI and transaction PTAN # available. There is also a voice message with options for the IVR - press 1 for NV-HI, option 2 for Northern CA, option 3 for Southern CA. A recorded message will let providers know CA provider records will not be available until September 2nd.
Electronic Data Interchange
Do Not Hesitate to Begin the Early Boarding Process
Take advantage of our Early Boarding option and become comfortable with submitting and receiving EDI transactions from Palmetto GBA. Ensure that you are not caught up in the inevitable delays in support and response times that happen when latecomers overwhelm support resources at the last minute.
Please call the Palmetto GBA EDI Technology Support Center (TSC) at (866) 749-4301 for assistance with EDI issues that are not addressed on the Web site. The TSC is available Monday through Friday from 8:00 a.m. to 5:00 p.m. PST.
Medical Review - Providers responding after September 2, 2008, to medical review additional development requests from NHIC should return the responses to:
J1MAC Palmetto GBA
PO Box 1476
Augusta, GA 30903-1476
or FAX the information to 803-462-3929.
Local Coverage Determination - For Segment 3 (California Part B), services provided on or after September 2, 2008 will be subject to J1 local coverage determinations (LCDs), while services provided prior to September 2, 2008 will be subject to NHIC’s LCDs. This is especially important in case of any redeterminations or post-pay review.
On-going Education – Providers will receive continued Medicare education via webinar and specialty seminars, as well as participate in educational forums.
Questions and Answers
Below is the outline of discussion for the Thursday, August 21 teleconference at 10:30am – 12:00pm.
Please do not hesitate to bring your questions to this conference call.
The call in information is:
866-212-0875
Passcode: 469922
PLEASE PRESS *6 TO MUTE AND UN-MUTE YOUR LINE DURING THE CALL.
If you have any questions, please do not hesitate to contact the MOASC office.
Thanks!
Phone: (909) 985-9061
Fax: (909) 985-8581
P.O. Box 161
Upland, California 91785-0161
moasc@moasc.org
Palmetto GBA General Transition Updates and Part B Claims Update
Presented by:
Pat Boardley
Palmetto GBA, J1 Manager Provider Customer Service
And
Margo Simpson
Palmetto GBA, Provider Outreach and Education
Regardless of the date of service, all claims processing, customer services and payments will be handled by Palmetto GBA as the J1 MAC, beginning September 2, 2008. NHIC will transfer all pending and in-process operations, all history previously on file with NHIC and pending work, to Palmetto GBA at that time.
On Thursday, August 28, 2008, Segment 3 of the Medicare Part B workload will begin its transition from NHIC, Corp (NHIC) to Palmetto GBA. The transition of Segment 3 affects Part B providers in California.
Discussion regarding important transition information for Medicare Part B providers in California will be addressed.
DATE: Thursday, August 21, 2008
TIME: 10:30 A.M. - 12:00 P.M.
Please RSVP to moasc@moasc.org by August 20 to receive call-in information and handouts.
Palmetto GBA Jurisdiction 1 MAC Part B Transition Update Agenda
Medical Oncology Association of Southern California
August 21, 2008
California Transition Updates
Implementation Schedule for Segment 3
California Part B
Contractor Workload Operational Date
NHIC California
Part B 9/2/08
Regardless of the date of service, all claims processing, customer services and payments will be handled by Palmetto GBA as the J1 MAC beginning September 2, 2008.
NHIC will transfer all pending and in-process operations, all history previously on file with NHIC and pending work to Palmetto GBA at that time.
Inquiries or Appeals - Effective September 2, 2008, if you have an inquiry or want to request an appeal on a claim processed prior to September 2, 2008, you will contact Palmetto GBA.
Provider Enrollment - All provider enrollment applications currently in process with NHIC will be transferred to Palmetto GBA at cutover for completion.
“Dark Days” - In order to complete the transition of the Medicare Part B workload for California, NHIC and Palmetto GBA will need to observe “dark days”. A “dark day” is defined as a day in which the Medicare claims processing system is not available for normal business operations. There will be no online access, current claim information will not be provided via the IVR or Provider Contact Center, and claims will not be processed.
“Dark days” for NHIC will be Thursday, August 28, 2008 and Friday, August 29, 2008, and for Palmetto GBA on Monday, September 1, 2008. Claims processing systems will not be available during the cutover weekend. Tuesday, September 2, 2008, will be the first day for all operations for Palmetto GBA, to include the Provider Contact Center and
Customer service
Interactive Voice Response (IVR) - The Palmetto GBA’s IVR system should be provider’s first point of contact for customer service. You are able to check claim status, eligibility, information for redetermination, the reason for denials, and check status. There is a voice message to provide options for each region. The IVR option for California is ready for service however there is a message letting providers know this region will transition Sept. 2nd.
IVR job aids – Are located through links on the J1 web site’s home page.
Part B IVR: (866) 931-3903
Customer Service Representative: (866) 931-3901
TTY: (866) 931-3902
Call Center Hours: 7 a.m. – 5 p.m. Pacific Time
Providers will need to have their NPI and transaction PTAN # available. There is also a voice message with options for the IVR - press 1 for NV-HI, option 2 for Northern CA, option 3 for Southern CA. A recorded message will let providers know CA provider records will not be available until September 2nd.
Electronic Data Interchange
Do Not Hesitate to Begin the Early Boarding Process
Take advantage of our Early Boarding option and become comfortable with submitting and receiving EDI transactions from Palmetto GBA. Ensure that you are not caught up in the inevitable delays in support and response times that happen when latecomers overwhelm support resources at the last minute.
Please call the Palmetto GBA EDI Technology Support Center (TSC) at (866) 749-4301 for assistance with EDI issues that are not addressed on the Web site. The TSC is available Monday through Friday from 8:00 a.m. to 5:00 p.m. PST.
Medical Review - Providers responding after September 2, 2008, to medical review additional development requests from NHIC should return the responses to:
J1MAC Palmetto GBA
PO Box 1476
Augusta, GA 30903-1476
or FAX the information to 803-462-3929.
Local Coverage Determination - For Segment 3 (California Part B), services provided on or after September 2, 2008 will be subject to J1 local coverage determinations (LCDs), while services provided prior to September 2, 2008 will be subject to NHIC’s LCDs. This is especially important in case of any redeterminations or post-pay review.
On-going Education – Providers will receive continued Medicare education via webinar and specialty seminars, as well as participate in educational forums.
Questions and Answers
ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) IN ADULTS AND THE NATIONAL ACTION PLAN
Association of Northern California Oncologists
presents two talks for oncologists and oncology nurses entitled
ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) IN ADULTS AND THE NATIONAL ACTION PLAN
with
W. ARCHIE BLEYER, M.D., F.R.C.P.
Medical Advisor, Cancer Treatment Center, St. Charles Medical Center (Bend, OR)
Director, CureSearch/Alfac Adolescent & Young Adult Cancer Research
Clinical Research Professor, Oregon Health & Sciences University
Professor of Pediatrics, University of Texas (Houston) Medical School
The educational objectives of these talks are:
• Recognize the disparity in progress of ALL therapy between children and adults.
• Appreciate the primary reason for ALL deficit in adolescents and young adults.
• Understand the basis for the new intergroup trial for 15-30 year-oldswith B-precursor ALL.
• Relate the deficit to ALL strategies underway in California,other states, and other countries.
These talks are scheduled for:
6:30PM Buffet Dinner Reception & 7:00PM Lecture
October 1st
The Claremont Resort
Ashby & Domingo Avenues
Oakland
(510) 843-3000
October 2nd
Hyatt Regency
1209 L Street
Sacramento
(916) 443-1234
These meetings are supported by Enzon Pharmaceuticals.
For directions, please call the meeting locations. FAX your RSVP(s) to José Luis González, ANCO Executive Director, at (415) 472-3961 no later than September 24th.
Download the meeting announcement and registration form at www.anco-online.org/bleyer.pdf
presents two talks for oncologists and oncology nurses entitled
ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) IN ADULTS AND THE NATIONAL ACTION PLAN
with
W. ARCHIE BLEYER, M.D., F.R.C.P.
Medical Advisor, Cancer Treatment Center, St. Charles Medical Center (Bend, OR)
Director, CureSearch/Alfac Adolescent & Young Adult Cancer Research
Clinical Research Professor, Oregon Health & Sciences University
Professor of Pediatrics, University of Texas (Houston) Medical School
The educational objectives of these talks are:
• Recognize the disparity in progress of ALL therapy between children and adults.
• Appreciate the primary reason for ALL deficit in adolescents and young adults.
• Understand the basis for the new intergroup trial for 15-30 year-oldswith B-precursor ALL.
• Relate the deficit to ALL strategies underway in California,other states, and other countries.
These talks are scheduled for:
6:30PM Buffet Dinner Reception & 7:00PM Lecture
October 1st
The Claremont Resort
Ashby & Domingo Avenues
Oakland
(510) 843-3000
October 2nd
Hyatt Regency
1209 L Street
Sacramento
(916) 443-1234
These meetings are supported by Enzon Pharmaceuticals.
For directions, please call the meeting locations. FAX your RSVP(s) to José Luis González, ANCO Executive Director, at (415) 472-3961 no later than September 24th.
Download the meeting announcement and registration form at www.anco-online.org/bleyer.pdf
Friday, August 15, 2008
Palmetto/J1MAC Website Updates
The following updates have been posted to the Palmetto/J1MAC website.
Part B LCD Update
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B%20LCD%20Update?opendocument
Under Indications and Limitations of Coverage and/or Medical Necessity- A.
General PM&R Guidelines #8 corrected spelling errors. Under Documentation
Requirements #5 changed "30 days" to now read "90 days" to support manual
instruction. This revision becomes effective 09/02/2008.
Applies to:
Part B Transition: General
----------
Part B LCD Update
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B%20LCD%20Update?opendocument
Under Indications and Limitations of Coverage and/or Medical Necessity- A.
General PM&R Guidelines #8 corrected spelling errors. Under Documentation
Requirements #5 changed "30 days" to now read "90 days" to support manual
instruction. This revision becomes effective 09/02/2008.
Applies to:
Part B Transition: General
----------
Thursday, August 14, 2008
CMS/Medicare: Evaluation & Management Services Guide
The July 2008 version of the Evaluation & Management Services Guide, which provides evaluation and management services information about medical record documentation, International Classification of Diseases and Current Procedural Terminology codes, and key elements of service, is now available on the Centers for Medicare & Medicaid Services Medicare Learning Network at
http://www.cms.hhs.gov/MLNProducts/downloads/eval_mgmt_serv_guide.pdf.
http://www.cms.hhs.gov/MLNProducts/downloads/eval_mgmt_serv_guide.pdf.
ESA Package Labeling Updates
AMGEN and Ortho Biotech have finalized the United States Food and Drug Administration (FDA) approved changes in the labeling information for the ESA class of drugs including Aranesp (darbepoetin alfa), EPOGEN (Epoetin alfa), and Procrit (Epoetin alfa). These changes include modifications to the BOXED WARNINGS, USAGE, and DOSAGE AND ADMINISTRATIONS sections for cancer patients on chemotherapy.
AMGEN and Ortho Biotech are informing healthcare professionals about the revisions to the U. S. prescribing information through a joint Dear Healthcare Professional letter. In addition to communicating the changes in the labeling, the letter also includes information about the new FDA Medication Guide and Patient Instruction requirements for the ESA class of drugs. The letter, updated prescribing information, Medication Guide, and Patient Instructions are posted on www.aranesp.com and www.procrit.com.
AMGEN and Ortho Biotech are informing healthcare professionals about the revisions to the U. S. prescribing information through a joint Dear Healthcare Professional letter. In addition to communicating the changes in the labeling, the letter also includes information about the new FDA Medication Guide and Patient Instruction requirements for the ESA class of drugs. The letter, updated prescribing information, Medication Guide, and Patient Instructions are posted on www.aranesp.com and www.procrit.com.
Wednesday, August 13, 2008
CMS/Medicare: Upcoming Training for the Medicare Part B Drugs Competitive Acquisition Program (CAP)
Noridian Administrative Services, the designated carrier for the CAP, offers interactive, online workshops about the CAP for Part B Drugs and Biologicals. These workshops train CAP vendors and elected physicians on a variety of CAP topics, and NAS staff can also answer questions. Interested parties may view additional information about and register for these workshops at https://www.noridianmedicare.com/cap_drug/train/workshops/index.html
An upcoming workshop will be held on the following date:
• 8/21/08 at 2:00PM CST
An upcoming workshop will be held on the following date:
• 8/21/08 at 2:00PM CST
Palmetto/J1MAC Website Updates
The following updates have been posted to the Palmetto/J1MAC website.
NHIC Customers (Segment 3): The J1 Part B "Go Live" Date is August 27,
2008!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NHIC%20Customers%20(Segment%203)%3A%20The%20J1%20Part%20B%20%22Go%20Live%22%20Date%20is%20August%2027%2C%202008!?opendocument
Attention NHIC Customers (Segment 3): 15 days and counting. Are you
ready ?!?
Applies to:
Part B Transition: EDI
----------
Part B
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B?opendocument
********NOTE: IF you are unable to access article through the link below,
go to www.palmettogba.com/j1, click on Learning and Education, click on
Policies and Procedures, then click on the Part B link in the middle of the
page.******** Palmetto GBA has posted articles outlining Part B claims
processing changes and/or reminders. The information contained in these
articles is applicable after the transition to the MAC contractor. Billing
and submission processes used by the current contractor remains in effect
until after the transition.
New articles added 8/12/2008:
* 1500 Claim Form Differences
Applies to:
Part B Transition: General
NHIC Customers (Segment 3): The J1 Part B "Go Live" Date is August 27,
2008!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NHIC%20Customers%20(Segment%203)%3A%20The%20J1%20Part%20B%20%22Go%20Live%22%20Date%20is%20August%2027%2C%202008!?opendocument
Attention NHIC Customers (Segment 3): 15 days and counting. Are you
ready ?!?
Applies to:
Part B Transition: EDI
----------
Part B
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B?opendocument
********NOTE: IF you are unable to access article through the link below,
go to www.palmettogba.com/j1, click on Learning and Education, click on
Policies and Procedures, then click on the Part B link in the middle of the
page.******** Palmetto GBA has posted articles outlining Part B claims
processing changes and/or reminders. The information contained in these
articles is applicable after the transition to the MAC contractor. Billing
and submission processes used by the current contractor remains in effect
until after the transition.
New articles added 8/12/2008:
* 1500 Claim Form Differences
Applies to:
Part B Transition: General
NHIC/Medicare: Additional Information Regarding 2008 Physician Quality Reporting Initiative (PQRI) ~ National Provider to be held on August 13th
The call has been extended an additional half hour to cover the following newly added topics:
2007 PQRI Feedback Reports
2007 PQRI Incentive Payments
The PowerPoint presentation for the National Provider Call can be accessed at www.qualitynet.org/pqri on the internet. The slides should be posted there by COB Monday, August 11, 2008. They can be accessed by clicking on "8/13/08 National Provider Call Slides" found on the left side navigation box on the PQRI Portal page - this information is not password protected.
In addition, information to access the PowerPoint presentation will be posted on the PQRI website under the "CMS Sponsored Calls" page, at least one day prior to the call, located at https://www.cms.hhs.gov/PQRI on the CMS website.
Thank you.
The Centers for Medicare & Medicaid Services' (CMS) Provider Communications Group will host the sixth in a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 3:30 p.m. - 5:30 p.m., EDT, on Wednesday, August 13, 2008.
This call will provide an overview of the PQRI provisions in the new Medicare Improvements for Patients and Providers Act (MIPPA) of 2008; information on the E-prescribing measure for 2008 PQRI (measure #125) and proposed measures for 2009 PQRI; incentives for electronic prescribing outlined in the MIPPA; an update on registry reporting for 2008, and a question and answer session.
Information on how to access the PowerPoint slide presentation will be posted to the PQRI web page at http://www.cms.hhs.gov/PQRI/02_CMSSponsoredCalls.asp on the CMS website for you to download prior to the call so that you can follow along with the presenters, Dr. Michael Rapp, and Dr. Daniel Green.
Following the presentation, callers will have an opportunity to ask questions of CMS subject matter experts.
Conference call details:
Date: August 13, 2008
Conference Title: 2008 Physician Quality Reporting Initiative National Provider Call
Time: 3:30-5:30 pm EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 3:30 p.m. EDT on August 12, 2008, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to http://www2.eventsvc.com/palmettogba/081308
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register."
You will be taken to the "Thank you for registering" page and will receive a confirmation email shortly thereafter.
Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 5:30 p.m. EDT 8/13/2008 until 11:59 p.m. EDT 8/20/2008. The call in data for the replay is (800) 642-1687 and the passcode is 55967176.
If you require services for the hearing impaired please send an email to Medicare.TTT@PalmettoGBA.com.
2007 PQRI Feedback Reports
2007 PQRI Incentive Payments
The PowerPoint presentation for the National Provider Call can be accessed at www.qualitynet.org/pqri on the internet. The slides should be posted there by COB Monday, August 11, 2008. They can be accessed by clicking on "8/13/08 National Provider Call Slides" found on the left side navigation box on the PQRI Portal page - this information is not password protected.
In addition, information to access the PowerPoint presentation will be posted on the PQRI website under the "CMS Sponsored Calls" page, at least one day prior to the call, located at https://www.cms.hhs.gov/PQRI on the CMS website.
Thank you.
The Centers for Medicare & Medicaid Services' (CMS) Provider Communications Group will host the sixth in a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 3:30 p.m. - 5:30 p.m., EDT, on Wednesday, August 13, 2008.
This call will provide an overview of the PQRI provisions in the new Medicare Improvements for Patients and Providers Act (MIPPA) of 2008; information on the E-prescribing measure for 2008 PQRI (measure #125) and proposed measures for 2009 PQRI; incentives for electronic prescribing outlined in the MIPPA; an update on registry reporting for 2008, and a question and answer session.
Information on how to access the PowerPoint slide presentation will be posted to the PQRI web page at http://www.cms.hhs.gov/PQRI/02_CMSSponsoredCalls.asp on the CMS website for you to download prior to the call so that you can follow along with the presenters, Dr. Michael Rapp, and Dr. Daniel Green.
Following the presentation, callers will have an opportunity to ask questions of CMS subject matter experts.
Conference call details:
Date: August 13, 2008
Conference Title: 2008 Physician Quality Reporting Initiative National Provider Call
Time: 3:30-5:30 pm EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 3:30 p.m. EDT on August 12, 2008, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to http://www2.eventsvc.com/palmettogba/081308
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register."
You will be taken to the "Thank you for registering" page and will receive a confirmation email shortly thereafter.
Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 5:30 p.m. EDT 8/13/2008 until 11:59 p.m. EDT 8/20/2008. The call in data for the replay is (800) 642-1687 and the passcode is 55967176.
If you require services for the hearing impaired please send an email to Medicare.TTT@PalmettoGBA.com.
Tuesday, August 12, 2008
ACCC'S NATIONAL ONCOLOGY ECONOMICS CONFERENCE: NEW SESSION ADDED
Major changes are happening to the DRUG COMPENDIA, changes that may affect patient access to cancer care.
That's why we've added a SPECIAL SESSION to ACCC's 25th National Oncology Economics Conference, September 17–20, 2008: "The Times Are Changing: A Look at the New Direction for ACCC's Compendia-Based Drug Bulletin."
Medicare has added to its list of nationally recognized drug compendia. The agency and private payers are reviewing processes, and reimbursement for oncology drugs may be significantly affected.
If you're interested in the future of drug reimbursement, this is a must-attend session. Gain insight into the coming changes AND examine how ACCC's COMPENDIA-BASED DRUG BULLETIN might change to reflect these changes.
This interactive session will allow you to help chart the path ahead for ACCC's Compendia-Based Drug Bulletin. What would you like to see within its pages? How can the publication best help your practice or program? You'll be able to vote!
Oncology practices and hospitals across the country look to ACCC's Compendia-Based Drug Bulletinas an indispensable resource and guide that allows quick and easy access to the hundreds of oncology-related indications contained within the thousands of pages that make up the officially recognized drug compendia. How will ACCC's Bulletin reflect the diverse information contains within the differing nationally recognized drug compendia? You'll have the opportunity to provide your ideas.
Of course, ACCC's 25th National Oncology Economics Conference in San Francisco, September 17–20, 2008, features lots of other sessions that provide FRESH IDEAS and INNOVATIVE STRATEGIES.
Browse the Agenda.
RETOOL YOUR NEGOTIATING SKILLS. Have you ever wanted to know the inside secrets of managed care companies—how they operate and what motivates them? In the "Economics of Insurance Contracts" you will learn from a reformed managed care executive with 18 years of experience who will examine how the managed care companies work and more importantly how you can succeed in your relationship with them. You'll be surprised (and your CEO will be delighted) at how much savings you can realize!
The early-bird registration rate is still available for ACCC's 25th National Oncology Economics Conference on September 17–20, 2008, at the Hyatt Regency in San Francisco, California. But hurry, the rate increases after August 15.
Register now to improve your service line, your bottom line, and your management skills. Only ACCC delivers practical sessions and innovative ideas for the entire cancer care team. See how model community cancer programs and practices are cutting costs and streamlining services. And find GREAT VALUE at this conference.
Registration Fees
Register by August 15 for the best rate! Members, registered and paid by August 15, just $490. Second registrant, just $350. Registration fees include official program events, materials, social events and all scheduled meal functions as outlined in the agenda.
Flights
You can book a flight into Oakland or San Francisco. Both are a short distance to the hotel.
Hotel Accommodations
Rooms are filling fast. Don't miss out. The Hyatt is holding rooms for the ACCC conference at a reduced rate until August 18, 2008 (or until the block of rooms is sold out): Single or Double rooms are $235 plus tax (currently 14% plus $.13 per night). For room reservations, please call central reservations at 888.421.1442, and refer to the group and conference name in order to obtain the discount. Online reservations are also available, please click here. The reduced rate is available from September 16-20, 2008. If you wish to extend your stay, the special group rate may be available up to three days before and after the conference based on hotel availability.
That's why we've added a SPECIAL SESSION to ACCC's 25th National Oncology Economics Conference, September 17–20, 2008: "The Times Are Changing: A Look at the New Direction for ACCC's Compendia-Based Drug Bulletin."
Medicare has added to its list of nationally recognized drug compendia. The agency and private payers are reviewing processes, and reimbursement for oncology drugs may be significantly affected.
If you're interested in the future of drug reimbursement, this is a must-attend session. Gain insight into the coming changes AND examine how ACCC's COMPENDIA-BASED DRUG BULLETIN might change to reflect these changes.
This interactive session will allow you to help chart the path ahead for ACCC's Compendia-Based Drug Bulletin. What would you like to see within its pages? How can the publication best help your practice or program? You'll be able to vote!
Oncology practices and hospitals across the country look to ACCC's Compendia-Based Drug Bulletinas an indispensable resource and guide that allows quick and easy access to the hundreds of oncology-related indications contained within the thousands of pages that make up the officially recognized drug compendia. How will ACCC's Bulletin reflect the diverse information contains within the differing nationally recognized drug compendia? You'll have the opportunity to provide your ideas.
Of course, ACCC's 25th National Oncology Economics Conference in San Francisco, September 17–20, 2008, features lots of other sessions that provide FRESH IDEAS and INNOVATIVE STRATEGIES.
Browse the Agenda.
RETOOL YOUR NEGOTIATING SKILLS. Have you ever wanted to know the inside secrets of managed care companies—how they operate and what motivates them? In the "Economics of Insurance Contracts" you will learn from a reformed managed care executive with 18 years of experience who will examine how the managed care companies work and more importantly how you can succeed in your relationship with them. You'll be surprised (and your CEO will be delighted) at how much savings you can realize!
The early-bird registration rate is still available for ACCC's 25th National Oncology Economics Conference on September 17–20, 2008, at the Hyatt Regency in San Francisco, California. But hurry, the rate increases after August 15.
Register now to improve your service line, your bottom line, and your management skills. Only ACCC delivers practical sessions and innovative ideas for the entire cancer care team. See how model community cancer programs and practices are cutting costs and streamlining services. And find GREAT VALUE at this conference.
Registration Fees
Register by August 15 for the best rate! Members, registered and paid by August 15, just $490. Second registrant, just $350. Registration fees include official program events, materials, social events and all scheduled meal functions as outlined in the agenda.
Flights
You can book a flight into Oakland or San Francisco. Both are a short distance to the hotel.
Hotel Accommodations
Rooms are filling fast. Don't miss out. The Hyatt is holding rooms for the ACCC conference at a reduced rate until August 18, 2008 (or until the block of rooms is sold out): Single or Double rooms are $235 plus tax (currently 14% plus $.13 per night). For room reservations, please call central reservations at 888.421.1442, and refer to the group and conference name in order to obtain the discount. Online reservations are also available, please click here. The reduced rate is available from September 16-20, 2008. If you wish to extend your stay, the special group rate may be available up to three days before and after the conference based on hotel availability.
THIS WEEK AT ACCC: AUGUST 11-15, 2008
The Association of Community Cancer Center's (ACCC) This Week at ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCC_aug11_08.html. ANCO is an Institutional Member of ACCC.
This week's edition features:
Best Rates Still Available for ACCC's Conference; New Session Added
Tell Your Pharmacists: An ACCC Meeting Just For Them
Sneak Peek: ACCC Meeting to Showcase Exhibitors
National Quality Forum Endorses 16 New Cancer Care Consensus Standards
Voluntary Recall of Procrit Lot Number P114942A
650 Listserv Members. . . And Growing
NCI Demonstration Project Focuses on Personalized Medicine
ACCC's CE Blackboard: New Continuing Education Programs for You
State Medical Oncology Societies Host Upcoming Meetings
This week's edition features:
Best Rates Still Available for ACCC's Conference; New Session Added
Tell Your Pharmacists: An ACCC Meeting Just For Them
Sneak Peek: ACCC Meeting to Showcase Exhibitors
National Quality Forum Endorses 16 New Cancer Care Consensus Standards
Voluntary Recall of Procrit Lot Number P114942A
650 Listserv Members. . . And Growing
NCI Demonstration Project Focuses on Personalized Medicine
ACCC's CE Blackboard: New Continuing Education Programs for You
State Medical Oncology Societies Host Upcoming Meetings
REMINDER: 2008 Physician Quality Reporting Initiative (PQRI) ~ National Provider to be held on August 13th
The last day to register for the call is Tuesday, August 12th at 3:30 pm. In your message, please direct eligible professionals and others interested in PQRI to cut and paste the URLs into their internet browser should they have a problem accessing the URLs embedded in the message.
The call has been extended an additional half hour to cover the following newly added topics:
2007 PQRI Feedback Reports
2007 PQRI Incentive Payments
The PowerPoint presentation for the National Provider Call can be accessed at www.qualitynet.org/pqri on the internet. The slides should be posted there by COB Monday, August 11, 2008. They can be accessed by clicking on "8/13/08 National Provider Call Slides" found on the left side navigation box on the PQRI Portal page - this information is not password protected.
In addition, information to access the PowerPoint presentation will be posted on the PQRI website under the "CMS Sponsored Calls" page, at least one day prior to the call, located at https://www.cms.hhs.gov/PQRI on the CMS website.
Thank you.
=============================================================================
The Centers for Medicare & Medicaid Services' (CMS) Provider Communications Group will host the sixth in a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 3:30 p.m. - 5:30 p.m., EDT, on Wednesday, August 13, 2008.
This call will provide an overview of the PQRI provisions in the new Medicare Improvements for Patients and Providers Act (MIPPA) of 2008; information on the E-prescribing measure for 2008 PQRI (measure #125) and proposed measures for 2009 PQRI; incentives for electronic prescribing outlined in the MIPPA; an update on registry reporting for 2008, and a question and answer session.
Information on how to access the PowerPoint slide presentation will be posted to the PQRI web page at http://www.cms.hhs.gov/PQRI/02_CMSSponsoredCalls.asp on the CMS website for you to download prior to the call so that you can follow along with the presenters, Dr. Michael Rapp, and Dr. Daniel Green.
Following the presentation, callers will have an opportunity to ask questions of CMS subject matter experts.
Conference call details:
Date: August 13, 2008
Conference Title: 2008 Physician Quality Reporting Initiative National Provider Call
Time: 3:30-5:30 pm EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 3:30 p.m. EDT on August 12, 2008, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to http://www2.eventsvc.com/palmettogba/081308
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the "Thank you for registering" page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 5:30 p.m. EDT 8/13/2008 until 11:59 p.m. EDT 8/20/2008. The call in data for the replay is (800) 642-1687 and the passcode is 55967176.
If you require services for the hearing impaired please send an email to Medicare.TTT@PalmettoGBA.com.
The call has been extended an additional half hour to cover the following newly added topics:
2007 PQRI Feedback Reports
2007 PQRI Incentive Payments
The PowerPoint presentation for the National Provider Call can be accessed at www.qualitynet.org/pqri on the internet. The slides should be posted there by COB Monday, August 11, 2008. They can be accessed by clicking on "8/13/08 National Provider Call Slides" found on the left side navigation box on the PQRI Portal page - this information is not password protected.
In addition, information to access the PowerPoint presentation will be posted on the PQRI website under the "CMS Sponsored Calls" page, at least one day prior to the call, located at https://www.cms.hhs.gov/PQRI on the CMS website.
Thank you.
=============================================================================
The Centers for Medicare & Medicaid Services' (CMS) Provider Communications Group will host the sixth in a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 3:30 p.m. - 5:30 p.m., EDT, on Wednesday, August 13, 2008.
This call will provide an overview of the PQRI provisions in the new Medicare Improvements for Patients and Providers Act (MIPPA) of 2008; information on the E-prescribing measure for 2008 PQRI (measure #125) and proposed measures for 2009 PQRI; incentives for electronic prescribing outlined in the MIPPA; an update on registry reporting for 2008, and a question and answer session.
Information on how to access the PowerPoint slide presentation will be posted to the PQRI web page at http://www.cms.hhs.gov/PQRI/02_CMSSponsoredCalls.asp on the CMS website for you to download prior to the call so that you can follow along with the presenters, Dr. Michael Rapp, and Dr. Daniel Green.
Following the presentation, callers will have an opportunity to ask questions of CMS subject matter experts.
Conference call details:
Date: August 13, 2008
Conference Title: 2008 Physician Quality Reporting Initiative National Provider Call
Time: 3:30-5:30 pm EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 3:30 p.m. EDT on August 12, 2008, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to http://www2.eventsvc.com/palmettogba/081308
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the "Thank you for registering" page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 5:30 p.m. EDT 8/13/2008 until 11:59 p.m. EDT 8/20/2008. The call in data for the replay is (800) 642-1687 and the passcode is 55967176.
If you require services for the hearing impaired please send an email to Medicare.TTT@PalmettoGBA.com.
Monday, August 11, 2008
Palmetto/J1MAC Website Updates
The following updates have been posted to the Palmetto/J1MAC website.
Billing Instructions for Investigational Device Exemptions (IDEs)
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Billing%20Instructions%20for%20Investigational%20Device%20Exemptions%20(IDEs)?opendocument
For Part B Providers in Nevada, Hawaii, the territories of Guam, American
Samoa, and the Northern Mariana Islands:
Find out Billing Instructions for Investigational Device Exemptions (IDEs)
for Part B Providers.
Applies to:
Part B Transition: General
----------
Claims: Requests for Additional Information (Automated Development
Requests)
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Claims%3A%20Requests%20for%20Additional%20Information%20(Automated%20Development%20Requests)?opendocument
Contractors request additional information from providers before processing
some claims. These requests for additional information are called
“automated development letters” or “automated development requests.” The
decision to request additional information is at the discretion of each
contractor.
Applies to:
Part B Transition: General
Billing Instructions for Investigational Device Exemptions (IDEs)
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Billing%20Instructions%20for%20Investigational%20Device%20Exemptions%20(IDEs)?opendocument
For Part B Providers in Nevada, Hawaii, the territories of Guam, American
Samoa, and the Northern Mariana Islands:
Find out Billing Instructions for Investigational Device Exemptions (IDEs)
for Part B Providers.
Applies to:
Part B Transition: General
----------
Claims: Requests for Additional Information (Automated Development
Requests)
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Claims%3A%20Requests%20for%20Additional%20Information%20(Automated%20Development%20Requests)?opendocument
Contractors request additional information from providers before processing
some claims. These requests for additional information are called
“automated development letters” or “automated development requests.” The
decision to request additional information is at the discretion of each
contractor.
Applies to:
Part B Transition: General
CMS/Medicare Website Updates--PQRI Reports (2007)
An ANCO member practice reports--We are signed up to view reports but every time I go to see the report is states "application currently unavailable" do you know of anyone else that is not able to see the reports? Or do you know if anyone has gotten the reports. When I call they state that they are not available yet but no ETA on when the will be available. It is very frustrating I understood that these would be available in Mid July.
Has anyone successfully downloaded their 2007 PQRI reports? Let us know!
The following updates have been posted to the CMS/Medicare website.
SE0830 – Steps for Individual Eligible Professionals to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports Personally
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf
SE0831 – Steps for Organizations to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf
Has anyone successfully downloaded their 2007 PQRI reports? Let us know!
The following updates have been posted to the CMS/Medicare website.
SE0830 – Steps for Individual Eligible Professionals to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports Personally
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf
SE0831 – Steps for Organizations to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf
Friday, August 8, 2008
SAVE THE DATE--Palmetto/J1MAC General Transition Updates & Part B Claims Update
MOASC has invited ANCO members to participate in this very important teleconference.
Palmetto GBA General Transition Updates and Part B Claims Update
Presented by:
Pat Boardley
Palmetto GBA, J1 Manager Provider Customer Service
And
Margo Simpson
Palmetto GBA, Provider Outreach and Education
Regardless of the date of service, all claims processing, customer services and payments will be handled by Palmetto GBA as the J1 MAC, beginning September 2, 2008. NHIC will transfer all pending and in-process operations, all history previously on file with NHIC and pending work, to Palmetto GBA at that time.
On Thursday, August 28, 2008, Segment 3 of the Medicare Part B workload will begin its transition from NHIC, Corp (NHIC) to Palmetto GBA. The transition of Segment 3 affects Part B providers in California.
Discussion regarding important transition information for Medicare Part B providers in California will be addressed.
DATE: Thursday, August 21, 2008
TIME: 10:30 A.M. - 12:00 P.M.
Please RSVP to moasc@moasc.org by August 20 to receive call-in information and handouts.
Palmetto GBA General Transition Updates and Part B Claims Update
Presented by:
Pat Boardley
Palmetto GBA, J1 Manager Provider Customer Service
And
Margo Simpson
Palmetto GBA, Provider Outreach and Education
Regardless of the date of service, all claims processing, customer services and payments will be handled by Palmetto GBA as the J1 MAC, beginning September 2, 2008. NHIC will transfer all pending and in-process operations, all history previously on file with NHIC and pending work, to Palmetto GBA at that time.
On Thursday, August 28, 2008, Segment 3 of the Medicare Part B workload will begin its transition from NHIC, Corp (NHIC) to Palmetto GBA. The transition of Segment 3 affects Part B providers in California.
Discussion regarding important transition information for Medicare Part B providers in California will be addressed.
DATE: Thursday, August 21, 2008
TIME: 10:30 A.M. - 12:00 P.M.
Please RSVP to moasc@moasc.org by August 20 to receive call-in information and handouts.
ASCO's Cancer Policy Today Published
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe5915767c62057c7d12&m=ff311d707460&ls=fe0112707160057f72157377&l=fea516737564057975&s=fe1f15797d620479731d75&ju=fe30167074640274731073. ANCO is a state/regional affiliate of ASCO.
This edition features:
Senate Appropriations Committee Details Second Economic Stimulus Package
FDA Orders Label Change for ESAs
House Passes Bill That Allows FDA to Regulate Tobacco Products
Senators Propose Legislation To Create Comparative Effectiveness Institute
Congressmen Introduce Medicare Oncology Care Quality Improvement Demonstration Project Act of 2008
FDA Strengthens Conflicts of Interest Policy
CMS Releases Policy on Preventable Hospital-Acquired Conditions
New Advances on E-Prescribing Adoption
FDA To Host Workshop on Clinical Trials for Local Treatment of Breast Cancer
Physician Practice Information Survey
This edition features:
Senate Appropriations Committee Details Second Economic Stimulus Package
FDA Orders Label Change for ESAs
House Passes Bill That Allows FDA to Regulate Tobacco Products
Senators Propose Legislation To Create Comparative Effectiveness Institute
Congressmen Introduce Medicare Oncology Care Quality Improvement Demonstration Project Act of 2008
FDA Strengthens Conflicts of Interest Policy
CMS Releases Policy on Preventable Hospital-Acquired Conditions
New Advances on E-Prescribing Adoption
FDA To Host Workshop on Clinical Trials for Local Treatment of Breast Cancer
Physician Practice Information Survey
OTN Legislative Calls: August 19th and 20th
The following information is provided by OTN/Onmark, McKesson Specialty Companies, an ANCO Corporate Member.
This month's Legislative calls will be on August 19th and 20th
Join your fellow community-practice physicians for a presentation and discussion, led by John Akscin, OTN's Vice President of Government Relations.
When:
Tuesday, August 19 at 3 p.m. CST
Wednesday, August 20 at 12 p.m. CST
Where:
Call 877-718-5107 at least 10 minutes prior to the meeting start time. No pre-registration required!
Discussion will include:
CMS updates on held claims
Lone CAP vendor to exit program
Update, 2007 PQRI participant reports
FDA’s revised labeling of ESAs
New drug reimb. info: Hycamtin Oral
CMS Tidbits
CMS Transmittals and MLMs
Legislative Update
Q&A
The Legislative, Regulatory and Reimbursement program is made possible through the generous support of Genentech. OTN appreciates their sponsorship of these calls.
Did you miss the July Legislative Update? Listen to a playback by calling 888-203-1112, ID #1411194 or, click here to download and listen to a podcast of OTN's conference call.
Good News for Coders:
This program has prior approval of the American Academy of Professional Coders (AAPC) for 1.0 Continuing Education Unit. Granting of this approval in no way constitutes endorsement by the Academy of the program, content or the program sponsor.
Additional Credits Available:
This program may qualify for continuing education credit for the American College of Medical Practice Executives (ACMPE). An ACMPE credit form will be sent to all attendees shortly after the end of the event.
This month's Legislative calls will be on August 19th and 20th
Join your fellow community-practice physicians for a presentation and discussion, led by John Akscin, OTN's Vice President of Government Relations.
When:
Tuesday, August 19 at 3 p.m. CST
Wednesday, August 20 at 12 p.m. CST
Where:
Call 877-718-5107 at least 10 minutes prior to the meeting start time. No pre-registration required!
Discussion will include:
CMS updates on held claims
Lone CAP vendor to exit program
Update, 2007 PQRI participant reports
FDA’s revised labeling of ESAs
New drug reimb. info: Hycamtin Oral
CMS Tidbits
CMS Transmittals and MLMs
Legislative Update
Q&A
The Legislative, Regulatory and Reimbursement program is made possible through the generous support of Genentech. OTN appreciates their sponsorship of these calls.
Did you miss the July Legislative Update? Listen to a playback by calling 888-203-1112, ID #1411194 or, click here to download and listen to a podcast of OTN's conference call.
Good News for Coders:
This program has prior approval of the American Academy of Professional Coders (AAPC) for 1.0 Continuing Education Unit. Granting of this approval in no way constitutes endorsement by the Academy of the program, content or the program sponsor.
Additional Credits Available:
This program may qualify for continuing education credit for the American College of Medical Practice Executives (ACMPE). An ACMPE credit form will be sent to all attendees shortly after the end of the event.
Thursday, August 7, 2008
CMS/Medicare Website Updates
The following updates have been posted to the CMS/Medicare website.
SE0830 – Steps for Individual Eligible Professionals to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports Personally
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf
SE0831 – Steps for Organizations to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf
SE0830 – Steps for Individual Eligible Professionals to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports Personally
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf
SE0831 – Steps for Organizations to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf
ORTHO BIOTECH ANNOUNCES NATIONWIDE VOLUNTARY RECALL OF PROCRIT® (EPOETIN ALFA) LOT NUMBER P114942A
The following information is provided by Ortho Biotech, an ANCO Corporate Member.
Ortho Biotech is announcing that it is voluntarily recalling one manufacturing lot (P114942A) of PROCRIT® (Epoetin alfa) after having identified cracks in the necks of a small number of vials upon post-manufacturing inspection. No other lot of this product is affected by this recall. Approximately 44,292 vials of lot P114942A in the following packaging configurations were distributed between April 15, 2008 and July 17, 2008.
NDC / Description / Lot Number / Expiration Date
59676-312-00 / Individual multi-dose vials of PROCRIT® (Epoetin alfa) 10,000 U/2mL / P114942A / 12/10
59676-312-04 / Cartons containing 4 multi-dose vials of PROCRIT® (Epoetin alfa) 10,000 U/2mL / P114942A / 12/10
Vials exhibiting even slight cracks may not maintain their sterile condition and should not be used for subcutaneous or intravenous injection.
To ensure patient safety, Ortho Biotech is voluntarily recalling PROCRIT vials from this manufacturing lot only. Ortho Biotech is notifying the authorized distributors, prescribing physicians and patients of this recall. The recall is being conducted in cooperation with the U.S. Food and Drug Administration.
PROCRIT from manufacturing lots other than the above, shipped from an authorized distributor is not being recalled.
PROCRIT vials from the above recalled lot should be promptly returned by contacting the returned goods service provider, at (800) 668-4391.
Healthcare providers and patients with questions about this recall notice can contact the Ortho Biotech Medical Information Department at 888-227-5624, Monday through Friday, 8:30 am to 5:00 pm EDT.
The amount of PROCRIT being withdrawn represents a very small proportion of the total product within the distribution channel; therefore the company does not anticipate a disruption in product availability for patients.
Ortho Biotech is announcing that it is voluntarily recalling one manufacturing lot (P114942A) of PROCRIT® (Epoetin alfa) after having identified cracks in the necks of a small number of vials upon post-manufacturing inspection. No other lot of this product is affected by this recall. Approximately 44,292 vials of lot P114942A in the following packaging configurations were distributed between April 15, 2008 and July 17, 2008.
NDC / Description / Lot Number / Expiration Date
59676-312-00 / Individual multi-dose vials of PROCRIT® (Epoetin alfa) 10,000 U/2mL / P114942A / 12/10
59676-312-04 / Cartons containing 4 multi-dose vials of PROCRIT® (Epoetin alfa) 10,000 U/2mL / P114942A / 12/10
Vials exhibiting even slight cracks may not maintain their sterile condition and should not be used for subcutaneous or intravenous injection.
To ensure patient safety, Ortho Biotech is voluntarily recalling PROCRIT vials from this manufacturing lot only. Ortho Biotech is notifying the authorized distributors, prescribing physicians and patients of this recall. The recall is being conducted in cooperation with the U.S. Food and Drug Administration.
PROCRIT from manufacturing lots other than the above, shipped from an authorized distributor is not being recalled.
PROCRIT vials from the above recalled lot should be promptly returned by contacting the returned goods service provider, at (800) 668-4391.
Healthcare providers and patients with questions about this recall notice can contact the Ortho Biotech Medical Information Department at 888-227-5624, Monday through Friday, 8:30 am to 5:00 pm EDT.
The amount of PROCRIT being withdrawn represents a very small proportion of the total product within the distribution channel; therefore the company does not anticipate a disruption in product availability for patients.
Wednesday, August 6, 2008
Oncology Nurse Wanted
An ANCO member practice seeks an Oncology Nurse.
Central Coast Oncology and Hematology is a physician office with an on-site infusion center located in Santa Cruz. Physicians are board-certified and Stanford affiliate with established practices.
Our infusion center has a dedicated chemotherapy mixing room, laminar flow hood and Pyxis machine. The infusion suite includes patient entertainment and comfort features.
We have an opening for an experience IV skilled chemotherapy nurse. Requirements include: CA RN license, 1 or more years oncology nursing experience, OCN desirable, and CPR certification.
Central Coast Oncology and Hematology offers a competitive benefit package including medical insurance, 401K and PTO. Salary based on pertinent experience.
Office hours are Monday through Friday, 8:30 to 4:30. No evening, night or weekend shifts required. Our entire team is unified with the goal to provide excellent and personal medical care.
Please e-mail resume to jhokanson@ccohassociates.com or fax 831-475-2221.
Central Coast Oncology and Hematology is a physician office with an on-site infusion center located in Santa Cruz. Physicians are board-certified and Stanford affiliate with established practices.
Our infusion center has a dedicated chemotherapy mixing room, laminar flow hood and Pyxis machine. The infusion suite includes patient entertainment and comfort features.
We have an opening for an experience IV skilled chemotherapy nurse. Requirements include: CA RN license, 1 or more years oncology nursing experience, OCN desirable, and CPR certification.
Central Coast Oncology and Hematology offers a competitive benefit package including medical insurance, 401K and PTO. Salary based on pertinent experience.
Office hours are Monday through Friday, 8:30 to 4:30. No evening, night or weekend shifts required. Our entire team is unified with the goal to provide excellent and personal medical care.
Please e-mail resume to jhokanson@ccohassociates.com or fax 831-475-2221.
Tuesday, August 5, 2008
CMA Alert: Court Denies Preliminary Injunction to Stop Medi-Cal Cuts
The California Medical Association's (CMA) Alert was published today and is available online at http://www.calphys.org/html/news.asp.
It features:
State Court Denies Preliminary Injunction to Stop Medi-Cal Cuts
DMHC Finalizes Balance Billing Regulations
Blue Cross Switches to AIM for Imaging Authorizations
Is Your Medical Group Having Medicare Payment Problems?
IMQ Seeking Physicians for Dept. of Correction Review Committees
Tomorrow Is Deadline to Submit Resolutions to 2008 House of Delegates
Benefit of the Week: Reduced Loan Administration Fees
It features:
State Court Denies Preliminary Injunction to Stop Medi-Cal Cuts
DMHC Finalizes Balance Billing Regulations
Blue Cross Switches to AIM for Imaging Authorizations
Is Your Medical Group Having Medicare Payment Problems?
IMQ Seeking Physicians for Dept. of Correction Review Committees
Tomorrow Is Deadline to Submit Resolutions to 2008 House of Delegates
Benefit of the Week: Reduced Loan Administration Fees
Palmetto/J1MAC Website Updates
The following updates have been posted to the Palmetto/J1MAC website.
NPI Development Letters: Rendering and/or Billing PTANs Needed
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NPI%20Development%20Letters%3A%20Rendering%20andor%20Billing%20PTANs%20Needed?opendocument
Palmetto GBA must request your legacy identifier information when a
one-to-one match is not found for your National Provider Identifier (NPI)
and your Provider Transaction Access Number (PTAN – also referred to as the
“Medicare legacy number”). When a one-to-one match for your NPI/PTAN
combination cannot be determined development letters are generated.
Applies to:
Part B Transition: General
----------
NPI Development Letters: Rendering and/or Billing PTANs Needed
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NPI%20Development%20Letters%3A%20Rendering%20andor%20Billing%20PTANs%20Needed?opendocument
Palmetto GBA must request your legacy identifier information when a
one-to-one match is not found for your National Provider Identifier (NPI)
and your Provider Transaction Access Number (PTAN – also referred to as the
“Medicare legacy number”). When a one-to-one match for your NPI/PTAN
combination cannot be determined development letters are generated.
Applies to:
Part B Transition: General
----------
CMS/Medicare Website Updates
The following updates have been posted to the CMS/Medicare website.
MM6107 – Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6107.pdf
SE0753 – Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC): THE SECOND IN A SERIES OF ARTICLES ON THE IACS
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0753.pdf
SE0747 – Individuals Authorized Access to CMS Computer Services (IACS)- Provider/Supplier Community (IACS-PC): THE FIRST IN A SERIES OF ARTICLES
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0747.pdf
SE0754 – Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC): THE THIRD IN A SERIES OF ARTICLES ON THE IACS-PC
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0754.pdf
MM6107 – Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6107.pdf
SE0753 – Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC): THE SECOND IN A SERIES OF ARTICLES ON THE IACS
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0753.pdf
SE0747 – Individuals Authorized Access to CMS Computer Services (IACS)- Provider/Supplier Community (IACS-PC): THE FIRST IN A SERIES OF ARTICLES
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0747.pdf
SE0754 – Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC): THE THIRD IN A SERIES OF ARTICLES ON THE IACS-PC
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0754.pdf
CMS/Medicare: National Plan and Provider Enumeration System (NPPES) & the National Provider Identifer (NPI) Registry will be Unavailable on August 10t
On August 10, 2008, the National Plan and Provider Enumeration System (NPPES) will undergo system maintenance. Neither NPPES nor the NPI Registry will be available on August 10, 2008. CMS will be implementing some enhancements/updates to the system. A detailed listing of the NPPES enhancements/updates can be found at http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/Revised_NPPES_Enhancements.pdf on the CMS NPI web page.
Need More Information?
Still not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found through the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand on the CMS website. Providers can apply for an NPI online at https://nppes.cms.hhs.gov or call the NPI enumerator to request a paper application at 1-800-465-3203. Having trouble viewing any of the URLs in this message? If so, try to cut and paste any URL in this message into your web browser to view the intended information.
Note: All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage.
Need More Information?
Still not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found through the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand on the CMS website. Providers can apply for an NPI online at https://nppes.cms.hhs.gov or call the NPI enumerator to request a paper application at 1-800-465-3203. Having trouble viewing any of the URLs in this message? If so, try to cut and paste any URL in this message into your web browser to view the intended information.
Note: All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage.
ASCO e-News Published
The American Society of Clinical Oncology (ASCO) e-News was published today and is available online at http://view.exacttarget.com/?j=fe5d15767d6c077b7516&m=ff2d16787160&ls=fde7127473670c7f7c1d7373&l=fe5c15747c64077b7d10&s=fdf2157972640d79751d7073&ju=fe3816707565027b771476. ANCO is a state/regional affiliate of ASCO.
It features:
Submit an Abstract for the 2009 Genitourinary Cancers Symposium
Spotlight on State Affiliates: Georgia Society of Clinical Oncology
ASCO Launches Electronic Health Record (EHR) Podcasts
Applications for the 2009 ASCO Cancer Foundation Grants Program Now Being Accepted
Submit an Abstract for 2009 Gastrointestinal Cancers Symposium
Editors Sought for ASCO Daily News and ASCO News & Forum
JCO Impact Factor Increases to 15.484 from 13.598
2008 Annual Meeting Products and Resources Available Online
Purchase Virtual Meeting, View Top ASCO Annual Meeting Presentations
Review ASCO State/Regional Affiliates Calendar of Events
Attend 2008 UICC World Cancer Congress
Cancer Policy Alert: Senators Introduce $5.2 Billion FY 2008 Supplemental Funding for NIH, Congress Overrides President's Veto of Medicare Legislation
For Your Patients: Patient Advocate Guest Column and Podcast
For Your Patients: New Cancer.Net Features on Managing Pain, Cancer Prevention, and Clinical Trials
JCO Early Release Articles Examine Molecular Disease Subsets for Estrogen-Receptor Positive Breast Cancer; Rituximab for Diffuse Large B-Cell Lymphoma; R-CVP Compared with Cyclophosphamide, Vincristine, and Prednisone Alone for Advanced Follicular Lymphoma
Future JCO Table of Contents
It features:
Submit an Abstract for the 2009 Genitourinary Cancers Symposium
Spotlight on State Affiliates: Georgia Society of Clinical Oncology
ASCO Launches Electronic Health Record (EHR) Podcasts
Applications for the 2009 ASCO Cancer Foundation Grants Program Now Being Accepted
Submit an Abstract for 2009 Gastrointestinal Cancers Symposium
Editors Sought for ASCO Daily News and ASCO News & Forum
JCO Impact Factor Increases to 15.484 from 13.598
2008 Annual Meeting Products and Resources Available Online
Purchase Virtual Meeting, View Top ASCO Annual Meeting Presentations
Review ASCO State/Regional Affiliates Calendar of Events
Attend 2008 UICC World Cancer Congress
Cancer Policy Alert: Senators Introduce $5.2 Billion FY 2008 Supplemental Funding for NIH, Congress Overrides President's Veto of Medicare Legislation
For Your Patients: Patient Advocate Guest Column and Podcast
For Your Patients: New Cancer.Net Features on Managing Pain, Cancer Prevention, and Clinical Trials
JCO Early Release Articles Examine Molecular Disease Subsets for Estrogen-Receptor Positive Breast Cancer; Rituximab for Diffuse Large B-Cell Lymphoma; R-CVP Compared with Cyclophosphamide, Vincristine, and Prednisone Alone for Advanced Follicular Lymphoma
Future JCO Table of Contents
THIS WEEK AT ACCC: AUGUST 4-8, 2008
The following information is provided by the Association of Community Cancer Centers (ACCC) and is available online at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCC_aug04_08.html. ANCO is an Institutional Member of ACCC.
It features:
FDA Announces Proposed Label Revisions for ESAs
Best Rates Still Available for ACCC's September 17-20 Conference
Tell Your Pharmacists: An ACCC Meeting Just For Them
Sneak Peek: ACCC Meeting to Showcase Exhibitors
Oncology Care Quality Improvement Legislation Introduced in House
Heard on the ACCC Listserv, The Sounds of Music and More
No Medicare Expansion of Colorectal Cancer Screening with PreGen-Plus
ACCC's CE Blackboard: New Continuing Education Programs for You
State Medical Oncology Societies Host Upcoming Meetings
It features:
FDA Announces Proposed Label Revisions for ESAs
Best Rates Still Available for ACCC's September 17-20 Conference
Tell Your Pharmacists: An ACCC Meeting Just For Them
Sneak Peek: ACCC Meeting to Showcase Exhibitors
Oncology Care Quality Improvement Legislation Introduced in House
Heard on the ACCC Listserv, The Sounds of Music and More
No Medicare Expansion of Colorectal Cancer Screening with PreGen-Plus
ACCC's CE Blackboard: New Continuing Education Programs for You
State Medical Oncology Societies Host Upcoming Meetings
Monday, August 4, 2008
The Efficient Oncology Practice Webcast (August 21, 2008)
US Oncology Physician Services, an ANCO Corporate Member, invites ANCO members to participate in The Efficient Oncology Practice, a webcast scheduled for August 21.
For more information and to register, please visit http://www.opspharmacist.com/opes/.
For more information and to register, please visit http://www.opspharmacist.com/opes/.
DHCS/MediCal: Complete Implementation of NPIs
The following information is provided by DHCS/MediCal.
This email is being sent to inform you that Medi-Cal will completely implement the NPI on October 1, 2008.
Medi-Cal and the Child Health and Disability Prevention (CHDP) program currently accept the National Provider Identifier (NPI) on all paper and electronic claims and transactions. To comply with the federally mandated NPI utilization date of May 23, 2008, providers should be using their NPI instead of a legacy provider number. Providers who are not ready to submit Medi-Cal and CHDP claims using an NPI are out of compliance. However, Medi-Cal and CHDP will continue to accept legacy provider numbers through September 30, 2008. Providers that have registered their NPI but have not submitted claims using their NPI will not, at this time, experience interruption in payments for claims submitted with a legacy provider number. Effective October 1, 2008, claims submitted with a legacy provider number will be denied.
The exceptions to this requirement for Medi-Cal claims are Blood banks, Christian Science Practitioners and Multipurpose Senior Services Program providers. These providers may continue to submit Medi-Cal claims with a legacy provider number. The exception is also applicable to Medi-Cal Managed Care plans when reporting CHDP health assessment information on the Confidential Screening/Billing Report (PM 160) Information-only form.
Additional information is included in an article entitled 'Complete Implementation of NPIs' updated on the NPI Web page on July 25, 2008. Please refer to the following link:
http://files.medi-cal.ca.gov/pubsdoco/npi/npi.asp
Please call the Telephone Service Center (TSC) at 1-800-541-5555 or visit the Medi-Cal Web site.
This email is being sent to inform you that Medi-Cal will completely implement the NPI on October 1, 2008.
Medi-Cal and the Child Health and Disability Prevention (CHDP) program currently accept the National Provider Identifier (NPI) on all paper and electronic claims and transactions. To comply with the federally mandated NPI utilization date of May 23, 2008, providers should be using their NPI instead of a legacy provider number. Providers who are not ready to submit Medi-Cal and CHDP claims using an NPI are out of compliance. However, Medi-Cal and CHDP will continue to accept legacy provider numbers through September 30, 2008. Providers that have registered their NPI but have not submitted claims using their NPI will not, at this time, experience interruption in payments for claims submitted with a legacy provider number. Effective October 1, 2008, claims submitted with a legacy provider number will be denied.
The exceptions to this requirement for Medi-Cal claims are Blood banks, Christian Science Practitioners and Multipurpose Senior Services Program providers. These providers may continue to submit Medi-Cal claims with a legacy provider number. The exception is also applicable to Medi-Cal Managed Care plans when reporting CHDP health assessment information on the Confidential Screening/Billing Report (PM 160) Information-only form.
Additional information is included in an article entitled 'Complete Implementation of NPIs' updated on the NPI Web page on July 25, 2008. Please refer to the following link:
http://files.medi-cal.ca.gov/pubsdoco/npi/npi.asp
Please call the Telephone Service Center (TSC) at 1-800-541-5555 or visit the Medi-Cal Web site.
Palmetto/J1MAC Website Updates
The following updates have been posted to the Palmetto/J1MAC website.
2008 Self Administered Drug (SAD) Exclusion List
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/2008%20Self%20Administered%20Drug%20(SAD)%20Exclusion%20List?opendocument
The Self-Administered Drug Exclusion List 2008 was revised to delete HCPCS
J9215 Interferon, Alfa N-3 as this is not a self-administered drug. The
effective dates for the articles are as follows:
Applies to:
Part A Transition: General
Part B Transition: General
----------
Attention Part B Providers in California - Segment 3 Transition Information
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Attention%20Part%20B%20Providers%20in%20California%20-%20Segment%203%20Transition%20Information?opendocument
On Thursday, August 28, 2008, Segment 3 of the Medicare Part B workload
will begin its transition from NHIC, Corp (NHIC) to Palmetto GBA. The
transition of Segment 3 affects Part B providers in California. Palmetto
GBA has posted an article that communicates Segment 3 transition
information. We encourage you to read this article so that you are informed
of important transition details.
Applies to:
Part B Transition: General
----------
2008 Self Administered Drug (SAD) Exclusion List
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/2008%20Self%20Administered%20Drug%20(SAD)%20Exclusion%20List?opendocument
The Self-Administered Drug Exclusion List 2008 was revised to delete HCPCS
J9215 Interferon, Alfa N-3 as this is not a self-administered drug. The
effective dates for the articles are as follows:
Applies to:
Part A Transition: General
Part B Transition: General
----------
Attention Part B Providers in California - Segment 3 Transition Information
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Attention%20Part%20B%20Providers%20in%20California%20-%20Segment%203%20Transition%20Information?opendocument
On Thursday, August 28, 2008, Segment 3 of the Medicare Part B workload
will begin its transition from NHIC, Corp (NHIC) to Palmetto GBA. The
transition of Segment 3 affects Part B providers in California. Palmetto
GBA has posted an article that communicates Segment 3 transition
information. We encourage you to read this article so that you are informed
of important transition details.
Applies to:
Part B Transition: General
----------
Friday, August 1, 2008
Palmetto/J1MAC Website Update
The following updates have been posted to the Palmetto/J1MAC website.
Part B Transition Web-based Trainings
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B%20Transition%20Web-based%20Trainings?opendocument
More Dates Added! Please register for one of the upcoming Part B Web-based
trainings..
Applies to:
Part B Transition: General
----------
Revised J1 A/B MAC Part B LCDs
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Revised%20J1%20AB%20MAC%20Part%20B%20LCDs?opendocument
All of the consolidated J1 A/B MAC Part B LCDs except Ablative Therapy:
Intra-thoracic and Intra-abdominal were revised to add Bill Type Code 999X
because the automated system transcription process was incomplete.
Applies to:
Part B Transition: General
----------
Urgent Information for J1 NHIC EDI Submitters
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Urgent%20Information%20for%20J1%20NHIC%20EDI%20Submitters?opendocument
J1 NHIC EDI Submitters: Urgent information regarding our EDI transition
schedule is now available.
Applies to:
Part B Transition: EDI
----------
Part B Transition Web-based Trainings
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B%20Transition%20Web-based%20Trainings?opendocument
More Dates Added! Please register for one of the upcoming Part B Web-based
trainings..
Applies to:
Part B Transition: General
----------
Revised J1 A/B MAC Part B LCDs
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Revised%20J1%20AB%20MAC%20Part%20B%20LCDs?opendocument
All of the consolidated J1 A/B MAC Part B LCDs except Ablative Therapy:
Intra-thoracic and Intra-abdominal were revised to add Bill Type Code 999X
because the automated system transcription process was incomplete.
Applies to:
Part B Transition: General
----------
Urgent Information for J1 NHIC EDI Submitters
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Urgent%20Information%20for%20J1%20NHIC%20EDI%20Submitters?opendocument
J1 NHIC EDI Submitters: Urgent information regarding our EDI transition
schedule is now available.
Applies to:
Part B Transition: EDI
----------
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