Wednesday, September 30, 2009

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) Updates Physician Payment Information for Value-Driven Health Care
To support the delivery of high-quality, efficient health care and enable consumers to make more informed health care decisions, the U.S. Department of Health and Human Services is making cost and quality data available to all Americans. As part of this initiative, Medicare posted information in 2007 and 2008 about the payments it made during the previous year for common and elective procedures and services provided by Hospitals, Ambulatory Surgery Centers (ASCs), Hospital Outpatient Departments, and Physicians.

The Hospital information is posted on the Hospital Compare Website where it can be viewed along with hospital quality information. The Hospital compare website may be found at www.medicare.gov.

On August 28, 2009, Medicare posted an update to the Ambulatory Surgery Center data. The Physician payment data was posted on September 25, 2009. Hospital Outpatient Department data will be updated later this year. The information is being displayed in the same format as in previous years, updated with calendar year (CY) 2008 data. The posting updates may be found at: www.cms.hhs.gov/HealthCareConInit/.


****PALMETTO/J1MAC NEWS****
Drug Lookup and Calculator Tool
The Drug Lookup and Calculator Tool was created to help providers submit
the correct number of 'units' on their claims by calculating and converting
the dosage administered to the patient. As a bonus, it will also display
the most current Maximum Allowed Units (MAUs) assigned to the drug. Be sure
to take a look at this new self-service tool.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7W8K9R6863?opendocument


J1 Part B LCD Update
The following J1 Part B LCDs have been revised: Stereotactic Body Radiation
Therapy and Stereotactic Radiosurgery.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7W7SK34877?opendocument


October 2009 J1 A/B MAC Medicare Advisory
The October 2009 J1 A/B Mac Medicare Advisory is available on the Palmetto
GBA Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7W8K4Q8450?opendocument


Medicare Provider Feedback Town Hall Meeting
The Centers for Medicare & Medicaid Services (CMS) requests your
participation in a Town Hall meeting on October 29, 2009, from 2 p.m. to 4
p.m. ET. The meeting will be held via conference call as well as in the
auditorium at the Centers for Medicare & Medicaid Services, 7500 Security
Blvd., Baltimore, Maryland 21244.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7WCKU73455?opendocument


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Friday, September 25, 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/Practice/Practice-Updates/4284.aspx. This edition features:

Senate Finance Committee Begins Markup on Chairman Baucus' Health Reform Proposal
White House Reaffirms Commitment to Fixing the Medicare Physician Payment Formula and Health Reform

ASH Urges Congress to Replace the Flawed SGR.

DHHS Alert: Cocaine Mixed with Levamisole Causing Agranulocytosis in Users

Changes Impacting Hematology ICD-9 Codes Become Effective October 1

What's New with the 2009 PQRI and E-Prescribing Incentive Programs

October 2009 ASP Files Available from Medicare


****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) is holding a Special Open Door Forum (ODF) in order to share the proposed key elements of the Medicare Imaging Demonstration design.

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.

Tentative Agenda:

1. Demonstration overview

2. Advanced imaging procedures

3. Decision Support Systems and guidelines

4. Quality

For a copy of the presentation slides and more general information about the demonstration, 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

Telephone participants will be given an opportunity to speak and will be asked to limit comments to 2 minutes.

Interested parties may submit comments or input in written form to ImagingDemo135b@cms.hhs.govby noon ET on Wednesday, September 30, 2009.
We look forward to your participation.

To participate by phone:
Dial: 1-800-837-1935 & Reference Conference ID: 29805623

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.
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 Tuesday, October 13, 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.


****PALMETTO/J1MAC NEWS****
Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC),
and Medicare Remit Easy Print (MREP) Update
CR 6604, from which this article is taken, announces the latest update of
Remittance Advice Remark Codes (RARCs) and Claim Adjustment Reason Codes
(CARCs), effective October 1, 2009. Be sure billing staff are aware of
these changes.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7W6LWF7023?opendocument


Implementation of Health Insurance Portability and Accountability Act of
1996 (HIPAA) version 5010 for Transaction 835 - Health Care Claim
Payment/Advice,
CR 6589, from which this article is taken, instructs Medicare Contractors
to implement Health Insurance Portability and Accountability Act of 1996
(HIPAA) Transaction 835 version 5010.
Make sure that your billing staffs are aware that the new HIPAA transaction
835 version 5010 is being implemented, and Medicare can begin to generate
the 835 version 5010 for testing with trading partners and/or for
transitioning early adopters of the new standard as of January 1, 2011.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7W6M2P2871?opendocument


ACT: General Medicare Updates - September 29, 2009
Join the Palmetto GBA J1 Part B Outreach and Education team for an Ask the
Contractor Teleconference (ACT) on September 29, 2009. The topic will be
general Medicare updates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7W7JTU0270?opendocument


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Wednesday, September 23, 2009

ACCC, CMA, CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****ACCC NEWS***
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCConnect_9-23-2009.html. ANCO is an Institutional Member of ACCC. This edition features:

ACCC Submits Comments to CMS on PET

Particle Beam Radiation Therapy Promising but Unproven for Treating Cancer

Prometheus Laboratories Inc Joins ACCC's Technical Advisory Council

Education Needs Assessment Survey: Oncology Practices

Virtual Tumor Board: Early Breast Cancer

ICD-9 Codes, ESAs, and Iron Supplementation

Myriad Genetics Launches Public Awareness Campaign for Healthcare Providers and Patients


****CMA NEWS***
The California Medical Association (CMA) Alert was published today and is available online at http://www.calphys.org/html/news.asp. This edition features:

Medical Liability Issues on the Front Burner in Washington

Alfred Gilchrist Named New CMA CEO

Senate Finance Finally Unveils Health Reform Bill

CDC Encourages Swift Use of Antivirals in High Risk H1N1 Patients

Hospital Outpatient Clinics: Legal Considerations for Physicians

Blue Cross Physicians: Don’t Forget to Review New Fees Before 11/11

CMA-Sponsored Bills Pass Legislature; Await Governor’s Signature

Annual Session Resolutions Available to Members Online

Tickets Now on Sale for CMA Foundation Annual Dinner

Best Practices: Improving the Patient Experience

Physician EHR Case Study Chapter 4: At the Brink of E-Prescribing


****CMS NEWS***
What’s New with 2009 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Incentive Programs
1. New Medicare Learning Network Education Product
2. New and Revised MLN Articles on the Physician Quality Reporting Initiative
3. Three Physician Quality Reporting Initiative Help Desk Resources Now Available for Eligible Professionals

Medicare Learning Network Announces Availability of the 2009 PQRI and E-Prescribing Program Web-based Training Course
The Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network (MLN) is pleased to announce that the Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Incentive Program (E-Prescribing) Web-based Training Course is now available.

The course provides information to physicians, health care professionals, and medical administrative staff on the completion, submission and maintenance of the documentation required to successfully participate in Physician Quality Reporting Initiative (PQRI) and Electronic Prescription Incentive (E-Prescribing) programs. The course offers continuing education credits; please see the course description page for the details.

The course can be accessed by going to http://www.cms.hhs.gov/MLNGenInfo on the CMS website and scrolling down to the “Related Links Inside CMS” section and selecting Web Based Training (WBT) Modules. Once on the web-based training module page, select the Physician Quality Reporting Initiative and Electronic Prescribing Incentive Program WBT from the list provided.

Medicare Learning Network Announces New and Revised MLN Articles on the 2009 PQRI
~New-MM6514- Coding and Reporting Principles for the Physician Quality Reporting Initiative (PQRI) and the Electronic Prescribing (E-Prescribing) Incentive Programs
http://www.cms.hhs.gov/mlnmattersarticles/downloads/MM6514.pdf

~Revised-SE0830- Steps for Individual Eligible Professionals to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports Personally
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf

~Revised-SE0831- Steps for Organizations to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Report
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf

These new and revised articles are intended to assist eligible professionals and group practices who report PQRI quality measures data to Medicare.

Three Physician Quality Reporting Initiative Help Desk Resources are 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.


SE0926 – 2009 - 2010 Seasonal Influenza (Flu) Resources for Health Care Professionals
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0926.pdf

MM6589 – Implementation of Health Insurance Portability and Accountability Act of 1996 (HIPAA) version 5010 for Transaction 835 - Health Care Claim Payment/Advice
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6589.pdf

MM6599 – Medicare Administrative Contractor (MAC) Transition and Outbound Health Insurance Portability and Accountability Act (HIPAA) Transactions
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6599.pdf

MM6604 – Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC), and Medicare Remit Easy Print (MREP) Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6604.pdf


****PALMETTO/J1MAC NEWS****
Registration is Open for J1 MACtoberfest October 29-30
Registration is now open for MACtoberfest, our fall face-to-face education
series, in Las Vegas October 29 through 30. It's the last in-person event
of the year and provides an opportunity to interact face to face with
Palmetto GBA representatives and other key Medicare partners.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7W4L6L1805?opendocument


J1 Provider Contact Center To Be Closed for Training on Friday, September 25
The J1 Provider Contact Center will be closed for training on Friday,
September 25, 2009 from 11 a.m. to 3 p.m. PST.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7W5MCA2360?opendocument


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Monday, September 21, 2009

Palmetto/J1MAC News

The following information has been received by ANCO.


****PALMETTO/J1MAC NEWS****
Centers for Medicare & Medicaid Services Provider Outreach Sessions
Save the date: CMS will host provider outreach sessions in San Luis
Obispo, California and Santa Barbara, California on September 29, 2009, and
September 30, 2009. These sessions will include a presentation by the CMS
central office on the Recovery Audit Contractor (RAC) program.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VYKJ21687?opendocument


J1 Part B LCD Update
Several J1 Part B LCDs have been revised and are available for review on
our Web site. Please share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VXSF76783?opendocument


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Friday, September 18, 2009

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
The results of the 2009 Medicare Contractor Provider Satisfaction Survey (MCPSS) are now available.

The MCPSS enables CMS to gauge provider satisfaction with key services performed by the Medicare Fee-for-Service (FFS) contractors that process and pay the more than $300 billion in Medicare claims each year. Respondents rated their FFS contractors between 4 and 6 on a 6-point scale, with “1” representing “not at all satisfied” and “6” representing “completely satisfied.” The 2009 MCPSS marked the fourth annual administration of the survey.

The national average has remained relatively stable through each MCPSS administration. The 2009 national average was 4.54, compared to last year’s national average of 4.51. The MCPSS was sent early this year to more than 32,000 randomly selected providers, including physicians, suppliers, health care practitioners and institutional facilities that serve Medicare beneficiaries across the country.

As in 2008, Provider Inquiries was cited as the top indicator of satisfaction. For the fourth consecutive year this business function was cited as one of the key predictors of provider satisfaction. Claims Processing remained a strong predictor of provider satisfaction as in the past three years.

The public reporting of the results over the last four years has increased awareness about the MCPSS. CMS has used the MCPSS to establish a uniform measure of provider satisfaction with FFS contractor performance. Each FFS contractor receives an individual report of findings specific to their organization, which can be used to implement process improvement initiatives.

The results of the 2009 survey are available through the CMS and MCPSS web pages at:
http://www.cms.hhs.gov/MCPSS/ and https://www.mcpsstudy.org/ .


The Centers for Medicare & Medicaid Services (CMS) has posted the October 2009 ASP pricing files and crosswalks, which are available for download at http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a1_2009aspfiles.asp .


The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that the PowerPoint presentation used during the September 17th, 2009 National Provider Call is posted on the CMS website.

To access the PowerPoint Presentation, visit http://www.cms.hhs.gov/PQRI on the CMS website and click on the CMS Sponsored Calls tab. Once on the CMS Sponsored Calls page, scroll down to the “Downloads” section and click on the “National Provider Call-September 17th 2009” link. As an added benefit, the presentation is also available as an Adobe Acrobat file.

CMS will continue to hold national conference calls on a variety of topics related to the Physician Quality Reporting Initiative and the Electronic Prescribing Incentive Program. When each call is announced, registration information will be provided on the CMS Sponsored Calls page. All calls are free of charge.

If you are unable to participate in a scheduled call, the option read the transcript of the call will be made available.

To access the registration information on all upcoming National Provider Calls, visit http://www.cms.hhs.gov/PQRI on the CMS website and click on the CMS Sponsored Calls tab.


****PALMETTO/J1MAC NEWS****
J1 Open Meetings
Have Palmetto GBA J1 coverage questions? Come to the Palmetto GBA J1
October Open Meetings in Hawaii, California or Nevada to have your
questions addressed. There will be no Draft Local Coverage Determinations
(LCDs) being presented for comment at the meetings.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VVMPK1270?opendocument


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Monday, September 14, 2009

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
MM6578 – Screening Computed Tomography Colonography (CTC) for Colorectal Cancer
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6578.pdf

MM6619 – 2010 Annual Update of HCPCS Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) for the Common Working File (CWF), A/B MACs, Medicare Carriers and Fiscal Intermediaries (FIs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6619.pdf

MM6595 – Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Version 5010 Only in Jurisdiction 10 and Jurisdiction 14 Parts A and B (A/B) Medicare Administrative Contractors (MACs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6595.pdf

SE0924 – Announcing the Release of the Revised CMS-855 Medicare Enrollment Applications
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0924.pdf


Enhancements/Updates to NPPES effective on/after September 13, 2009
On September 13, 2009, the National Plan and Provider Enumeration System (NPPES) will undergo system maintenance. As such, neither NPPES nor the National Provider Identifier (NPI) Registry will be available on September 13, 2009.

The following security enhancements will be incorporated into NPPES:
· NPPES web users will be required to select five secret questions and answers. Upon implementation of this enhancement and upon successful login, NPPES web users will be prompted to select five secret questions and provide answers to those questions. These five secret questions and answers will be saved and used for verification in order to allow NPPES web users to reset their own passwords.
· NPPES web users will be prevented from changing their passwords more than once within 24 hours from the last password update. Upon implementation of this enhancement, NPPES web users will be required to wait 24 hours before attempting to change their passwords once they have already successfully reset their passwords.
Electronic File Interchange (EFI)
In addition, the EFI User Manual and Technical Companion Guide have been revised. The upcoming changes will not impact the EFI XML Schema.

Additional Information

Health care providers can apply for an NPI online at https://nppes.cms.hhs.gov . Health care providers needing assistance with applying for an NPI or updating their data in NPPES records may contact the NPI Enumerator at 1-800-465-3203 or email the request to the NPI Enumerator at CustomerService@NPIEnumerator.com.

Not sure if you have already obtained an NPI or cannot remember your NPI, you can visit the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do to search for the information. The NPI Registry enables you to search for a provider’s NPPES information, which includes the NPI. All information displayed in the NPI Registry is done so in accordance with the NPPES Data Dissemination Notice. Information in the NPI Registry is updated daily. You may run simple queries to retrieve this read-only data. For example, users may search for a provider by the NPI or Legal Name/Legal Business Name. There is no charge to use the NPI Registry.

Visit CMS' dedicated NPI web page at http://www.cms.hhs.gov/NationalProvIdentStand for additional NPI education and information.


****PALMETTO/J1MAC NEWS****
The J1 Medicare educational symposia and networking
program has been fully planned and will take place in beautiful Las Vegas, NV
on October 28-30. We have two full days packed with multiple breakout sessions
conducted by subject matter experts with full expertise and knowledge in each
of their respective areas. Attendees will also have an opportunity to hear
directly from other Medicare Partner organizations such as the PSCs; QIOs and
the RAC. Each will be on hand and conducting educational sessions.
Visit http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Jurisdiction%201%20Part%20B~Registration%20is%20Open%20for%20J1%20MACtoberfest%20October%2029-30?open&cat=events for more information and to register.


ACT Minutes: Comprehensive Error Rate Testing (CERT) - August 25, 2009
(PDF, 58 KB)
The meeting minutes of the J1 Part B Ask the Contractor Teleconference
(ACT): CERT on August 25, 2009, are now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VSPY78724?opendocument


California Contractor Advisory Committee Meeting Minutes
The minutes for the California Contractor Advisory Committee (CAC) meeting
on July 22, 2009, are now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7SWQGW2011?opendocument


CPT Code 93228 - Provider Types/Specialities
Due to an incorrect system update to CPT code 93228, a processing error
occurred with claims in Nevada, Hawaii, Guam, American Samoa and Northern
Marianna Islands. The error excluded this procedure code from being payable
to several provider types that would normally be permitted to bill the
service. Claims have been denied in error since April 15, 2009. A mass
adjustment will be performed once the system is updated.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VRP3S1071?opendocument


CPT Code 95920 - Provider Types/Specialties
Due to an incorrect system update to CPT code 95920, previously allowed
provider types and specialties might have been denied. This error affected
claims processed July 1, 2009, through August 19, 2009. A mass adjustment
has been requested to reprocess affected claims.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VRPBZ8335?opendocument


September 15, 2009: POE-AG Agenda
The agenda of the J1 Part B Provider Outreach and Education Advisory Group
meeting on September 15, 2009, is now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VSMNN5150?opendocument


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Friday, September 11, 2009

ACCC, ASH, & Palmetto/J1MAC News

The following information has been received by ANCO.


****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCConnect_9-9-2009.html. ANCO is an Institutional Member of ACCC. This edition features:

A Push for Consensus in Healthcare Reform

Three ACCC Educational Projects with Your Needs in Mind

New Toolkit Helps Expedite Clinical Trial Contract Negotiations

NCI Plans to Expand Outreach through Community-based Research Programs

New Patient Brochure on Palliative Care Offers Answers, Highlights Benefits

FDA Approves Zevalin Expanded Label as Part of First-Line Therapy in Treatment of Follicular Non-Hodgkin's Lymphoma

Virtual Tumor Board: Early Breast Cance


****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/Practice/Practice-Updates/4241.aspx. This edition features:

President Obama’s Speech to Congress Reignites Efforts to Pass a Bill this Year

PQRI National Provider Call With Q&A – Thursday, September 17, 2009 from 2:30-4:30 EDT

New Medicare Guidance – Coverage and Reimbursement Rules for the H1N1 Vaccine

Government Accountability Office (GAO) Recommends that CMS Should Explore Finding Savings When Multiple Non-Imaging and Non-Surgical Procedures Performed on the Same Day – Impact for Hematology


****PALMETTO/J1MAC NEWS****
J1 Provider Outreach and Education Event Calendar
Palmetto GBA J1 Learning and Education Event Calendar for September 2009 is now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument


2010 Annual Update of HCPCS Codes for Skilled Nursing Facility (SNF)
Consolidated Billing (CB) for the Common Working File (CWF), A/B MACs,
Medicare Carriers and Fiscal Intermediaries (FIs)
This article is based on Change Request (CR) 6619 which provides the 2010
annual update of Healthcare Common Procedure Coding System (HCPCS) Codes
for Skilled Nursing Facility Consolidated Billing (SNF CB) that will be
used in Medicare claims processing systems. Be sure billing staff are aware
of these updates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VQRS70106?opendocument


October Update to the 2009 Medicare Physician Fee Schedule Database
(MPFSDB) Revised
This article was revised on September 2, 2009, to reflect the revised CR
6617 that was issued by the Centers for Medicare & Medicaid Services on
September 1, 2009. The article contains a revised CR release date,
transmittal number, and Web address for accessing CR 6617. The article also
now shows an effective date of September 1, 2009 for codes G9141 and G9142.
All other information remains the same.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VJK3F3251?opendocument


Screening Computed Tomography Colonography (CTC) for Colorectal Cancer
This article is based on Change Request (CR) 6578 which instructs that the
Centers for Medicare & Medicaid Services (CMS) has determined that current
evidence is inadequate to conclude that Computed Tomography Colonography
(CTC) is an appropriate colorectal cancer screening test under section
1861(pp)(1) of the Social Security Act (the Act). Therefore, effective May
12, 2009, CTC for colorectal cancer screening, also known as virtual
colonoscopy, remains nationally non-covered by Medicare. Medicare
contractors will continue to process claims for CTC for colorectal cancer
screening without change.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7VQL9T2144?opendocument


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Wednesday, September 9, 2009

CMA, CMS, & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is online at http://www.calphys.org/html/news.asp. This edition features:

CMA Fighting Cost-Cutting Health Reform Proposals that Would Punish Physicians in High-Cost Regions
Physicians Urged to Pre-Register for H1N1 Vaccine
Senate to Vote this Week on Bill to Stop Unjust Health Insurance Cancellations
We Need Your Help to Protect the Ban on the Corporate Practice of Medicine
Blue Cross Will Continue to Pay Claims from Physicians Who Have Not Signed New Healthy Families Contract

Important Information for Blue Cross Contracted Physicians

Best Practices: Hiring the Right Receptionist

Physician EHR Case Study Chapter 3: A Trip Up the Amazon


****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). This toll-free call will take place from 2:30 p.m. – 4:30 p.m., EDT, on Thursday, September 17, 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.

The topics covered on this national provider call will include:

Status of the 2007 re-run and 2008 PQRI Incentive payments and feedback reports;
How to access the 2007 re-run and 2008 PQRI feedback reports; Resources to assist eligible professionals; and
PQRI and E-Prescribing Alternative Report Request Process
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: 9/17/2009
Conference Title: 2009 Physician Quality Reporting Initiative 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. Registration will close at 2:30 p.m. EDT on 9/16/2009, 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/091709
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 transcript of the call will be available at least one week after the call at http://www.cms.hhs.gov/pqri on the CMS website.

If you require services for the hearing impaired please send an email to: Medicare.TTT@PalmettoGBA.com.


Third National Medicare Fee-For-Service (FFS) Education Call on HIPAA Version 5010
Conference call details:

Date: September 9, 2009
Conference Title: Third National Medicare FFS Education Call on HIPAA Version 5010
Time: 2:00 p.m. – 3:30 p.m. ET

The Centers for Medicare & Medicaid Services (CMS) will present the third in a series of National Education Conference Calls focused on Medicare’s Fee-for-Service (FFS) implementation of HIPAA Version 5010. The presentation will cover Medicare FFS error handling transactions (TA1, 999, and 277CA), planned use of each transaction and applicable rules and exceptions for the Medicare FFS program. The presentation is geared to billing software programmers or developers that reside within provider organizations. A Question & Answer (Q&A) session will follow the presentation that will give participants an opportunity to ask questions of CMS’ subject matter experts.

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.

Registration will close at 2:00 p.m. ET on September 8, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
1. To register for the call participants need to go to:
http://www2.eventsvc.com/palmettogba/090909
2. Fill in all required data.
3. Verify your time zone is displayed correctly the drop down box.
4. Click "Register".
5. 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.
A few days prior to the call (not before September 6th), check the Educational Resources page on CMS’ 5010 web page at http://www.cms.hhs.gov/Versions5010andD0/40_Educational_Resources.asp to obtain a copy of the presentation that will be used during the call.
Learn more about 5010, visit CMS’ dedicated page at http://www.cms.hhs.gov/Versions5010andD0/ on the web.


****PALMETTO/J1MAC NEWS****
Addition/Deletion of HCPCS Codes – October 2009 Quarterly Update
This article explains updates, effective for dates of service on or after
October 1, 2009 (unless otherwise specified), to the Healthcare Common
Procedure Coding System (HCPCS) codes for certain drugs and biologicals.
Ensure that your staffs are aware of these changes.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VJJQU7208?opendocument


Claim Status Category Code and Claim Status Code Update
This article, based on CR6609, explains that the Claim Status Codes and
Claim Status Category Codes for use by Medicare contractors with the Health
Claim Status Request and Response ASC X12N 276/277 were updated during the
June 2009 meeting of the national Code Maintenance Committee and code
changes approved at that meeting were posted at
www.wpc-edi.com/content/view/180/223/ on the Internet on or about June 30,
2009. All providers should ensure that their billing staffs are aware of
the updated codes.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VJKDZ6257?opendocument


2009 PQRI National Call: September 17, 2009
CMS Provider Communications Group will host a national provider conference
call on the 2009 Physician Quality Reporting Initiative (PQRI). This
toll-free call will take place from 2:30 p.m. to 4:30 p.m. EDT, on
Thursday, September 17, 2009. The topics covered on this national provider
call will include: status of the 2007 re-run and 2008 PQRI Incentive
payments and feedback reports; how to access the 2007 re-run and 2008 PQRI
feedback reports; resources to assist eligible professionals and
PQRI/E-Prescribing Alternative Report Request Process.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VKJQ36061?opendocument


October Update to the 2009 Medicare Physician Fee Schedule Database
(MPFSDB)
This article is based on Change Request (CR) 6617 which amends payment
files that were issued to contractors based upon the 2009 Medicare
Physician Fee Schedule (MPFS) Final Rule. Billing staff should be aware of
these updates.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VJQ591522?opendocument


Webinar: Part B Top 10 Billing Errors on September 9
Please note the Palmetto GBA J1 Part B free Webinar on Top 10 Billing
Errors will be on Wednesday, September 9.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7UKT6J1472?opendocument


What You Don’t Know About A CERT Claim Review That May Have Consequences
For You And Your Peers
The CERT contractor’s review of your claims is the first of a cascade of
steps in Medicare’s global payment safeguard program process.
The Medicare global payment safeguard program process consists of the CERT
contractor, the Medicare administrative contractors (MACs), the payment
safeguard benefit integrity contractors (PSCs, but soon to be called ZPICs)
and the recovery audit contractors (RACs). Please review and share with
your staff.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VJQZ50870?opendocument


The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!

Thursday, September 3, 2009

ACCC, ASH, CMS, & Palmetto/J1MAC News

The following information has been received by ANCO.


****ACCC NEWS****
The Association of Community Cancer Centers (ACCC) ACCConnect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCConnect_8-26-2009.html. ANCO is an Institutional Member of ACCC. This edition features:

$1.2B in Grants Available for Hospitals and Other Providers for EHR

PQRI Payment Coming in October

Genetic Counseling: Heard on ACCC's Listserve

ICD-10-CMs Are Coming. Are You Ready?

ACCC Seeks Nominations for Two 2010 Prestigious Awards

ESAs and Iron Supplementation


Community Perspective on Multiple Myeloma Management Strategies
The Association of Community Cancer Centers (ACCC) and Medscape Oncology have launched a new online educational initiative that offers a community-provider perspective about emerging data and treatment strategies presented at scientific meetings, such as those of the American Society of Clinical Oncology (ASCO) and the American Society of Hematology (ASH).

While much of the data coming out of large national meetings is important and relevant to cancer patients and providers, sometimes it is not clear how this information translates into practice in the community setting. With this in mind, ACCC and Medscape have teamed up to provide community-based oncologists, nurses, pharmacists, and others with perspectives from their colleagues in the field.

The first program explores multiple myeloma and looks at data presented at ASCO and the European Hematology Association meetings.

Visit https://profreg.medscape.com/px/getlogin.do;meddomainjsession=3xKYKdhXFFJ16GGTffgCvQbQFq3PrQBtw2XrG8JqnYLRyH0WPRK0!421957684?urlCache=aHR0cDovL2NtZS5tZWRzY2FwZS5jb20vdmlld2NvbGxlY3Rpb24vMzA0MTc/c3JjPWNtZV9leHRfcHJvbW8=
to view the online program. If you are not registered with Medscape, you will need to sign up.

CMEs for physicians, nurses, and pharmacists are available.


****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/Practice/Practice-Updates/4174.aspx. This edition features:

White House Reaffirms Commitment to Medicare Physician Payment Fix

ASH Comments on Proposed Physician Fee Schedule Changes

ASH Comments on Proposed HOPPS

FDA Publishes Two New Rules Related to Investigational Drugs

Medicare Average Sales Price Updates Available

ARRA Grants Available for Electronic Health Records

Planning for a Successful Implementation of ICD-10

Only Two Days Left to Register for the 2009 ASH State-of-the-Art Symposium


****CMS NEWS****
The revised publication titled ICD-10-CM/PCS: An Introduction Fact Sheet (August 2009), which was previously titled ICD-10-Clinical Modification/Procedure Coding System Fact Sheet, is now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10factsheet2009.pdf . This fact sheet provides general information about the International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) including benefits of adopting the new coding system, structural differences between ICD-9-CM and ICD-10-CM/PCS, and implementation planning recommendations.


MM6570 – New Waived Tests
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6570.pdf


The revised ICD-10-CM/PCS Bookmark (August 2009), which provides information about the ICD-10-Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) including the benefits of adopting the coding system, recommended steps to be taken in order to plan and prepare for implementation of the coding system, and where additional information about the coding system can be found, 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.”


SE0916 – Medicare Parts A and B Coverage and Prior Authorization
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0916.pdf


MM6617 – October Update to the 2009 Medicare Physician Fee Schedule Database (MPFSDB)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6617.pdf


MM6594 – Addition/Deletion of HCPCS Codes – October 2009 Quarterly Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6594.pdf


MM6568 – Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6568.pdf


MM6609 – Claim Status Category Code and Claim Status Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6609.pdf


****PALMETTO/J1MAC NEWS****
Appropriate Use of Modifier 50 and Add-On Current Procedural Terminology
Codes (CPT) for Facet Joint Injection Services (Corrected)
Note: This article was revised on August 10, 2009, to reflect a revision made to CR6518. The transmittal number (see above) and the Web address for accessing CR6518 have been changed. All other information remains the same. The article clarifies the appropriate use of modifier 50 and add-on codes for facet joint injection services. Physicians should ensure that billing staffs are aware of this clarification.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7V8KYR7501?opendocument


Taking EDI to the Next Level: 3rd Education Call on HIPAA Version 5010
The Centers for Medicare & Medicaid Services (CMS) will present the third in a series of National Education Conference Calls focused on Medicare's Fee-for-Service (FFS) implementation of HIPAA Version 5010 on September 9, 2009, from 2 p.m. to 3:30 p.m. ET. The presentation is geared to billing software programmers or developers that reside within provider organizations.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7V8L526043?opendocument


The ABCs of the Comprehensive Error Rate Testing (CERT) Program and How toRespond to CERT Requests (Revised August 2009)
Revised August 2009 - Learn the ABCs of the Comprehensive Error RateTesting (CERT) Program and how to Respond to CERT Requests!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7V5JR71776?opendocument


Rescheduled Webinar: Part B Top 10 Billing Errors from August 26 to September 9
Please note the Palmetto GBA J1 Part B free Webinar on Top 10 Billing Errors has been rescheduled from August 26 to Wednesday, September 9. If you have registered for the Webinar, no action from you is required. Your registration information will be transferred automatically to the new date.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7UKT6J1472?opendocument


Vice President Biden Announces Availability of Nearly $1.2 Billion in Grants to Help Hospitals and Doctors Use Electronic Health Records
Vice President Joe Biden announced on August 20, 2009, the availability of grants worth nearly $1.2 billion to help hospitals and health care providers implement and use electronic health records. The grants will be funded by the American Recovery and Reinvestment Act of 2009 (ARRA) and will help health care providers qualify for new incentives that will be made available in 2010 to doctors and hospitals that meaningfully use electronic health records.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7V8FEX6038?opendocument


J1 Part B LCD Update
Several J1 Part B LCDs have been updated. Please review and alert your staff.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7VAQ7Q4648?opendocument


Provider Web portal of Health Data Insights (HDI) Is Live
The provider Web portal of Health Data Insights (HDI) has been approved by CMS and is currently available for providers at
http://racinfo.healthdatainsights.com or www.racinfo.com.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7V3LHH7763?opendocument


Medicare Secondary Payer Changes: Paper Claims
This article explains the changes that apply to Medicare Secondary Payer (MSP) paper claims and become effective for claims processed on and after September 1, 2009.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7V9KMN5341?opendocument


September J1 A/B MAC Medicare Advisory
The September J1 Medicare Advisory is now available.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7VAT9G7233?opendocument


Healthcare Provider Taxonomy Codes (HPTC): October 1, 2009 Update
CMS has released the summary of changes reflected in the Health Care Provider Taxonomy Code (HPTC) list. Medicare carriers and DME MACs will update their HPTC tables with this new version effective on October 1, 2009. Please review the information and stay current on all HIPAA requirements to assure timely processing of your claims.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7VBKAL6460?opendocument


Advance Notice To Those Billing Lab Services
The Medicare Comprehensive Error Rate Testing (CERT) contractor’s review of services billed to Medicare for lab services has identified a high claims payment error rate for the claims. As a result Palmetto GBA will soon be doing medical review of these claims and it’s likely that some of your claims will be selected. Please review and share with your staff.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VGK2J5788?opendocument