The following information has been received by ANCO.
****ASH NEWS***
The American Society of Hematology's (ASH) Practice Update was published today and is available online at http://www.hematology.org/policy/practice/05282009.cfm#1. This edition features:
Update on Health Reform: ASH Comments on Senate Finance Committee Health-Care Reform Proposals
Medicare Average Sales Price Updates Available
ABMS Approves New Standards for Maintenance of Certification® Program; ASH Expresses Concerns
Top Level Positions Filled at FDA, CDC
IOM Releases a Report on Conflict of Interest in Medical Research, Education, and Practice; ASH’s Established Policies Are Already in Compliance
ASH Grassroots Network on Facebook
ASH Participates in June American Medical Association House of Delegates Meeting
****PALMETTO/J1MAC NEWS****
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.2,
Effective July 1, 2009
This article is based on Change Request (CR) 6469, which reminds physicians
to take note of the quarterly updates to Correct Coding Initiative (CCI)
edits.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7SGKY83150?opendocument
Friday, May 29, 2009
Thursday, May 28, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
MM6469 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.2, Effective July 1, 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6469.pdf
MM6417 – Expansion of the Current Scope of Editing for Ordering/Referring Providers for claims processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6417.pdf
MM6431 – Billing Routine Costs of Clinical Trials
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6431.pdf
What’s New with 2009 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Incentive Programs
1. Article Regarding Implementation Advice for 2009 PQRI and E-Prescribing Incentive Programs Now Available
2. Three Physician Quality Reporting Initiative Help Desk Resources Now Available for Eligible Professionals
CMS Announces Availability of a New Educational Resource Article on the 2009 PQRI and E-Prescribing Program
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that a new educational resource has been posted to the PQRI webpage on the CMS website. An article titled: Physician Quality
Reporting Initiative (PQRI) & E-Prescribing: Implementation Advice for the Office Manager outlines step-by-step how to get started in reporting 2009 PQRI measures.
The article is available at http://www.cms.hhs.gov/PQRI/31_PQRIToolKit.asp on the CMS website as a downloadable document and is accessible by scrolling down to the Downloads section and selecting the “2009 PQRI and E-Prescribing Implementation Advice” link.
Three Physician Quality Reporting Initiative Help Desk Resources are Now Available for Eligible Professionals
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce three PQRI Help Desk Resources to assist eligible professionals with their questions on the Physician Quality Reporting Initiative.
1. Provider Call Center Directory
· Remittance Advice Notices
· Incentive payment distribution status
· Adjustments made to incentive payment due to sanctions/overpayments
For contact information, see the “Provider Center Toll-free Numbers Directory” by clicking the link under the “Related Links Inside CMS” section below and scrolling down to the “Downloads” section.
2. External User Services (EUS) – 7:00 AM – 7:00 PM EST
· Registering/creating an IACS account
· Accessing an IACS account
· Changing an IACS account
· Approving users into an organization
Phone: 1-866-484-8049
TTY: 1-866-523-4759
3. QualityNet Help Desk – 7:00 AM – 7:00 PM CST
· General CMS PQRI & ERX Information
· PQRI Portal Password Issues
· PQRI feedback report availability and access
Phone: 1-866-288-8912
All publicly available information on the CMS Physician Quality Reporting Initiative can be found at http://www.cms.hhs.gov/PQRI, on the CMS website.
All publicly available information on the CMS Electronic Prescribing Incentive Program can be found at http://www.cms.hhs.gov/ERxIncentive on the CMS website.
****PALMETTO/J1MAC NEWS****
Requesting a Redetermination of an Overpayment for Multiple Beneficiaries
and/or Multiple Claims
Palmetto GBA recently has been receiving individual redetermination
requests for overpayments containing multiple beneficiaries and/or multiple
claims with only one Accounts Receivable (AR)/Financial Control Number
(FCN). If you receive a demand letter for an overpayment with multiple
beneficiaries/claims and wish to appeal, please submit the redetermination
request as one bulk request, not individual requests for each claim or
beneficiary.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7SES446030?opendocument
Weekly Part B ACT Call May 28 on EDI and Schedule Change Starting June 2
The next weekly J1 Part B Ask the Contractor Teleconference (ACT) call will
be held on Thursday, May 28 at 2 p.m. PST. The subject will be Electronic
Data Interchange (EDI). Starting June 2, the weekly ACT calls will be
rescheduled to Tuesdays at 12:30 p.m. PST.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3T650154?opendocument
****CMS NEWS****
MM6469 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.2, Effective July 1, 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6469.pdf
MM6417 – Expansion of the Current Scope of Editing for Ordering/Referring Providers for claims processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6417.pdf
MM6431 – Billing Routine Costs of Clinical Trials
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6431.pdf
What’s New with 2009 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Incentive Programs
1. Article Regarding Implementation Advice for 2009 PQRI and E-Prescribing Incentive Programs Now Available
2. Three Physician Quality Reporting Initiative Help Desk Resources Now Available for Eligible Professionals
CMS Announces Availability of a New Educational Resource Article on the 2009 PQRI and E-Prescribing Program
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that a new educational resource has been posted to the PQRI webpage on the CMS website. An article titled: Physician Quality
Reporting Initiative (PQRI) & E-Prescribing: Implementation Advice for the Office Manager outlines step-by-step how to get started in reporting 2009 PQRI measures.
The article is available at http://www.cms.hhs.gov/PQRI/31_PQRIToolKit.asp on the CMS website as a downloadable document and is accessible by scrolling down to the Downloads section and selecting the “2009 PQRI and E-Prescribing Implementation Advice” link.
Three Physician Quality Reporting Initiative Help Desk Resources are Now Available for Eligible Professionals
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce three PQRI Help Desk Resources to assist eligible professionals with their questions on the Physician Quality Reporting Initiative.
1. Provider Call Center Directory
· Remittance Advice Notices
· Incentive payment distribution status
· Adjustments made to incentive payment due to sanctions/overpayments
For contact information, see the “Provider Center Toll-free Numbers Directory” by clicking the link under the “Related Links Inside CMS” section below and scrolling down to the “Downloads” section.
2. External User Services (EUS) – 7:00 AM – 7:00 PM EST
· Registering/creating an IACS account
· Accessing an IACS account
· Changing an IACS account
· Approving users into an organization
Phone: 1-866-484-8049
TTY: 1-866-523-4759
3. QualityNet Help Desk – 7:00 AM – 7:00 PM CST
· General CMS PQRI & ERX Information
· PQRI Portal Password Issues
· PQRI feedback report availability and access
Phone: 1-866-288-8912
All publicly available information on the CMS Physician Quality Reporting Initiative can be found at http://www.cms.hhs.gov/PQRI, on the CMS website.
All publicly available information on the CMS Electronic Prescribing Incentive Program can be found at http://www.cms.hhs.gov/ERxIncentive on the CMS website.
****PALMETTO/J1MAC NEWS****
Requesting a Redetermination of an Overpayment for Multiple Beneficiaries
and/or Multiple Claims
Palmetto GBA recently has been receiving individual redetermination
requests for overpayments containing multiple beneficiaries and/or multiple
claims with only one Accounts Receivable (AR)/Financial Control Number
(FCN). If you receive a demand letter for an overpayment with multiple
beneficiaries/claims and wish to appeal, please submit the redetermination
request as one bulk request, not individual requests for each claim or
beneficiary.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7SES446030?opendocument
Weekly Part B ACT Call May 28 on EDI and Schedule Change Starting June 2
The next weekly J1 Part B Ask the Contractor Teleconference (ACT) call will
be held on Thursday, May 28 at 2 p.m. PST. The subject will be Electronic
Data Interchange (EDI). Starting June 2, the weekly ACT calls will be
rescheduled to Tuesdays at 12:30 p.m. PST.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3T650154?opendocument
5th Annual Oncology Congress (September 24-26; San Francisco)
The most up-to-date information on the 5th Annual Oncology Congress taking place in San Francisco from September 24-26th is available at http://www.oncologycongress.com.
ANCO members can use registration code ANCO09 at https://reed.eventready.com/index.cfm?fuseaction=reg.page&event_id=1368 to activate a special discounted registration rate of $100.
ANCO members can use registration code ANCO09 at https://reed.eventready.com/index.cfm?fuseaction=reg.page&event_id=1368 to activate a special discounted registration rate of $100.
Wednesday, May 27, 2009
ACCC, ASCO, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Centers (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_5-26-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Patient Navigation: Dr. Harold P. Freeman Provides Insight
CMS Will Share Data with Hospitals on New Imaging Efficiency Measures
ACCC Public Policy: Webinar on Hospital/Physician Clinical Integration
Q&A on ACCC's Listserve: Physician Supervision in Infusion Suite
Houston, We Have a Free Meeting June 10
ACCC's National Oncology Economics Conference: Updated Agenda
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) ASCO Express was published today. ANCO is a state/regional affiliate of ASCO. This edition features:
Abstracts from the 2009 Annual Meeting Now Available on ASCO.org
Register for a Best of ASCO® Meeting
Best of ASCO® International – Coming to a City Near You
Submit an Abstract for the 2009 Breast Cancer Symposium
Registration and Housing Now Open for the 2009 Breast Cancer Symposium
Registration and Housing Now Open for the 2009 ASCO Electronic Health Records Symposium
ASCO Launches Four New Lung Cancer Treatment Plan and Summary Templates
NIH Seeks Comments on Online Presentation of Clinical Trials Data
NCI Expands TARGET Initiative to Include Pediatric Cancers
Senate Finance Committee Releases Health Care Reform Policy Options
Read the JCO Original Report, "Prostate-specific Antigen Progression Predicts Overall Survival in Patients With Metastatic Prostate Cancer"
Read the JOP Special Series on the Cancer Quality Alliance Proceedings
****PALMETTO/J1MAC NEWS****
J1 A/B MAC June Medicare Advisory
The June 2009 J1 A/B MAC Medicare Advisory is now available to be viewed on
the Palmetto GBA Web site. It contains the latest updates and useful
information regarding Medicare. Please share this information with your
staff.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7SEPPG2004?opendocument
Palmetto GBA J1 A/B MAC Web Updates Notice
Palmetto GBA has updated the J1 Part A and Part B CERT Introduction page.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3J2U7382?opendocument
Weekly Part B ACT Call May 28 on EDI and Schedule Change Starting June 2
The next weekly J1 Part B Ask the Contractor Teleconference (ACT) call will
be held on Thursday, May 28 at 2 p.m. PST. The subject will be Electronic
Data Interchange (EDI). Starting June 2, the weekly ACT calls will be
rescheduled to Tuesdays at 12:30 p.m. PST.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3T650154?opendocument
****ACCC NEWS****
The Association of Community Cancer Centers (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_5-26-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Patient Navigation: Dr. Harold P. Freeman Provides Insight
CMS Will Share Data with Hospitals on New Imaging Efficiency Measures
ACCC Public Policy: Webinar on Hospital/Physician Clinical Integration
Q&A on ACCC's Listserve: Physician Supervision in Infusion Suite
Houston, We Have a Free Meeting June 10
ACCC's National Oncology Economics Conference: Updated Agenda
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) ASCO Express was published today. ANCO is a state/regional affiliate of ASCO. This edition features:
Abstracts from the 2009 Annual Meeting Now Available on ASCO.org
Register for a Best of ASCO® Meeting
Best of ASCO® International – Coming to a City Near You
Submit an Abstract for the 2009 Breast Cancer Symposium
Registration and Housing Now Open for the 2009 Breast Cancer Symposium
Registration and Housing Now Open for the 2009 ASCO Electronic Health Records Symposium
ASCO Launches Four New Lung Cancer Treatment Plan and Summary Templates
NIH Seeks Comments on Online Presentation of Clinical Trials Data
NCI Expands TARGET Initiative to Include Pediatric Cancers
Senate Finance Committee Releases Health Care Reform Policy Options
Read the JCO Original Report, "Prostate-specific Antigen Progression Predicts Overall Survival in Patients With Metastatic Prostate Cancer"
Read the JOP Special Series on the Cancer Quality Alliance Proceedings
****PALMETTO/J1MAC NEWS****
J1 A/B MAC June Medicare Advisory
The June 2009 J1 A/B MAC Medicare Advisory is now available to be viewed on
the Palmetto GBA Web site. It contains the latest updates and useful
information regarding Medicare. Please share this information with your
staff.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7SEPPG2004?opendocument
Palmetto GBA J1 A/B MAC Web Updates Notice
Palmetto GBA has updated the J1 Part A and Part B CERT Introduction page.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3J2U7382?opendocument
Weekly Part B ACT Call May 28 on EDI and Schedule Change Starting June 2
The next weekly J1 Part B Ask the Contractor Teleconference (ACT) call will
be held on Thursday, May 28 at 2 p.m. PST. The subject will be Electronic
Data Interchange (EDI). Starting June 2, the weekly ACT calls will be
rescheduled to Tuesdays at 12:30 p.m. PST.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3T650154?opendocument
Tuesday, May 26, 2009
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
July 2009 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing
Files and Revisions to Prior Quarterly Pricing Files
This MLN article, Change Request (CR) 6471, instructs Medicare Contractors
to download and implement the July 2009 ASP drug pricing file to determine
the payment limit for claims for separately payable Medicare Part B drugs
processed or reprocessed on or after July 6, 2009 with dates of service
July 1, 2009, through September 30, 2009.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S9LVX6631?opendocument
Erythropoietin Stimulating Agents (ESAs) for the Treatment of Anemia Unrelated to Dialysis Therapy Rounding Error
States Applicable to Alert:
American Samoa, Guam, Hawaii, Nevada, Northern Mariana Islands, Northern
California and Southern California
Background Information:
From April 1, 2009 through May 9, 2009, there was an error in the EDI system, which may have caused claims submitted with a Hematocrit (HCT) and/or Hemoglobin (HGB) level, to process incorrectly. The system may have been erroneously rounding the levels to the nearest whole number. Claims with .4 or below were rounded down and claims with .5 or higher were rounded up. If the levels were rounded to high (i.e. if the HBG was rounded to 10.0 or the HCT was rounded to 30.0) then the service may have been denied in error.
Applies To Procedure Code(s):
J0881
J0885
Modifier(s):
EA
Remark /Reason Codes:
50 - These are non-covered services because this is not deemed a "medical necessity" by the payer.
N386 - This decision was based on a National Coverage Determination (NCD). An NCD provides a coverage determination as to whether a particular item or service is covered. A copy of this policy is available at http://www.cms.hhs.gov/mcd/search.asp. If you do not have web access, you may contact the contractor to request a copy of the NCD.
MAC Action:
Services brought to our attention by affected providers will be adjusted.
Provider Action:
If you feel that you have claims that meet this criteria please contact the Telephone Reopening Line at 1-866-669-5543 to have your claims reopened. You may also request your Reopenings in writing.
****PALMETTO/J1MAC NEWS****
July 2009 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing
Files and Revisions to Prior Quarterly Pricing Files
This MLN article, Change Request (CR) 6471, instructs Medicare Contractors
to download and implement the July 2009 ASP drug pricing file to determine
the payment limit for claims for separately payable Medicare Part B drugs
processed or reprocessed on or after July 6, 2009 with dates of service
July 1, 2009, through September 30, 2009.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S9LVX6631?opendocument
Erythropoietin Stimulating Agents (ESAs) for the Treatment of Anemia Unrelated to Dialysis Therapy Rounding Error
States Applicable to Alert:
American Samoa, Guam, Hawaii, Nevada, Northern Mariana Islands, Northern
California and Southern California
Background Information:
From April 1, 2009 through May 9, 2009, there was an error in the EDI system, which may have caused claims submitted with a Hematocrit (HCT) and/or Hemoglobin (HGB) level, to process incorrectly. The system may have been erroneously rounding the levels to the nearest whole number. Claims with .4 or below were rounded down and claims with .5 or higher were rounded up. If the levels were rounded to high (i.e. if the HBG was rounded to 10.0 or the HCT was rounded to 30.0) then the service may have been denied in error.
Applies To Procedure Code(s):
J0881
J0885
Modifier(s):
EA
Remark /Reason Codes:
50 - These are non-covered services because this is not deemed a "medical necessity" by the payer.
N386 - This decision was based on a National Coverage Determination (NCD). An NCD provides a coverage determination as to whether a particular item or service is covered. A copy of this policy is available at http://www.cms.hhs.gov/mcd/search.asp. If you do not have web access, you may contact the contractor to request a copy of the NCD.
MAC Action:
Services brought to our attention by affected providers will be adjusted.
Provider Action:
If you feel that you have claims that meet this criteria please contact the Telephone Reopening Line at 1-866-669-5543 to have your claims reopened. You may also request your Reopenings in writing.
Thursday, May 21, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
MM6440 – Additional Data Collection on Hospice Claims
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6440.pdf
MM6471 – July 2009 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6471.pdf
Revised:
SE0832 – The ICD-10 Clinical Modification/Procedure Coding System (CM/PCS)—The Next Generation of Coding
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0832.pdf
****PALMETTO/J1MAC NEWS****
The Comprehensive Error Rate Testing (CERT) Fact Sheet
The J1 Comprehensive Error Rate Testing (CERT) Fact Sheet is now available
at Palmetto GBA Web site.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S7RXH5804?opendocument
****CMS NEWS****
MM6440 – Additional Data Collection on Hospice Claims
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6440.pdf
MM6471 – July 2009 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6471.pdf
Revised:
SE0832 – The ICD-10 Clinical Modification/Procedure Coding System (CM/PCS)—The Next Generation of Coding
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0832.pdf
****PALMETTO/J1MAC NEWS****
The Comprehensive Error Rate Testing (CERT) Fact Sheet
The J1 Comprehensive Error Rate Testing (CERT) Fact Sheet is now available
at Palmetto GBA Web site.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S7RXH5804?opendocument
Wednesday, May 20, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
MM6480 – July 2009 Integrated Outpatient Code Editor (I/OCE) Specifications Version 10.2
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6480.pdf
MM6481 – Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6481.pdf
Revised:
SE0832 – The ICD-10 Clinical Modification/Procedure Coding System (CM/PCS)—The Next Generation of Coding
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0832.pdf
****PALMETTO/J1MAC NEWS****
2009 Physician Quality Reporting Initiative (PQRI) and Electronic
Prescribing Incentive Program (E-Prescribing) National Provider Call
PowerPoint Presentation is Available
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce
that the PowerPoint presentation that will be used during the May 20, 2009,
PQRI and E-Prescribing National Provider call is available on the CMS Web
site.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S7QSH6057?opendocument
June 4, 2009: POE-AG Agenda
The agenda for the Palmetto GBA J1 Provider Outreach and Education Advisory
Group meeting on June 4, 2009, is now available at our Web site.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3SZT6621?opendocument
Palmetto GBA J1 A/B MAC Contract Provider To Be closed Monday, May 25,
2009, For Memorial Day
Palmetto GBA's offices and the Provider Contact Centers (PCCs) will be
closed Monday, May 25, 2009, in observance of Memorial Day.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S7KDU2146?opendocument
Weekly J1 Part B Ask the Contractor Teleconference (ACT) Calls Reinstated
Starting May 21
Palmetto GBA will reinstate the weekly J1 Part B Ask the Contractor
Teleconference (ACT) calls every Thursday starting May 21 through July 2009
to address the latest concerns within the provider community.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3T650154?opendocument
****CMS NEWS****
MM6480 – July 2009 Integrated Outpatient Code Editor (I/OCE) Specifications Version 10.2
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6480.pdf
MM6481 – Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6481.pdf
Revised:
SE0832 – The ICD-10 Clinical Modification/Procedure Coding System (CM/PCS)—The Next Generation of Coding
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0832.pdf
****PALMETTO/J1MAC NEWS****
2009 Physician Quality Reporting Initiative (PQRI) and Electronic
Prescribing Incentive Program (E-Prescribing) National Provider Call
PowerPoint Presentation is Available
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce
that the PowerPoint presentation that will be used during the May 20, 2009,
PQRI and E-Prescribing National Provider call is available on the CMS Web
site.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S7QSH6057?opendocument
June 4, 2009: POE-AG Agenda
The agenda for the Palmetto GBA J1 Provider Outreach and Education Advisory
Group meeting on June 4, 2009, is now available at our Web site.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3SZT6621?opendocument
Palmetto GBA J1 A/B MAC Contract Provider To Be closed Monday, May 25,
2009, For Memorial Day
Palmetto GBA's offices and the Provider Contact Centers (PCCs) will be
closed Monday, May 25, 2009, in observance of Memorial Day.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S7KDU2146?opendocument
Weekly J1 Part B Ask the Contractor Teleconference (ACT) Calls Reinstated
Starting May 21
Palmetto GBA will reinstate the weekly J1 Part B Ask the Contractor
Teleconference (ACT) calls every Thursday starting May 21 through July 2009
to address the latest concerns within the provider community.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7S3T650154?opendocument
Tuesday, May 19, 2009
CMS News
The following information has been received by ANCO.
****CMS NEWS****
Background materials for the May 20, 2009 Special Open Door Forum: Outpatient Imaging Efficiency Measures are available for review at http://www.QualityNet.org and http://www.ImagingMeasures.com.
Centers for Medicare & Medicaid Services
Special Open Door Forum:
Outpatient Imaging Efficiency Measures
Wednesday, May 20, 2009
2:00PM – 4:00PM Eastern Time (ET)
Conference Call Only
Featuring:
John Cooper, M.D. (CMS),
Mark Zezza, Ph.D. (The Lewin Group),
Thomas G. Dehn, M.D., FACR (National Imaging Associates, Inc.),
Joan DaVanzo, Ph.D. (Dobson | DaVanzo & Associates, LLC).
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the development and implementation of facility-level hospital Outpatient Imaging Efficiency measures. The CMS has contracted with The Lewin Group, to develop a set of imaging efficiency measures. National Imaging Associates, and Dobson & DaVanzo are subcontracted by Lewin to support this effort.
During this Special ODF, CMS staff will discuss:
· Each of the four outpatient imaging efficiency measures currently required under the Hospital Outpatient Quality Data Reporting Program
(HOP QDRP) for CY2010 payment determination;
· Highlight some frequently asked questions;
· New Outpatient Imaging Efficiency measures under development.
Afterwards, there will be an opportunity for the public to ask questions.
To make the call as informative as possible, we recommend that participants:
· Visit the QualityNet (http://www.QualityNet.org) and Choose “Imaging Efficiency Measures” under “Hospital – Outpatient” and also http://www.ImagingMeasures.com ;
· Pre-submit any questions you wish to have addressed on the call to Imaging.Measures@lewin.com. Please type “Question for National Open Door Forum” in your Subject line. The most frequently asked questions received by 5 pm ET on Thursday, May 14, 2009, will be addressed on the call. Submitted questions not selected for the call will be answered individually via e-mail reply.
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 94281978
Note: TTY Communications Relay Services are available for the Hearing Impaired.
For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning May 29, 2009.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
Thank you for your interest in CMS Open Door Forums.
2009 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Incentive Program (E-Prescribing) National Provider Call PowerPoint Presentation is now available
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that the PowerPoint presentation that will be used during the May 20th, 2009 PQRI and E-Prescribing National Provider call is now available on the CMS website.
This presentation provides an update on the Quality Data Code (QDC) Error Report; tips for satisfactorily reporting a Measures Group in the 2009 PQRI; and frequently asked questions on E-Prescribing.
To access the presentation, go to http://www.cms.hhs.gov/PQRI/04_CMSSponsoredCalls.asp., scroll down to the Downloads section and select the “National Provider Call - May 20, 2009” link.
****CMS NEWS****
Background materials for the May 20, 2009 Special Open Door Forum: Outpatient Imaging Efficiency Measures are available for review at http://www.QualityNet.org and http://www.ImagingMeasures.com.
Centers for Medicare & Medicaid Services
Special Open Door Forum:
Outpatient Imaging Efficiency Measures
Wednesday, May 20, 2009
2:00PM – 4:00PM Eastern Time (ET)
Conference Call Only
Featuring:
John Cooper, M.D. (CMS),
Mark Zezza, Ph.D. (The Lewin Group),
Thomas G. Dehn, M.D., FACR (National Imaging Associates, Inc.),
Joan DaVanzo, Ph.D. (Dobson | DaVanzo & Associates, LLC).
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the development and implementation of facility-level hospital Outpatient Imaging Efficiency measures. The CMS has contracted with The Lewin Group, to develop a set of imaging efficiency measures. National Imaging Associates, and Dobson & DaVanzo are subcontracted by Lewin to support this effort.
During this Special ODF, CMS staff will discuss:
· Each of the four outpatient imaging efficiency measures currently required under the Hospital Outpatient Quality Data Reporting Program
(HOP QDRP) for CY2010 payment determination;
· Highlight some frequently asked questions;
· New Outpatient Imaging Efficiency measures under development.
Afterwards, there will be an opportunity for the public to ask questions.
To make the call as informative as possible, we recommend that participants:
· Visit the QualityNet (http://www.QualityNet.org) and Choose “Imaging Efficiency Measures” under “Hospital – Outpatient” and also http://www.ImagingMeasures.com ;
· Pre-submit any questions you wish to have addressed on the call to Imaging.Measures@lewin.com. Please type “Question for National Open Door Forum” in your Subject line. The most frequently asked questions received by 5 pm ET on Thursday, May 14, 2009, will be addressed on the call. Submitted questions not selected for the call will be answered individually via e-mail reply.
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 94281978
Note: TTY Communications Relay Services are available for the Hearing Impaired.
For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning May 29, 2009.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
Thank you for your interest in CMS Open Door Forums.
2009 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Incentive Program (E-Prescribing) National Provider Call PowerPoint Presentation is now available
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that the PowerPoint presentation that will be used during the May 20th, 2009 PQRI and E-Prescribing National Provider call is now available on the CMS website.
This presentation provides an update on the Quality Data Code (QDC) Error Report; tips for satisfactorily reporting a Measures Group in the 2009 PQRI; and frequently asked questions on E-Prescribing.
To access the presentation, go to http://www.cms.hhs.gov/PQRI/04_CMSSponsoredCalls.asp., scroll down to the Downloads section and select the “National Provider Call - May 20, 2009” link.
ACCC & CMS News
The following information has been received by ANCO.
****ACCC NEWS****
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/2009/media_ACCCNEWSLETTER_5-18-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Many Disagree with Medicare's "No" Decision for Virtual Colonoscopy
ACCC Public Policy Update: Two CMS May 20 Teleconferences
Health Plan Paperwork/Interactions Taking Much Physician and Nurse Time
New FTC "Red Flags" Rule on Identity Theft Applies to Many Providers
Q&A on ACCC's Listserve: Use of Nurse Practitioners
Houston, We Have a Free Meeting June 10
A Compelling Value This September in Minneapolis: Updated Agenda
US Oncology Launches Audio Reimbursement Education for Practices
****CMS NEWS****
Centers for Medicare & Medicaid Services
Special Open Door Forum:
Medicare Imaging Demonstration Project
Wednesday, May 27, 2009
9:30 am – 11:30 am ET
The Centers for Medicare and Medicaid Services (CMS) is holding a Special Open Door Forum (ODF) in order to solicit stakeholder input for the design and development of the Appropriate Use of Imaging Services Demonstration. This Special ODF will be a “listening session” in which CMS hopes to gather information from stakeholders about issues that will affect Demonstration design and implementation.
This demonstration was authorized by Section 135(b) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) for the purpose of collecting data regarding physician use of advanced diagnostic imaging services. For purposes of this demonstration, advanced diagnostic imaging services are defined as diagnostic magnetic resonance imaging, computed tomography, and nuclear medicine (including positron emission tomography).
CMS is interested in holding this Special ODF to gather input related to the design and implementation of this provision. CMS will not be able to respond to comments at this Forum but intends to consider the information we obtain as input develop this demonstration.
CMS is especially interested in information and feedback in the following topic areas:
1. Demonstration Framework:
a. Given that prior authorization is excluded from the demonstration by legislative mandate, how can we best design the demonstration to test both point of order (POO) and point of service (POS) systems?
b. How could CMS assess the impact of POO and POS systems through randomized designs or other comparative models?
c. What will motivate physician participation in the demonstration? How should physicians be recruited? What is the role of economic and non-economic incentives in encouraging participation?
2. Point of Order (POO) and Point of Service Systems (POS):
a. What are the major characteristics of POO and POS? How are they similar and how are they different in their assessments of appropriateness? How are these systems currently used by providers and payers?
b. What data are captured by the systems and what is the comparability in data elements across systems? Are there distinctions in how appropriateness of individual procedures is assessed between these two systems?
c. Does use of POO versus POS systems vary systematically by type of service, service setting, type of physician, and/or geography? How common is the use of these systems by specialists, primary care physicians and performing physicians?
d. How do ordering and performing physicians interface with the POO or POS systems? Do individual physicians or group practices use of more than one system?
3. Imaging Procedures:
a. Specific procedures being considered for inclusion in the demonstration are likely to be high in volume, high in growth, exhibit geographic variation, and have consensus around clinical guidelines. Are there other criteria we should consider when selecting procedures for inclusion in the demonstration?
b. What procedures that have the characteristics described above have been incorporated into POO and POS?
c. Should the demonstration focus on applying a decision support system for only specific types of imaging procedure use (e.g., MRI for Lumbar Spine, rather than all MRIs)? Might a focus on only specific types of procedures cause confusion for physicians or increase burden on physicians?
For a more information, please see the demonstration website: http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=3&sortOrder=descending&itemID=CMS1222075&intNumPerPage=10
We ask that all interested parties who wish to present their positions or comments prepare to speak for no more than 2 minutes. Telephone participants will also be given an opportunity to speak and will be under the same time limitation.
CMS requests that interested parties prepare their comments or input in written form and submit this information toImagingDemo135b@cms.hhs.gov . We also request that you bring a hard copy of your written material for collection at the Special ODF.
We look forward to your participation.
There are two ways to participate, by phone or "in-person".
1. To participate by phone:
Dial: 1-800-837-1935 & Reference Conference ID: 90111467
Persons participating by phone are not required to RSVP.
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
2. To participate "in-person" at the CMS Baltimore Site, RSVP is required.
Please RSVP by 2pmET Thursday, May 21, 2009 to: SpecialODF@cms.hhs.gov . Please use “Medicare Imaging Demonstration” in the subject line, send your name along with the name of your organization, your contact information, and indicate whether or not you plan to speak.
Please plan to arrive no later than 9:00 AM to account for time required to pass through security. Visitors are subject to a vehicle search and an examination of all parcels (including purses) brought into the complex. Visitors all must have a valid Government-issued photo identification card or badge.
ADDRESS:
CMS Single Site Building
Auditorium
7500 Security Boulevard
Baltimore, MD 21244
An audio recording and transcript of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning June 8, 2009.
For automatic emails of Open Door Forum schedule updates, E-Mailing list subscriptions and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
Thank you for your interest in CMS Open Door Forums.
****ACCC NEWS****
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/2009/media_ACCCNEWSLETTER_5-18-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Many Disagree with Medicare's "No" Decision for Virtual Colonoscopy
ACCC Public Policy Update: Two CMS May 20 Teleconferences
Health Plan Paperwork/Interactions Taking Much Physician and Nurse Time
New FTC "Red Flags" Rule on Identity Theft Applies to Many Providers
Q&A on ACCC's Listserve: Use of Nurse Practitioners
Houston, We Have a Free Meeting June 10
A Compelling Value This September in Minneapolis: Updated Agenda
US Oncology Launches Audio Reimbursement Education for Practices
****CMS NEWS****
Centers for Medicare & Medicaid Services
Special Open Door Forum:
Medicare Imaging Demonstration Project
Wednesday, May 27, 2009
9:30 am – 11:30 am ET
The Centers for Medicare and Medicaid Services (CMS) is holding a Special Open Door Forum (ODF) in order to solicit stakeholder input for the design and development of the Appropriate Use of Imaging Services Demonstration. This Special ODF will be a “listening session” in which CMS hopes to gather information from stakeholders about issues that will affect Demonstration design and implementation.
This demonstration was authorized by Section 135(b) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) for the purpose of collecting data regarding physician use of advanced diagnostic imaging services. For purposes of this demonstration, advanced diagnostic imaging services are defined as diagnostic magnetic resonance imaging, computed tomography, and nuclear medicine (including positron emission tomography).
CMS is interested in holding this Special ODF to gather input related to the design and implementation of this provision. CMS will not be able to respond to comments at this Forum but intends to consider the information we obtain as input develop this demonstration.
CMS is especially interested in information and feedback in the following topic areas:
1. Demonstration Framework:
a. Given that prior authorization is excluded from the demonstration by legislative mandate, how can we best design the demonstration to test both point of order (POO) and point of service (POS) systems?
b. How could CMS assess the impact of POO and POS systems through randomized designs or other comparative models?
c. What will motivate physician participation in the demonstration? How should physicians be recruited? What is the role of economic and non-economic incentives in encouraging participation?
2. Point of Order (POO) and Point of Service Systems (POS):
a. What are the major characteristics of POO and POS? How are they similar and how are they different in their assessments of appropriateness? How are these systems currently used by providers and payers?
b. What data are captured by the systems and what is the comparability in data elements across systems? Are there distinctions in how appropriateness of individual procedures is assessed between these two systems?
c. Does use of POO versus POS systems vary systematically by type of service, service setting, type of physician, and/or geography? How common is the use of these systems by specialists, primary care physicians and performing physicians?
d. How do ordering and performing physicians interface with the POO or POS systems? Do individual physicians or group practices use of more than one system?
3. Imaging Procedures:
a. Specific procedures being considered for inclusion in the demonstration are likely to be high in volume, high in growth, exhibit geographic variation, and have consensus around clinical guidelines. Are there other criteria we should consider when selecting procedures for inclusion in the demonstration?
b. What procedures that have the characteristics described above have been incorporated into POO and POS?
c. Should the demonstration focus on applying a decision support system for only specific types of imaging procedure use (e.g., MRI for Lumbar Spine, rather than all MRIs)? Might a focus on only specific types of procedures cause confusion for physicians or increase burden on physicians?
For a more information, please see the demonstration website: http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=3&sortOrder=descending&itemID=CMS1222075&intNumPerPage=10
We ask that all interested parties who wish to present their positions or comments prepare to speak for no more than 2 minutes. Telephone participants will also be given an opportunity to speak and will be under the same time limitation.
CMS requests that interested parties prepare their comments or input in written form and submit this information toImagingDemo135b@cms.hhs.gov . We also request that you bring a hard copy of your written material for collection at the Special ODF.
We look forward to your participation.
There are two ways to participate, by phone or "in-person".
1. To participate by phone:
Dial: 1-800-837-1935 & Reference Conference ID: 90111467
Persons participating by phone are not required to RSVP.
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
2. To participate "in-person" at the CMS Baltimore Site, RSVP is required.
Please RSVP by 2pmET Thursday, May 21, 2009 to: SpecialODF@cms.hhs.gov . Please use “Medicare Imaging Demonstration” in the subject line, send your name along with the name of your organization, your contact information, and indicate whether or not you plan to speak.
Please plan to arrive no later than 9:00 AM to account for time required to pass through security. Visitors are subject to a vehicle search and an examination of all parcels (including purses) brought into the complex. Visitors all must have a valid Government-issued photo identification card or badge.
ADDRESS:
CMS Single Site Building
Auditorium
7500 Security Boulevard
Baltimore, MD 21244
An audio recording and transcript of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning June 8, 2009.
For automatic emails of Open Door Forum schedule updates, E-Mailing list subscriptions and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
Thank you for your interest in CMS Open Door Forums.
Monday, May 18, 2009
CMA & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
New Medicare Enrollment Rules Could Have Costly Consequences for Physicians
Are You Looking for Your IMQ CME Certification Form?
CMA Launches Language Access Project with Physician Survey
Governor Proposes Major Cuts to Health Care
CMA Supports Senate Move to Expand Health Care Coverage,
Says Access to Care Must Be Protected
CMA Bill Would Bring Fairness and Transparency to Peer Review System
Webinar: How the Stimulus Bill Impacts Your HIPAA Obligations
****PALMETTO/J1MAC NEWS****
Palmetto GBA has updated the J1 Part B Fee Schedules introduction page to
better serve our Web users.
Palmetto GBA J1 Part B Web Updates Notice
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7S3J2U7382?opendocument
****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
New Medicare Enrollment Rules Could Have Costly Consequences for Physicians
Are You Looking for Your IMQ CME Certification Form?
CMA Launches Language Access Project with Physician Survey
Governor Proposes Major Cuts to Health Care
CMA Supports Senate Move to Expand Health Care Coverage,
Says Access to Care Must Be Protected
CMA Bill Would Bring Fairness and Transparency to Peer Review System
Webinar: How the Stimulus Bill Impacts Your HIPAA Obligations
****PALMETTO/J1MAC NEWS****
Palmetto GBA has updated the J1 Part B Fee Schedules introduction page to
better serve our Web users.
Palmetto GBA J1 Part B Web Updates Notice
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7S3J2U7382?opendocument
Friday, May 15, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) will host a national education conference call to address the implementation of HIPAA Version 5010. This call is being conducted for all Medicare fee-for-service providers. The call will give a general overview of the transition to HIPAA Version 5010 and address some of the exceptions and situations you may encounter as the new version is implemented. A presentation will be given and CMS Subject Matter Experts will be available to answer questions. A PowerPoint presentation will be posted on the CMS 5010 Web page prior to the call. The 5010 Web page is located at http://www.cms.hhs.gov/ElectronicBillingEDITrans/18_5010D0.asp
Conference call details:
Date: June 9, 2009
Conference Title:
CMS audio conference call: HIPAA Version 5010 – What you need to know!
Time: 2:30 – 4:00 p.m. ET
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 2:30 p.m. ET on June 8, 2009, 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/060909
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.
****PALMETTO/J1MAC NEWS****
This J1 Part B alert informs providers that some Colorectal Cancer
Screening procedure codes were being suspended for manual coverage review
in error. Therefore, an express adjustment or mass adjustment will be
performed on the claims being denied incorrectly.
Colorectal Cancer Screenings
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RZQG87431?opendocument
Share this with your staff - This J1 Part B alert informs providers that
Palmetto will begin rejecting claims with dates of service on and after
July 1, 2009, if submitted without an invoice. For a limited time only,
Palmetto GBA will send providers development letters asking for invoices
for claims submitted without one.
Development Letter: Invoice for Radiopharmaceuticals
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RZQXC2863?opendocument
The ICD-9-CM diagnosis code 0600 alert has been updated. ICD-9-CM diagnosis
code 0600 ‘Sylvatic’ was incorrectly end dated in our system. Palmetto GBA
has tried to perform a mass adjustment but was unsuccessful due to the
services being rejects rather than denials. Providers are asked to contact
the Palmetto GBA PCC at 1-866-931-3901 and ask for the claims to be
reprocessed.
ICD-9-CM Diagnosis Code 0600 Update
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Q3JV82052?opendocument
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) will host a national education conference call to address the implementation of HIPAA Version 5010. This call is being conducted for all Medicare fee-for-service providers. The call will give a general overview of the transition to HIPAA Version 5010 and address some of the exceptions and situations you may encounter as the new version is implemented. A presentation will be given and CMS Subject Matter Experts will be available to answer questions. A PowerPoint presentation will be posted on the CMS 5010 Web page prior to the call. The 5010 Web page is located at http://www.cms.hhs.gov/ElectronicBillingEDITrans/18_5010D0.asp
Conference call details:
Date: June 9, 2009
Conference Title:
CMS audio conference call: HIPAA Version 5010 – What you need to know!
Time: 2:30 – 4:00 p.m. ET
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 2:30 p.m. ET on June 8, 2009, 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/060909
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.
****PALMETTO/J1MAC NEWS****
This J1 Part B alert informs providers that some Colorectal Cancer
Screening procedure codes were being suspended for manual coverage review
in error. Therefore, an express adjustment or mass adjustment will be
performed on the claims being denied incorrectly.
Colorectal Cancer Screenings
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RZQG87431?opendocument
Share this with your staff - This J1 Part B alert informs providers that
Palmetto will begin rejecting claims with dates of service on and after
July 1, 2009, if submitted without an invoice. For a limited time only,
Palmetto GBA will send providers development letters asking for invoices
for claims submitted without one.
Development Letter: Invoice for Radiopharmaceuticals
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RZQXC2863?opendocument
The ICD-9-CM diagnosis code 0600 alert has been updated. ICD-9-CM diagnosis
code 0600 ‘Sylvatic’ was incorrectly end dated in our system. Palmetto GBA
has tried to perform a mass adjustment but was unsuccessful due to the
services being rejects rather than denials. Providers are asked to contact
the Palmetto GBA PCC at 1-866-931-3901 and ask for the claims to be
reprocessed.
ICD-9-CM Diagnosis Code 0600 Update
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Q3JV82052?opendocument
Thursday, May 14, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
Centers for Medicare & Medicaid Services
Special Open Door Forum:
2009 Physician Quality Reporting Initiative (PQRI) &
Electronic Prescribing (E-Prescribing) Incentive Programs
with the American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Executives
Tuesday, May 19, 2009
3:30pm-5pm ET
Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will co-host a Special Open Door Forum on the 2009 PQRI and E-Prescribing Incentive Programs with the American Academy of Orthopaedic Surgeons (AAOS) and the American Association of Orthopaedic Executives (AAOE).
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes a new and separate incentive program for individual eligible professionals who are successful electronic prescribers (e-Prescribers) as defined by MIPPA. This new incentive is separate from and is in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) and known as the Physician Quality Reporting Initiative (PQRI).
This Special Open Door Forum will be geared towards orthopaedic-specific topics related to participation in the PQRI and E-Prescribing Incentive Programs. Following the presentation, the telephone lines will be opened to allow participants to ask questions of the AAOS/AAOE presenters, including Robert H. Haralson, III, MD, MBA; Toya M. Sledd, MPH, MBA; Barbara Sack, MHSA, CMPE; as well as CMS PQRI subject matter expert, Sylvia Publ.
PQRI information and educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website. E-Prescribing information and educational products are available on the E-Prescribing dedicated web page located at, http://www.cms.hhs.gov/ERXIncentive , on the CMS website.
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 94236628
Note: TTY Communications Relay Services are available for the Hearing Impaired.
For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning May 28, 2009.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
****PALMETTO/J1MAC NEWS****
Limits on Billed Amounts: Instructions for Submitting Claims
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Limits%20on%20Billed%20Amounts%20Instructions%20for%20Submitting%20Claims?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/EFB6A9D625B136F5852575B50044D97E?opendocument
This J1 Part B article provides instructions for submitting claims to Part
B claims processing system (the Multi-Carrier System or MCS) when the total
charge on a single claim exceeds $99,999.99.
Modification of the Working Common File (CWF) Copybook to Transmit "WC"
Qualifier Alpha Codes to Various Systems
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLN%20Matters%20Articles~All%20Part%20A%20MLNs~Modification%20of%20the%20Working%20Common%20File%20(CWF)%20Copybook%20to%20Transmit%20"WC"%20Qualifier%20Alpha%20Codes%20to%20Various%20Systems?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575B500605A4D?opendocument
This MLN Matters article, change request 6438, allows from the transfer of
the WC modifier's alpha codes from the CWF system to other important
Medicare systems.
Provider Enrollment Application Finder Help Tool
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~General~Provider%20Enrollment%20Application%20Finder%20Help%20Tool?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/46C6740D13ABD39C852575B50044D988?opendocument
Are you unsure which provider enrollment application you need to complete
to obtain a provider number? Confused about what documents you should send
with your application? The Provider Enrollment Application Finder Help Tool
provides answers to these questions and more. By completing a quick
questionnaire, you can find out which application to submit, which sections
to complete, and what other documentation must be submitted with the
application. Try it today!
Revised: Medicare Claims Processing Manual Clarifications for Skilled
Nursing Facility (SNF) and Therapy Billing
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLN%20Matters%20Articles~All%20Part%20A%20MLNs~Revised%20Medicare%20Claims%20Processing%20Manual%20Clarifications%20for%20Skilled%20Nursing%20Facility%20(SNF)%20and%20Therapy%20Billing?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758B00535476?opendocument
The revised MLN article (CR6407), Medicare Claims Processing Manual
Clarifications for Skilled Nursing Facility (SNF) and Therapy Billing is
now available on our Web site.
****CMS NEWS****
Centers for Medicare & Medicaid Services
Special Open Door Forum:
2009 Physician Quality Reporting Initiative (PQRI) &
Electronic Prescribing (E-Prescribing) Incentive Programs
with the American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Executives
Tuesday, May 19, 2009
3:30pm-5pm ET
Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will co-host a Special Open Door Forum on the 2009 PQRI and E-Prescribing Incentive Programs with the American Academy of Orthopaedic Surgeons (AAOS) and the American Association of Orthopaedic Executives (AAOE).
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes a new and separate incentive program for individual eligible professionals who are successful electronic prescribers (e-Prescribers) as defined by MIPPA. This new incentive is separate from and is in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) and known as the Physician Quality Reporting Initiative (PQRI).
This Special Open Door Forum will be geared towards orthopaedic-specific topics related to participation in the PQRI and E-Prescribing Incentive Programs. Following the presentation, the telephone lines will be opened to allow participants to ask questions of the AAOS/AAOE presenters, including Robert H. Haralson, III, MD, MBA; Toya M. Sledd, MPH, MBA; Barbara Sack, MHSA, CMPE; as well as CMS PQRI subject matter expert, Sylvia Publ.
PQRI information and educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website. E-Prescribing information and educational products are available on the E-Prescribing dedicated web page located at, http://www.cms.hhs.gov/ERXIncentive , on the CMS website.
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 94236628
Note: TTY Communications Relay Services are available for the Hearing Impaired.
For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning May 28, 2009.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
****PALMETTO/J1MAC NEWS****
Limits on Billed Amounts: Instructions for Submitting Claims
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Limits%20on%20Billed%20Amounts%20Instructions%20for%20Submitting%20Claims?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/EFB6A9D625B136F5852575B50044D97E?opendocument
This J1 Part B article provides instructions for submitting claims to Part
B claims processing system (the Multi-Carrier System or MCS) when the total
charge on a single claim exceeds $99,999.99.
Modification of the Working Common File (CWF) Copybook to Transmit "WC"
Qualifier Alpha Codes to Various Systems
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLN%20Matters%20Articles~All%20Part%20A%20MLNs~Modification%20of%20the%20Working%20Common%20File%20(CWF)%20Copybook%20to%20Transmit%20"WC"%20Qualifier%20Alpha%20Codes%20to%20Various%20Systems?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575B500605A4D?opendocument
This MLN Matters article, change request 6438, allows from the transfer of
the WC modifier's alpha codes from the CWF system to other important
Medicare systems.
Provider Enrollment Application Finder Help Tool
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~General~Provider%20Enrollment%20Application%20Finder%20Help%20Tool?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/46C6740D13ABD39C852575B50044D988?opendocument
Are you unsure which provider enrollment application you need to complete
to obtain a provider number? Confused about what documents you should send
with your application? The Provider Enrollment Application Finder Help Tool
provides answers to these questions and more. By completing a quick
questionnaire, you can find out which application to submit, which sections
to complete, and what other documentation must be submitted with the
application. Try it today!
Revised: Medicare Claims Processing Manual Clarifications for Skilled
Nursing Facility (SNF) and Therapy Billing
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLN%20Matters%20Articles~All%20Part%20A%20MLNs~Revised%20Medicare%20Claims%20Processing%20Manual%20Clarifications%20for%20Skilled%20Nursing%20Facility%20(SNF)%20and%20Therapy%20Billing?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758B00535476?opendocument
The revised MLN article (CR6407), Medicare Claims Processing Manual
Clarifications for Skilled Nursing Facility (SNF) and Therapy Billing is
now available on our Web site.
Wednesday, May 13, 2009
ASCO, CMS, & NCI News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Practice Insider was published today and is available online at http://view.exacttarget.com/?j=fe5515797c640d787c14&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe3616737465077f7c1573. ANCO is a state/regional affiliate of ASCO. This edition features:
1. "Red flags" rule compliance date pushed to Aug. 1
2. Medicare Updates Instructions on Billing Routine Costs of Clinical Trials (Part A and B)
3. Drug Shortage Updates
4. FDA Reverses Action to Pull Unapproved Liquid Morphine Off Market
5. CIGNA Modifier Policy
6. Kathleen Sebelius Confirmed as Secretary of the Department of Health and Human Services
7. Medicare Announces Sites for Pilot Program to Improve Quality as Patients Move Across Care Settings
8. Q&A with Sue Bowman of AHIMA: ICD-10-CM Diagnosis and ICD-10-CM PCS Transition
9. Billing and Coding Q&A
Best of ASCO® Los Angeles Deadlines Quickly Approaching!
Act by 11:59 PM Eastern Time on May 13, 2009 to receive discounted registration rates for the Best of ASCO Los Angeles meeting scheduled for June 19-20, 2009 in Los Angeles, CA. The meeting will feature premier abstracts from the 2009 ASCO Annual Meeting, representing the most relevant, cutting-edge research in oncology today. Also, don’t forget to make your housing reservation for the meeting prior to the May 13, 2009housing deadline. Go to www.asco.org/boa to register and reserve housing today!
****CMS NEWS****
Providers may now register for the Centers for Medicare & Medicaid Services’ ICD-10-CM/PCS Implementation and General Equivalence Mappings (Crosswalks) National Provider Conference Call that will be conducted on May 19, 2009 from 1:00 p.m. – 2:30 p.m. Eastern Daylight Time. This conference call will include a discussion of the following topics:
· An overview of the ICD-10 final rule, which requires the implementation of ICD-10-CM/PCS on October 1, 2013;
· The differences between ICD-9-CM and ICD-10-CM/PCS codes;
· The use of the General Equivalence Mappings that have been created to assist in converting
policies, edits, and trend data from ICD-9-CM to ICD-10-CM/PCS; and
· The resources that are available to assist in planning for the transition from ICD-9-CM to ICD-10-CM/PCS.
Note:
A new fact sheet has been developed that provides additional information about the ICD-10 General Equivalence Mappings, and the slide presentation that will be discussed during the conference call has been revised. These discussion materials have been posted in the Downloads Section at http://www.cms.hhs.gov/ICD10/07a_2009_CMS_Sponsored_Calls.asp . If you are unable to access the hyperlink in this message, please copy and paste the URL into your Internet browser.
A new Medicare Secondary Payer Fact Sheet (April 2009), which provides a general overview of the MSP provisions for individuals involved in the admission and billing procedures at provider, physician, and other supplier settings is now available in downloadable format from the Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/MSP_Fact_Sheet.pdf .
MM6438 – Modification of the Common Working File (CWF) Copybook to Transmit “WC” Qualifier Alpha Codes to Various Systems. (supplement to CR 5371)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6438.pdf
MM6358 – Processing and Payment of Physician and Non-Physician Practitioner Services Reassigned to Ambulatory Surgical Centers (ASCs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6358.pdf
MM6395 – Section 148 of The Medicare Improvements for Patients and Providers Act (MIPPA)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6395.pdf
SE0726 – Clarification about the Medical Privacy of Protected Health Information
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0726.pdf
MM6407 – Medicare Claims Processing Manual Clarifications for Skilled Nursing Facility (SNF) and Therapy Billing
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6407.pdf
****NCI NEWS****
We are pleased to announce the launch of the new NCI Publications Locator (NCIPL) site! NCIPL offers users the ability to view and order NCI publications online. Please check it out...
www.cancer.gov/publications
Over the past year, a team worked to completely redesign NCIPL to offer a much more user friendly experience and improved public interface. Usability and focus group testing was conducted as well. The result is a refreshed, secure system with greater ease of use, accessibility and advanced features.
Improvements to the site include:
- A look and feel similar to cancer.gov
- A homepage that offers additional browsing options
- Links to Announcements, Featured Publications and New and Updated Publications
- Improved search capabilities to locate, select and order materials
- More publication information to include last reviewed date, publication format and page count
- An expanded Publications Details page that includes Audience, Language, Physical Description and Related Products
- Thumbnail images for most publications
- Advanced order capabilities to include a shopping cart and order progress bar
- A Self-Printing options page offering various ways to print the publications
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Practice Insider was published today and is available online at http://view.exacttarget.com/?j=fe5515797c640d787c14&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe3616737465077f7c1573. ANCO is a state/regional affiliate of ASCO. This edition features:
1. "Red flags" rule compliance date pushed to Aug. 1
2. Medicare Updates Instructions on Billing Routine Costs of Clinical Trials (Part A and B)
3. Drug Shortage Updates
4. FDA Reverses Action to Pull Unapproved Liquid Morphine Off Market
5. CIGNA Modifier Policy
6. Kathleen Sebelius Confirmed as Secretary of the Department of Health and Human Services
7. Medicare Announces Sites for Pilot Program to Improve Quality as Patients Move Across Care Settings
8. Q&A with Sue Bowman of AHIMA: ICD-10-CM Diagnosis and ICD-10-CM PCS Transition
9. Billing and Coding Q&A
Best of ASCO® Los Angeles Deadlines Quickly Approaching!
Act by 11:59 PM Eastern Time on May 13, 2009 to receive discounted registration rates for the Best of ASCO Los Angeles meeting scheduled for June 19-20, 2009 in Los Angeles, CA. The meeting will feature premier abstracts from the 2009 ASCO Annual Meeting, representing the most relevant, cutting-edge research in oncology today. Also, don’t forget to make your housing reservation for the meeting prior to the May 13, 2009housing deadline. Go to www.asco.org/boa to register and reserve housing today!
****CMS NEWS****
Providers may now register for the Centers for Medicare & Medicaid Services’ ICD-10-CM/PCS Implementation and General Equivalence Mappings (Crosswalks) National Provider Conference Call that will be conducted on May 19, 2009 from 1:00 p.m. – 2:30 p.m. Eastern Daylight Time. This conference call will include a discussion of the following topics:
· An overview of the ICD-10 final rule, which requires the implementation of ICD-10-CM/PCS on October 1, 2013;
· The differences between ICD-9-CM and ICD-10-CM/PCS codes;
· The use of the General Equivalence Mappings that have been created to assist in converting
policies, edits, and trend data from ICD-9-CM to ICD-10-CM/PCS; and
· The resources that are available to assist in planning for the transition from ICD-9-CM to ICD-10-CM/PCS.
Note:
A new fact sheet has been developed that provides additional information about the ICD-10 General Equivalence Mappings, and the slide presentation that will be discussed during the conference call has been revised. These discussion materials have been posted in the Downloads Section at http://www.cms.hhs.gov/ICD10/07a_2009_CMS_Sponsored_Calls.asp . If you are unable to access the hyperlink in this message, please copy and paste the URL into your Internet browser.
A new Medicare Secondary Payer Fact Sheet (April 2009), which provides a general overview of the MSP provisions for individuals involved in the admission and billing procedures at provider, physician, and other supplier settings is now available in downloadable format from the Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/MSP_Fact_Sheet.pdf .
MM6438 – Modification of the Common Working File (CWF) Copybook to Transmit “WC” Qualifier Alpha Codes to Various Systems. (supplement to CR 5371)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6438.pdf
MM6358 – Processing and Payment of Physician and Non-Physician Practitioner Services Reassigned to Ambulatory Surgical Centers (ASCs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6358.pdf
MM6395 – Section 148 of The Medicare Improvements for Patients and Providers Act (MIPPA)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6395.pdf
SE0726 – Clarification about the Medical Privacy of Protected Health Information
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0726.pdf
MM6407 – Medicare Claims Processing Manual Clarifications for Skilled Nursing Facility (SNF) and Therapy Billing
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6407.pdf
****NCI NEWS****
We are pleased to announce the launch of the new NCI Publications Locator (NCIPL) site! NCIPL offers users the ability to view and order NCI publications online. Please check it out...
www.cancer.gov/publications
Over the past year, a team worked to completely redesign NCIPL to offer a much more user friendly experience and improved public interface. Usability and focus group testing was conducted as well. The result is a refreshed, secure system with greater ease of use, accessibility and advanced features.
Improvements to the site include:
- A look and feel similar to cancer.gov
- A homepage that offers additional browsing options
- Links to Announcements, Featured Publications and New and Updated Publications
- Improved search capabilities to locate, select and order materials
- More publication information to include last reviewed date, publication format and page count
- An expanded Publications Details page that includes Audience, Language, Physical Description and Related Products
- Thumbnail images for most publications
- Advanced order capabilities to include a shopping cart and order progress bar
- A Self-Printing options page offering various ways to print the publications
Monday, May 11, 2009
ACCC, ASCO, & CMS News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_5-11-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
ACCC Selects Five Sites to Participate in Prostate Cancer Project
Arriving in Your Mail Box Soon: Cancer Care Patient Navigation Supplement
Webinar Planned on Patient Navigation Services, June 10, 2009
Washington Health Policy Expert to Deliver Keynote at ACCC's Conference
Houston, We Have a Free Meeting, June 10, Reimbursement, Management
DRUGDEX® Drug Compendium Available to ACCC Members
ACCC's 2009 Cancer Program Administrator Survey Reveals Challenges
Has Your Job or Title Changed? New Phone or Email? Let ACCC Know
Q&A on ACCC's Listserve: Use of Nurse Practitioners
ACCC's CE Blackboard: New Course on Adjuvant Treatment of Breast Cancer
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Poilcy Today was published and is available online at http://www.asco.org/ASCOv2/Public+Policy/Cancer+Policy+News/Cancer+Policy+Today/May+11%3A+ASCO+Meets+with+Legislators+to+Encourage+Funding+for+Cancer+Research%2C+President+Obama+Announces+FY+2010+Budget+Request. ANCO is a state/regional affiliate of ASCO. This edition features:
ASCO Meets with Legislators to Encourage Funding for Cancer Research
President Obama Announces FY 2010 Budget Request
Drug Shortage Updates
Reps. Speier and Bono Mack Introduce the Childhood Cancer Survivorship Bill
Sen. Kennedy Introduces Tobacco Control Legislation
State of Indiana Adopts Clinical Trials Coverage Law
ASCO Hosts 2009 Electronic Health Records Symposium
Kathleen Sebelius Sworn in as HHS Secretary
AHA Announces Two Calls as Part of Coding Clinic Audio Conference Series
New Edition of Practical Tips for the Oncology Practice
Join ASCO's Advocacy Network
ASCO Extends Resources to Practice Administrators
The American Society of Clinical Oncology's (ASCO) Express was published today and is available online at http://view.exacttarget.com/?j=fe5715797d6d03797415&m=ff2d16787160&ls=fdee1375776d077d7c107473&l=fe5d1575726004757c14&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe3a167374640475711473. This edition features:
Best of ASCO® Los Angeles Deadlines Approaching
Best of ASCO® International – Coming to a City Near You
Submit an Abstract for the 2009 Breast Cancer Symposium
Apply for the Accelerating Anticancer Agent Development and Validation Workshop
****CMS NEWS****
SE0908 – Mandatory Claims Submission and its Enforcement
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0908.pdf
Centers for Medicare & Medicaid Services
Special Open Door Forum:
Outpatient Imaging Efficiency Measures
Wednesday, May 20, 2009
2:00PM – 4:00PM Eastern Time (ET)
Conference Call Only
Featuring:
John Cooper, M.D. (CMS),
Mark Zezza, Ph.D. (The Lewin Group),
Thomas G. Dehn, M.D., FACR (National Imaging Associates, Inc.),
Joan DaVanzo, Ph.D. (Dobson | DaVanzo & Associates, LLC).
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the development and implementation of facility-level hospital Outpatient Imaging Efficiency measures. The CMS has contracted with The Lewin Group, to develop a set of imaging efficiency measures. National Imaging Associates, and Dobson & DaVanzo are subcontracted by Lewin to support this effort.
During this Special ODF, CMS staff will discuss:
· Each of the four outpatient imaging efficiency measures currently required under the Hospital Outpatient Quality Data Reporting Program (HOP QDRP) for CY2010 payment determination;
· Highlight some frequently asked questions;
· New Outpatient Imaging Efficiency measures under development.
Afterwards, there will be an opportunity for the public to ask questions.
To make the call as informative as possible, we recommend that participants:
Visit the QualityNet (http://www.QualityNet.org) and Choose “Imaging Efficiency Measures” under “Hospital – Outpatient” and also http://www.ImagingMeasures.com ;
Pre-submit any questions you wish to have addressed on the call to Imaging.Measures@lewin.com. Please type “Question for National Open Door Forum” in your Subject line. The most frequently asked questions received by 5 pm ET on Thursday, May 14, 2009, will be addressed on the call. Submitted questions not selected for the call will be answered individually via e-mail reply.
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 94281978
Note: TTY Communications Relay Services are available for the Hearing Impaired.
For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning May 29, 2009.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_5-11-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
ACCC Selects Five Sites to Participate in Prostate Cancer Project
Arriving in Your Mail Box Soon: Cancer Care Patient Navigation Supplement
Webinar Planned on Patient Navigation Services, June 10, 2009
Washington Health Policy Expert to Deliver Keynote at ACCC's Conference
Houston, We Have a Free Meeting, June 10, Reimbursement, Management
DRUGDEX® Drug Compendium Available to ACCC Members
ACCC's 2009 Cancer Program Administrator Survey Reveals Challenges
Has Your Job or Title Changed? New Phone or Email? Let ACCC Know
Q&A on ACCC's Listserve: Use of Nurse Practitioners
ACCC's CE Blackboard: New Course on Adjuvant Treatment of Breast Cancer
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Poilcy Today was published and is available online at http://www.asco.org/ASCOv2/Public+Policy/Cancer+Policy+News/Cancer+Policy+Today/May+11%3A+ASCO+Meets+with+Legislators+to+Encourage+Funding+for+Cancer+Research%2C+President+Obama+Announces+FY+2010+Budget+Request. ANCO is a state/regional affiliate of ASCO. This edition features:
ASCO Meets with Legislators to Encourage Funding for Cancer Research
President Obama Announces FY 2010 Budget Request
Drug Shortage Updates
Reps. Speier and Bono Mack Introduce the Childhood Cancer Survivorship Bill
Sen. Kennedy Introduces Tobacco Control Legislation
State of Indiana Adopts Clinical Trials Coverage Law
ASCO Hosts 2009 Electronic Health Records Symposium
Kathleen Sebelius Sworn in as HHS Secretary
AHA Announces Two Calls as Part of Coding Clinic Audio Conference Series
New Edition of Practical Tips for the Oncology Practice
Join ASCO's Advocacy Network
ASCO Extends Resources to Practice Administrators
The American Society of Clinical Oncology's (ASCO) Express was published today and is available online at http://view.exacttarget.com/?j=fe5715797d6d03797415&m=ff2d16787160&ls=fdee1375776d077d7c107473&l=fe5d1575726004757c14&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe3a167374640475711473. This edition features:
Best of ASCO® Los Angeles Deadlines Approaching
Best of ASCO® International – Coming to a City Near You
Submit an Abstract for the 2009 Breast Cancer Symposium
Apply for the Accelerating Anticancer Agent Development and Validation Workshop
****CMS NEWS****
SE0908 – Mandatory Claims Submission and its Enforcement
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0908.pdf
Centers for Medicare & Medicaid Services
Special Open Door Forum:
Outpatient Imaging Efficiency Measures
Wednesday, May 20, 2009
2:00PM – 4:00PM Eastern Time (ET)
Conference Call Only
Featuring:
John Cooper, M.D. (CMS),
Mark Zezza, Ph.D. (The Lewin Group),
Thomas G. Dehn, M.D., FACR (National Imaging Associates, Inc.),
Joan DaVanzo, Ph.D. (Dobson | DaVanzo & Associates, LLC).
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the development and implementation of facility-level hospital Outpatient Imaging Efficiency measures. The CMS has contracted with The Lewin Group, to develop a set of imaging efficiency measures. National Imaging Associates, and Dobson & DaVanzo are subcontracted by Lewin to support this effort.
During this Special ODF, CMS staff will discuss:
· Each of the four outpatient imaging efficiency measures currently required under the Hospital Outpatient Quality Data Reporting Program (HOP QDRP) for CY2010 payment determination;
· Highlight some frequently asked questions;
· New Outpatient Imaging Efficiency measures under development.
Afterwards, there will be an opportunity for the public to ask questions.
To make the call as informative as possible, we recommend that participants:
Visit the QualityNet (http://www.QualityNet.org) and Choose “Imaging Efficiency Measures” under “Hospital – Outpatient” and also http://www.ImagingMeasures.com ;
Pre-submit any questions you wish to have addressed on the call to Imaging.Measures@lewin.com. Please type “Question for National Open Door Forum” in your Subject line. The most frequently asked questions received by 5 pm ET on Thursday, May 14, 2009, will be addressed on the call. Submitted questions not selected for the call will be answered individually via e-mail reply.
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 94281978
Note: TTY Communications Relay Services are available for the Hearing Impaired.
For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning May 29, 2009.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
Friday, May 8, 2009
ASH, CMS, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ASH NEWS****
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/05072009.cfm#1. It features:
Influenza A (H1N1): Updated Information for Clinicians
Federal Budget Passes With Language to Ease Passage of Health Reform and to Avert Physician Payment Cuts
Medicare Proposal Includes ASH Recommendations to Limit Coverage of Genetic Tests to Determine Best Warfarin Dosage
FTC Delays Implementation of Red Flags Rule for Physicians
ASH Committee on Practice Discusses Health Reform and Physician Payment Issues With Congress
Successful ASH Webinar on PQRI & E-Prescribing
****CMS NEWS****
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host a national provider conference call on the 2009 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Incentive Program (e-Prescribing). This toll-free call will take place from 2:30 p.m. – 4:30 p.m., EDT, on Wednesday, May 20, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
Section 132 of MIPPA authorizes a new and separate incentive program for individual eligible professionals who are successful electronic prescribers (e-Prescribers) as defined by MIPPA. This new incentive is separate from and is in addition to PQRI.
The topics covered on this national provider call will include:
An update on the Quality Data Code (QDC) Error Report;
Tips for satisfactorily reporting a Measures Group in the 2009 PQRI; and
Frequently Asked Questions on e-Prescribing.
Following this presentation, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website, in the Educational Resources section, section, as well as educational products are available on the e-prescribing dedicated web page located at http://www.cms.hhs.gov/ERxIncentive. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: May 20, 2009
Conference Title: 2009 Physician Quality Reporting Initiative and Electronic Prescribing Incentive Program-National Provider Call
Time: 2:30 p.m. 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 2:30 p.m. EDT on May 19, 2009, 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/052009
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 5/20/2009 until 11:59 p.m. EDT 5/27/2009. The call in data for the replay is (800) 642-1687 and the passcode is 90613260.
If you require services for the hearing impaired please send an email to:Medicare.TTT@PalmettoGBA.com.
MM6303 – Requirements for Specialty Codes
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6303.pdf
****PALMETTO/J1MAC NEWS****
An Introductory Overview of the HIPAA 5010
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~An%20Introductory%20Overview%20of%20the%20HIPAA%205010?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AF00695282?opendocument
SE0904, An Introductory Overview of the HIPAA 5010, outlines substantial
changes in the content of the data that must be submitted with claims, as
well as to the data available in response to electronic inquiries. The
implementation will require changes to the software, systems and perhaps
procedures used for billing Medicare and other payers.
Requirements for Specialty Codes
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Requirements%20for%20Specialty%20Codes?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AF00696010?opendocument
CR6303, Requirements for Specialty Codes, alerts providers that the Centers
for Medicare & Medicaid Services (CMS) is to revising the Medicare Claims
Processing Manual, Chapter 26, Section 10.8 in order to clarify the
criteria CMS considers when reviewing Medicare physician/non-physician
practitioner specialty code requests.
****ASH NEWS****
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/05072009.cfm#1. It features:
Influenza A (H1N1): Updated Information for Clinicians
Federal Budget Passes With Language to Ease Passage of Health Reform and to Avert Physician Payment Cuts
Medicare Proposal Includes ASH Recommendations to Limit Coverage of Genetic Tests to Determine Best Warfarin Dosage
FTC Delays Implementation of Red Flags Rule for Physicians
ASH Committee on Practice Discusses Health Reform and Physician Payment Issues With Congress
Successful ASH Webinar on PQRI & E-Prescribing
****CMS NEWS****
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host a national provider conference call on the 2009 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Incentive Program (e-Prescribing). This toll-free call will take place from 2:30 p.m. – 4:30 p.m., EDT, on Wednesday, May 20, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
Section 132 of MIPPA authorizes a new and separate incentive program for individual eligible professionals who are successful electronic prescribers (e-Prescribers) as defined by MIPPA. This new incentive is separate from and is in addition to PQRI.
The topics covered on this national provider call will include:
An update on the Quality Data Code (QDC) Error Report;
Tips for satisfactorily reporting a Measures Group in the 2009 PQRI; and
Frequently Asked Questions on e-Prescribing.
Following this presentation, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website, in the Educational Resources section, section, as well as educational products are available on the e-prescribing dedicated web page located at http://www.cms.hhs.gov/ERxIncentive. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: May 20, 2009
Conference Title: 2009 Physician Quality Reporting Initiative and Electronic Prescribing Incentive Program-National Provider Call
Time: 2:30 p.m. 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 2:30 p.m. EDT on May 19, 2009, 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/052009
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 5/20/2009 until 11:59 p.m. EDT 5/27/2009. The call in data for the replay is (800) 642-1687 and the passcode is 90613260.
If you require services for the hearing impaired please send an email to:Medicare.TTT@PalmettoGBA.com.
MM6303 – Requirements for Specialty Codes
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6303.pdf
****PALMETTO/J1MAC NEWS****
An Introductory Overview of the HIPAA 5010
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~An%20Introductory%20Overview%20of%20the%20HIPAA%205010?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AF00695282?opendocument
SE0904, An Introductory Overview of the HIPAA 5010, outlines substantial
changes in the content of the data that must be submitted with claims, as
well as to the data available in response to electronic inquiries. The
implementation will require changes to the software, systems and perhaps
procedures used for billing Medicare and other payers.
Requirements for Specialty Codes
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Requirements%20for%20Specialty%20Codes?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AF00696010?opendocument
CR6303, Requirements for Specialty Codes, alerts providers that the Centers
for Medicare & Medicaid Services (CMS) is to revising the Medicare Claims
Processing Manual, Chapter 26, Section 10.8 in order to clarify the
criteria CMS considers when reviewing Medicare physician/non-physician
practitioner specialty code requests.
Thursday, May 7, 2009
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
Billing Routine Cost of Clinical Trials (Revised)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Billing%20Routine%20Cost%20of%20Clinical%20Trials%20(Revised)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AE005CEE2C?opendocument
Change Request (CR) 6431, alerts providers that they should continue to
report the International Classification of Diseases diagnosis code V70.7
(Examination of Participant in Clinical Trial) on clinical trial claims. It
is no longer necessary to make a distinction between a diagnostic and
therapeutic clinical trial service on the claim. Note: This article was
revised on April 30, 2009, to reflect a revised CR 6431, issued by the
Centers for Medicare & Medicaid Services (CMS) on April 29, 2009.
Expansion of the Current Scope of Editing for Ordering/Referring Providers
for Claims Processed by Medicare Carriers and Part B Medicare
Administrative Contractors (MACs)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Expansion%20of%20the%20Current%20Scope%20of%20Editing%20for%20OrderingReferring%20Providers%20for%20Claims%20Processed%20by%20Medicare%20Carriers%20and%20Part%20B%20Medicare%20Administrative%20Contractors%20(MACs)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AE006C139D?opendocument
CR6417, Expansion of the Current Scope of Editing for Ordering/Referring
Providers for Claims Processed by Medicare Carriers and Part B Medicare
Administrative Contractors (MACs), announces that CMS is expanding claim
editing to verify that the ordering/referring provider on a claim is
enrolled in Medicare and is eligible to order or refer Medicare services.
Update to List of Medicare Telehealth Services
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Update%20to%20List%20of%20Medicare%20Telehealth%20Services?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AE005F852C?opendocument
CR6458, Update to List of Medicare Telehealth Services, changes the list of
Medicare telehealth services to reflect the coding changes for ESRD-related
services that took effect during the 2009 Healthcare Procedural Coding
System (HCPCS) update.
Updated: Independent Diagnostic Testing Facility Table
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~IDTF~Updated%20Independent%20Diagnostic%20Testing%20Facility%20Table?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257590006C0948?opendocument
This table shows the CPT codes, physician supervision levels and physician
and technician requirements for independent diagnostic testing facilities.
****PALMETTO/J1MAC NEWS****
Billing Routine Cost of Clinical Trials (Revised)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Billing%20Routine%20Cost%20of%20Clinical%20Trials%20(Revised)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AE005CEE2C?opendocument
Change Request (CR) 6431, alerts providers that they should continue to
report the International Classification of Diseases diagnosis code V70.7
(Examination of Participant in Clinical Trial) on clinical trial claims. It
is no longer necessary to make a distinction between a diagnostic and
therapeutic clinical trial service on the claim. Note: This article was
revised on April 30, 2009, to reflect a revised CR 6431, issued by the
Centers for Medicare & Medicaid Services (CMS) on April 29, 2009.
Expansion of the Current Scope of Editing for Ordering/Referring Providers
for Claims Processed by Medicare Carriers and Part B Medicare
Administrative Contractors (MACs)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Expansion%20of%20the%20Current%20Scope%20of%20Editing%20for%20OrderingReferring%20Providers%20for%20Claims%20Processed%20by%20Medicare%20Carriers%20and%20Part%20B%20Medicare%20Administrative%20Contractors%20(MACs)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AE006C139D?opendocument
CR6417, Expansion of the Current Scope of Editing for Ordering/Referring
Providers for Claims Processed by Medicare Carriers and Part B Medicare
Administrative Contractors (MACs), announces that CMS is expanding claim
editing to verify that the ordering/referring provider on a claim is
enrolled in Medicare and is eligible to order or refer Medicare services.
Update to List of Medicare Telehealth Services
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Update%20to%20List%20of%20Medicare%20Telehealth%20Services?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AE005F852C?opendocument
CR6458, Update to List of Medicare Telehealth Services, changes the list of
Medicare telehealth services to reflect the coding changes for ESRD-related
services that took effect during the 2009 Healthcare Procedural Coding
System (HCPCS) update.
Updated: Independent Diagnostic Testing Facility Table
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~IDTF~Updated%20Independent%20Diagnostic%20Testing%20Facility%20Table?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257590006C0948?opendocument
This table shows the CPT codes, physician supervision levels and physician
and technician requirements for independent diagnostic testing facilities.
Wednesday, May 6, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
MM6417 – Expansion of the Current Scope of Editing for Ordering/Referring Providers for claims processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6417.pdf
MM6455 – Ensuring Only Clinical Trial Services Receive Fee-for-Service (FFS) Payment on Claims Billed for Managed Care Beneficiaries
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6455.pdf
MM6330 – Clarification on Use of National Drug Codes (NDCs) in 837 I Billing
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6330.pdf
MM6431 – Billing Routine Costs of Clinical Trials
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6431.pdf
****PALMETTO/J1MAC NEWS****
PC-ACE Pro32 version 2.12 update file
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~Software%20Manuals~PC-ACE%20Pro32%20version%20212%20update%20file?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852574F7007E6407?opendocument
The PC-ACE Pro32 software has been updated with several CMS Medicare
mandates and enhancements. All PC-ACE Pro32 users must download and install
the attached software update file immediately.
Updated: Independent Diagnostic Testing Facility Table
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~IDTF~Updated%20Independent%20Diagnostic%20Testing%20Facility%20Table?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257590006C0948?opendocument
This table shows the CPT codes, physician supervision levels and physician
and technician requirements for independent diagnostic testing facilities.
Important Information Regarding the Centers for Medicare & Medicaid
Services (CMS) National Claims Crossover Process
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Important%20Information%20Regarding%20the%20Centers%20for%20Medicare%20Medicaid%20Services%20(CMS)%20National%20Claims%20Crossover%20Process?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AD004610FA?opendocument
CR SE0909, which includes information on the National Claims Crossover
Process, requests that providers allow sufficient time for the Medicare
crossover process before attempting to balance bill their patients’
supplemental insurers and payers for amounts remaining after Medicare’s
payment determination on their submitted claims.
****CMS NEWS****
MM6417 – Expansion of the Current Scope of Editing for Ordering/Referring Providers for claims processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6417.pdf
MM6455 – Ensuring Only Clinical Trial Services Receive Fee-for-Service (FFS) Payment on Claims Billed for Managed Care Beneficiaries
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6455.pdf
MM6330 – Clarification on Use of National Drug Codes (NDCs) in 837 I Billing
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6330.pdf
MM6431 – Billing Routine Costs of Clinical Trials
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6431.pdf
****PALMETTO/J1MAC NEWS****
PC-ACE Pro32 version 2.12 update file
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~Software%20Manuals~PC-ACE%20Pro32%20version%20212%20update%20file?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852574F7007E6407?opendocument
The PC-ACE Pro32 software has been updated with several CMS Medicare
mandates and enhancements. All PC-ACE Pro32 users must download and install
the attached software update file immediately.
Updated: Independent Diagnostic Testing Facility Table
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~IDTF~Updated%20Independent%20Diagnostic%20Testing%20Facility%20Table?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257590006C0948?opendocument
This table shows the CPT codes, physician supervision levels and physician
and technician requirements for independent diagnostic testing facilities.
Important Information Regarding the Centers for Medicare & Medicaid
Services (CMS) National Claims Crossover Process
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Important%20Information%20Regarding%20the%20Centers%20for%20Medicare%20Medicaid%20Services%20(CMS)%20National%20Claims%20Crossover%20Process?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575AD004610FA?opendocument
CR SE0909, which includes information on the National Claims Crossover
Process, requests that providers allow sufficient time for the Medicare
crossover process before attempting to balance bill their patients’
supplemental insurers and payers for amounts remaining after Medicare’s
payment determination on their submitted claims.
Monday, May 4, 2009
ACCC & CMS News
The following information has been received by ANCO.
****ACCC NEWS****
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/2009/media_ACCCNEWSLETTER_5-4-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
DRUGDEX® Drug Compendium Available to ACCC Members
ACCC's 2009 Cancer Program Administrator Survey Reveals Challenges
Meeting Focuses on Cancer Center Construction, Renovation
Minneapolis Is Site for ACCC's September Oncology Economics Conference
Webinar Planned on Patient Navigation Services, June 10, 2009
FDA Updates Renal Dosing for Revlimid
New Early Detection Studies of Lung Cancer in Non-Smokers Launched Today
Cincinnati Get Ready: ACCC's Symposium Is May 6; Houston to Follow
Q&A on ACCC's Listserve: More on Patient Navigation
ACCC's CE Blackboard: New Course on Best Practices in RCC
****CMS NEWS****
The General Equivalence Mappings – ICD-9-CM To and From ICD-10-CM and ICD-10-PCS (Fact Sheet) (March 2009), which provides information and resources regarding the General Equivalence Mappings that were developed as a tool to assist with the conversion of International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) codes to International Classification of Diseases, 10th Edition (ICD-10) and the conversion of ICD-10 codes back to ICD-9-CM, is now available in print format from the Centers for Medicare & Medicaid Services Medicare Learning Network. To place your order, visit http://www.cms.hhs.gov/MLNGenInfo/ , scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”
SE0904 – An Introductory Overview of the HIPAA 5010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0904.pdf
The implementation of HIPAA 5010 presents substantial changes in the content of the data that providers submit with their claims, as well as the data available to them in response to their electronic inquiries. This Special Edition MLN Matters article alerts providers of these HIPAA changes and how they need to plan for their implementation.
****ACCC NEWS****
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/2009/media_ACCCNEWSLETTER_5-4-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
DRUGDEX® Drug Compendium Available to ACCC Members
ACCC's 2009 Cancer Program Administrator Survey Reveals Challenges
Meeting Focuses on Cancer Center Construction, Renovation
Minneapolis Is Site for ACCC's September Oncology Economics Conference
Webinar Planned on Patient Navigation Services, June 10, 2009
FDA Updates Renal Dosing for Revlimid
New Early Detection Studies of Lung Cancer in Non-Smokers Launched Today
Cincinnati Get Ready: ACCC's Symposium Is May 6; Houston to Follow
Q&A on ACCC's Listserve: More on Patient Navigation
ACCC's CE Blackboard: New Course on Best Practices in RCC
****CMS NEWS****
The General Equivalence Mappings – ICD-9-CM To and From ICD-10-CM and ICD-10-PCS (Fact Sheet) (March 2009), which provides information and resources regarding the General Equivalence Mappings that were developed as a tool to assist with the conversion of International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) codes to International Classification of Diseases, 10th Edition (ICD-10) and the conversion of ICD-10 codes back to ICD-9-CM, is now available in print format from the Centers for Medicare & Medicaid Services Medicare Learning Network. To place your order, visit http://www.cms.hhs.gov/MLNGenInfo/ , scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”
SE0904 – An Introductory Overview of the HIPAA 5010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0904.pdf
The implementation of HIPAA 5010 presents substantial changes in the content of the data that providers submit with their claims, as well as the data available to them in response to their electronic inquiries. This Special Edition MLN Matters article alerts providers of these HIPAA changes and how they need to plan for their implementation.
CMA News
The following information has been received by ANCO.
All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available online at http://anco-online.blogspot.com/.
****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
FTC Delays Enforcement of Red Flag Rules for 3 Months
Swine Flu Guidance for Physicians Available on CMA Website
CMA Opposes Efforts to Erode the Bar on Corporate Practice of Medicine in California
CMA Kills Bills to Expand Nonphysicians’ Scope of Practice
CIGNA Clarifies Policy Regarding Claims Documentation
Physicians Face 21% Medicare Rate Cut in 2010
Aetna Amends Physician Contracts to Include Medicare Products
Nominate a Colleague for the CMA Foundation Leadership Awards
2009-2010 Council and Committee Nomination Deadline Is May 29
Board Highlights Now Available
All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available online at http://anco-online.blogspot.com/.
****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
FTC Delays Enforcement of Red Flag Rules for 3 Months
Swine Flu Guidance for Physicians Available on CMA Website
CMA Opposes Efforts to Erode the Bar on Corporate Practice of Medicine in California
CMA Kills Bills to Expand Nonphysicians’ Scope of Practice
CIGNA Clarifies Policy Regarding Claims Documentation
Physicians Face 21% Medicare Rate Cut in 2010
Aetna Amends Physician Contracts to Include Medicare Products
Nominate a Colleague for the CMA Foundation Leadership Awards
2009-2010 Council and Committee Nomination Deadline Is May 29
Board Highlights Now Available
Friday, May 1, 2009
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
Medicare Part B Medical Records: Signature Requirements, Acceptable and
Unacceptable Practices
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Medicare%20Part%20B%20Medical%20Records%20Signature%20Requirements%20Acceptable%20and%20Unacceptable%20Practices?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575A80064242F?opendocument
CMS guidelines mandate the presence of signatures specifically for all
“medical review” purposes, modifiers, etc., records pertaining to any
procedures billed to Medicare Part B. Please share with your staff the
signature requirement changes for incident to, split/shared services and
co-surgeon or assistant-at-surgery services.
****PALMETTO/J1MAC NEWS****
Medicare Part B Medical Records: Signature Requirements, Acceptable and
Unacceptable Practices
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Medicare%20Part%20B%20Medical%20Records%20Signature%20Requirements%20Acceptable%20and%20Unacceptable%20Practices?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575A80064242F?opendocument
CMS guidelines mandate the presence of signatures specifically for all
“medical review” purposes, modifiers, etc., records pertaining to any
procedures billed to Medicare Part B. Please share with your staff the
signature requirement changes for incident to, split/shared services and
co-surgeon or assistant-at-surgery services.
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