CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
MM6806 – Revision of Definition of Compendia as Authoritative Source for Use in the Determination of a Medically-Accepted Indication of Drugs/Biologicals Used Off-label in Anti-Cancer Chemotherapeutic Regimens
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6806.pdf


The Centers for Medicare and Medicaid Services (CMS) has issued a Notice of Proposed Rule Making (NPRM) for the Medicare and Medicaid EHR incentive programs established by the Recovery Act. The HITECH provisions are a subset of the Recovery Act. The rule, sometimes called the “meaningful use NPRM,” proposes a definition for the meaningful use of certified EHR technology as well as many other policy proposals. Join us to learn the basics of the rule from the CMS experts.

Learn about
· CMS’ proposed rule for the EHR incentive programs including:
o Who is eligible
o What constitutes meaningful use
o How to demonstrate meaningful use
o What incentives are available under Medicare and Medicaid
· How to make comments
· Where to find additional resources

Hear first hand from the CMS Experts
When: Tuesday, February 23rd
Time: 1:30-2:30 pm EST

We suggest you call in early as lines are limited.
To join the meeting, dial 1-866-501-5502
The conference ID is 58353012

Materials will be available on the morning of the call at
http://www.cms.hhs.gov/NationalMedicareTrainingProgram/10_Audio_Conference_Training.asp


****PALMETTO/J1MAC NEWS****
2010 Coding & Reimbursement Update
The 2010 Coding & Reimbursement Update contains a wealth of information
that will be helpful to your office. Some of the articles in this
publication include: Additions, Deletions and Changes for HCPCS, CDT, and
CPT codes and modifiers; Proper use of modifiers and more.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Z9Q8Q1420?opendocument


Update: Pricing for Lupron Injections
This Alert announces that claims processed on January 4, 2010, through
January 19, 2010, were priced incorrectly. Services were paid at the
submitted charge instead of the correct price. This was due to a MCS System
field change. The pricing error was due to the system reading the year of
service incorrectly. A mass adjustment was performed to issue corrected
payments. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/82RRYT1885?opendocument


Medicare Systems Edit Refinements Related to Hospice Services
This J1 A/B MAC MLN Matters article (CR6778) announces revisions for
existing Medicare standard systems edits to allow Medicare fee for service
(FFS) claims to process for beneficiaries in a Medicare Advantage plan on
the date of a Medicare hospice election. This article also adds new edits
ensuring the appropriate place of service is reported for hospice general
inpatient care (GIP), respite and continuous home care (CHC). Lastly, this
article provides a technical correction to the Medicare Benefit Policy
Manual regarding the requirement for nursing care related to hospice
continuous home care. Providers are encouraged to review the information
and share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/82SNGD4105?opendocument


New Waived Tests
This J1 Part B MLN Matters article (CR6800) alerts clinical laboratories
and providers that the Centers for Medicare & Medicaid Services (CMS) has
listed the latest tests approved by the Food and Drug Administration (FDA)
as waived tests under the Clinical Laboratory Improvement Amendments of
1988 (CLIA). CLIA regulations require a laboratory facility to be
appropriately certified for each test it performs. To ensure that Medicare
and Medicaid only pay for laboratory tests categorized as waived complexity
under CLIA in facilities with a CLIA certificate of waiver, laboratory
claims are currently edited at the CLIA certificate level. The tests newly
added to the waived tests are in the table in the Background Section of
this article. Providers and clinical labs are encouraged to review this
information and share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/82RQAA7884?opendocument


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