ASCO, CMS, DHCS/MediCal, & Palmetto/J1MAC News

The following information has been received by ANCO.

All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available at http://anco-online.blogspot.com/.


****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe591578736405747c10&m=ff311d707460&ls=fdec12777c65017975127971&l=fe601575776601757d14&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2f167172660174711472. ANCO is a state/regional affiliate of ASCO. This edition features:

NIH Funding Appropriations Update

Update on Medicare Payment Provisions

Status of Legislation to Coordinate Treatment Care Planning

Update on E-Prescribing Initiatives

Genetic Nondiscrimination Bill Signed Into Law

ASCO Oncology Workforce Initiatives Update

Review of ESA Label Revisions

FDA Recognizes ASCO for Partnership on Critical Path Initiative

Update on Insurance Coverage of Clinical Trials

QOPI Update

Update on Expanded Access to Unapproved Drugs

Four Physicians Join the 111th Congress

President-elect Obama's Transition Team Reaches Out to Public on Health Care

ASCO Issues New Clinical Practice Guidelines

ASCO Creates Generic Chemotherapy Treatment Plan and Summary

ASCO Designs Modifiable Chemotherapy Consent Form

ASCO Issues Statement and Practice Resources on Exemplary Clinical Trial Site Attributes

ASCO Released EHR Field Guide


****CMS NEWS****
The transcript of the Centers for Medicare & Medicaid Services (CMS) ICD-10-CM/PCS National Provider Conference Call for Physicians that was held on November 17, 2008 is now available at
http://www.cms.hhs.gov/ICD10/Downloads/November17calltranscript.pdf .

CMS has updated the ICD-10 download files by posting the 2009 version of the following documents at http://www.cms.hhs.gov/ICD10/02_ICD-10-PCS.asp :
• ICD-10 General Equivalence Mappings (these refer to procedure codes)
• Reimbursement mappings and guides for the use of the Mappings
• 2009 version of ICD-10-Procedure Coding System (PCS)
• ICD-10 version of the digestive Medicare Severity Diagnosis Related Groups (MS-DRG)

The 2009 ICD-10-CM (Diagnosis codes) General Equivalence Mappings have been posted at http://www.cms.hhs.gov/ICD10/03_ICD_10_CM.asp .

The 2009 version of ICD-10-Clinical Modifications (CM), Diagnoses, will be posted by the end of December 2008 on the following sites:
http://www.cdc.gov/nchs/icd9.htm
http://www.cms.hhs.gov/ICD10/03_ICD_10_CM.asp

If you are unable to access any of the hyperlinks in this message, please copy and paste the URL into your Internet browser.


The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the release of the detailed specifications for the 2009 Physician Quality Reporting Initiative (PQRI) measures and the 2009 PQRI measures groups. The following resources have been posted to the PQRI webpage on the CMS website:

2009 PQRI Quality Measure Specifications Manual and Release Notes- Contains the detailed specifications (including codes and reporting instructions) for the 153 2009 PQRI quality measures for claims or registry-based reporting and a summary of the changes from the 2008 PQRI Measure Specifications (in the form of release notes delineated by measure number).

2009 PQRI Implementation Guide - Provides guidance about how to implement 2009 PQRI claims-based reporting of measures to facilitate satisfactory reporting of quality data codes by eligible professionals for the 2009 PQRI.

2009 PQRI Measures Group Specifications Manual and Release Notes- Contains the detailed specifications and instructions for the seven (7) 2009 PQRI measures groups and a summary of the changes from the 2008 PQRI Measures Groups Specifications (in the form of release notes).

Getting Started with 2009 PQRI Reporting of Measures Groups - Provides guidance about implementing the 2009 PQRI measures groups.

To access the 2009 PQRI Quality Measure Specifications Manual and Release Notes, the 2009 PQRI Implementation Guide, the 2009 PQRI Measures Group Specifications Manual and Release Notes, or the Getting Started with 2009 PQRI Reporting of Measures Groups, visit http://www.cms.hhs.gov/PQRI/15_MeasuresCodes.asp#TopOfPage on the CMS website. Once on the Measure/Codes page, scroll down to the “Downloads” section and click on the appropriate link.

Please note that the 2009 PQRI quality measure specifications for any given quality measure may be different from specifications for the same quality measure used in 2008. Therefore, specifications for all 2009 PQRI quality measures, whether or not included in the 2008 PQRI program, must be obtained from the 2009 PQRI Quality Measure Specifications Manual.

In addition, measures group specifications are different from the specifications for individually reported measures that form the group. Therefore, the specifications and reporting instructions for the 2009 PQRI measures groups must be obtained from the 2009 PQRI Measures Group Specifications Manual.

Reporting for the 2009 PQRI begins January 1, 2009. Please note there is no need to sign up or pre-register in order to participate.

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce a new section page on the Physician Quality Reporting Initiative web page. The “Spotlight” section page can be accessed on PQRI web page at http://www.cms.hhs.gov/pqri/ on the CMS website and click on the Spotlight tab. The “Spotlight” page is updated frequently and was created to alert eligible professionals to the newest program information available on the PQRI web page.

Detailed information on the 2009 PQRI may be found in the 2009 Medicare Physician Fee Schedule final rule with comment period (73 FR 69817 through 69847) that was published in the Federal Register on November 19, 2008. The final rule with comment period can be found in the “Related Links Outside of CMS” section of the Physician Quality Reporting Initiative website at: http://edocket.access.gpo.gov/2008/pdf/E8-26213.pdf on the CMS website.


****DHCS/MediCal NEWS****
Effective for dates of service on or after February 1, 2009, providers may no longer bill Medi-Cal using a recipient’s Social Security Number (SSN). Claims submitted with a recipient’s SSN will be denied. All exemptions to this policy are discontinued except for Medicare crossover claims. Providers may continue to bill Medicare crossover claims using the recipient’s SSN.

Claims submitted with a valid nine-digit Client Index Number will continue to be accepted. However, all providers are expected to use the Medi-Cal identification number from the recipient’s Benefits Identification Card (BIC) or paper ID card when verifying eligibility, billing Medi-Cal or submitting Treatment Authorization Requests (TARs).

Medi-Cal recognizes the importance of protecting the identity and health information of recipients and strongly encourages all providers to avoid using a recipient’s SSN whenever possible.

This notice has been published on the Medi-Cal Web site, http://www.medi-cal.ca.gov/, as a link from the home page Newsroom section.


****PALMETTO/J1MAC NEWS****
12/18/08 Part B LCD Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~121808%20Part%20B%20LCD%20Update?opendocument

This is the 12/18/08 Part B LCD Update. It contains Ambulance Services
(J1B-08-0007-L), Cardiovascular Nuclear Medicine: Myocardial Perfusion
Imaging & Cardiac Blood Pool Studies (J1B-08-0018-L), Category III CPT
Codes (J1B-08-0020-L), Diabetes Mellitus Therapy Using Hepatic Activation
or PIVIT Therapy (J1B-08-0024-L), Genetic Testing (J1B-08-0036-L),
Gonadotropin Releasing Hormone Analogs (J1B-08-0046-L), Intravenous Immune
Globulin IVIg, J1B-08-0047-L), Psychotherapy Services (J1B-08-0066-L),
Treatment of Obstructive Sleep Apnea (J1B-08-0079-L) and Nervous System
Studies- Autonomic Function, Nerve Conduction and Electromyography
(J1B-08-0054-L).


January 2009 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~January%202009%20J1%20AB%20MAC%20Medicare%20Advisory?opendocument

The January 2009 J1 A/B MAC Medicare Advisory is now available to be viewed
on the Palmetto GBA Web site.