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