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/4498.aspx. This edition features:

• House Advances Health-Care Reform Legislation: Now Is the Time to Take Action to Support Physician Payment Fix
• ASH Practice Forum: New American Health-Care Policy and the Practice of Hematology
• Medicare Releases Final 2010 Payment Regulations; Physician Payment to Be Cut 21 Percent Absent Congressional Action
• Medicare Announces Changes to Hospital Outpatient Payment in 2010
• Medicare RAC Program Goes National – What You Need to Know
• FDA Issues Drug Warning on Dexferrum (Iron Dextran Injection)
• Medicare Contractors to Review Claims Data Related to Chemotherapy Administration
• CMS Announces 2008 PQRI Payments and Feedback Reports
• ASH Annual Meeting: Policy & Practice Events You Will Want to Attend
• Four Dates, Six Locations, One Great Program – The Only Official Highlights of ASH


****CMS NEWS****
MM6670 – Instructions for Processing Claims Containing Anti-Markup Services but with Partial Information Completed in Item 20 of the CMS-1500 Claim Form
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6670.pdf

MM6717 – Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6717.pdf


Centers for Medicare & Medicaid Services
Special Open Door Forum:
2009 Physician Quality Reporting Initiative (PQRI) Program with the American College of Emergency Physicians (ACEP)/CEP America
Thursday, November 12, 2009
2:00-3:30 pm ET Conference Call Only

The Centers for Medicare & Medicaid Services (CMS) will co-host a Special Open Door Forum on the 2009 PQRI Program with the American College of Emergency Physicians/CEP America. 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.

This Special Open Door Forum will be geared towards emergency medicine-specific topics related to participation in the PQRI Program. Following the presentation, the telephone lines will be opened to allow participants to ask questions of the ACEP/CEP America presenters, including: Dennis Beck, MD FACEP; Richards Newell, MD MPH; and Mike Granovsky, MD FACEP, as well as CMS PQRI subject matter experts.

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.

We look forward to your participation.

Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 31712023
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 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 November 23, 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****
How to Determine If You Are an Independent Diagnostic Testing Facility
(IDTF)?
Are you an Independent Diagnostice Testing Facility? If a substantial
portion of the entity’s business involves the performance of diagnostic
tests, the diagnostic testing services might be a sufficiently separate
business to warrant enrollment as an independent diagnostic testing
facility. In that case, the physician or group can continue to be enrolled
as a physician or a group practice of physicians, but must also enroll as
an independent diagnostic testing facility.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7QMR824802?opendocument


Updated: Independent Diagnostic Testing Facility Table
The updated version of the Independent Diagnostic Testing Facility Table
(IDTF) is now available on the Palmetto GBA J1 Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7QUPVL5118?opendocument


Reason/Remark Code Lookup
Check out the handy PDF lists of the current Medicare specific
Reason/Denial Codes and the Remark Codes on the Palmetto GBA J1 Web site!
These two PDF lists will be updated annually.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XMTNC3288?opendocument


Updated: Independent Diagnostic Testing Facilities:Therapeutic
Procedures/Effect on Availability of Codes
The Independent Diagnostic Testing Facility (IDTF) Local Coverage
Determination (LCD) was retired, as there were CPT codes listed in the LCD
that were not diagnostic services or were inappropriate for an IDTF. A mass
adjustment was completed on August 24, 2009, with 619 claims adjusted in
Southern California, 259 claims in Northern California and 28 claims in
Hawaii and Nevada.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7T4KKD1007?opendocument


2010 Medicare Physician Fee Schedule (MPFS) Amounts Currently Unavailable
The 2010 Medicare Physician Fee Schedule (MPFS) amounts are currently
unavailable until further notice, but will be posted as soon as they become
available. Please check this Web site periodically for any updates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XPMAE2184?opendocument


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