Monday, March 29, 2010

ACCC, ASH, 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/2010/ACCConnect-3-25-2010.html. ANCO is an Institutional Member of ACCC. This edition features:

• ACCC Annual Meeting Presentations and Summary Now Online

• Heard on ACCC's ListServ: Billing for Social Work Services

• ACCC Submits Comments to CMS About Radiation Therapy for Localized Prostate Cancer

• Two New Online CE Programs: New Treatment Strategies

• April ASP Drug Pricing Files Posted


****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/5059.aspx. This edition features:

• Historic Health-Care Reform Signed into Law

• Physician Payment Cuts Scheduled to Begin April 1; Contact Congress Now to Stop the 21% Cut

• Clinical Trials Coverage Provision Included in Final Health Reform Bill

• FDA Launches New Safety Program for ESAs March 24; ASH Clarifying Requirements for Hematologists Who Treat Anemia not Caused by Cancer

• President Obama Announces New Fraud Control Initiatives

• ASH Comments on Proposed Rule for Electronic Health Record Incentive Program

• Medicare Requires Physicians to Update Enrollment Information in PECOS to Receive Payment

• Highmark's Update Policy on ESAs is Now Active

• FDA "Black Box" Warning on Blood Thinner Plavix

• Medicare Releases Updates on Hospital Outpatient Prospective Payment System (OPPS)

• Medicare Releases Updates of the Quarterly Average Sales Price (ASP)


****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare Physician Fee Schedule (MPFS). As you are aware, the Temporary Extension Act of 2010, enacted on March 2, 2010, extended the zero percent (0%) update to the 2010 MPFS through March 31, 2010.

CMS believes Congress is working to avert the negative update that will take effect April 1. Consequently, CMS has instructed its contractors to hold claims containing services paid under the MPFS (including anesthesia services) for the first 10 business days of April. This hold will only affect claims with dates of service April 1, 2010, and forward. In addition, the hold should have minimum impact on provider cash flow because, under the current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt.
Be on the alert for more information about the 2010 Medicare Physician Fee Schedule Update.


MM6852 – Clinical Laboratory Fee Schedule (CLFS) - Special Instructions for Specific Test Codes (CPT Code 80100, CPT Code 80101, CPT Code 80101QW, G0430, G0430QW, and G0431QW)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6852.pdf

MM6864 – Clinical Laboratory Fee Schedule (CLFS) - Medicare Travel Allowance Fees for Collection of Specimens
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6864.pdf

MM6777 – Billing and Processing Claims with Unlimited Occurrence Span Codes (OSCs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6777.pdf

MM6807 – Change in Provider Enrollment Timeliness Standards for Certain Paper Applications
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6807.pdf

MM6683 – Validating the Billing of End Stage Renal Disease (ESRD) 50/50 Rule Modifier
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6683.pdf



****PALMETTO/J1MAC NEWS****
Clinical Laboratory Fee Schedule (CLFS) - Medicare Travel Allowance Fees
for Collection of Specimens
This J1 A/B MAC MLN Matters article (CR6864) updates the Medicare travel
allowance fees for collection of specimens for CY 2010. The Centers for
Medicare & Medicaid Services (CMS) will issue annual updated travel
allowance amounts via a recurring update CR. The travel allowance, which is
intended to cover the estimated travel costs of collecting a specimen is
made only if a specimen collection fee is also payable. The travel codes
allow for such payment either on a per mileage basis or on a flat rate per
trip basis. Providers are encouraged to review the information and to share
with staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83VLP93873?opendocument


Evaluation and Management (E/M) Services Review Checklist and Scoresheet
Tool (for Established Patients)
Palmetto GBA is pleased to announce the creation of the online Evaluation
and Management (E/M) Checklist and Scoresheet Tool created to improve the
accuracy of procedure code selection based on the services you provide.
This tool can be used for services provided to established patients and is
based on the Current Procedural Terminology (CPT). This revolutionary
online tool has the potential to dramatically improve your accuracy in the
selection of the correct E/M procedure code. The E/M tool will guide you
to the appropriate CPT procedure code based on the data you enter. The
scoresheet is designed to help you determine the appropriate level of care
procedure code to submit, in an effort to reduce billing errors.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83WNBR2836?opendocument


J1 Open Draft LCD Meeting: California, April 13, 2010
Palmetto GBA J1 A/B MAC will host an Open Draft Local Coverage
Determination (LCD) meeting for both Part A and Part B in California, from
9 a.m. to 11 a.m. PST on April 13, 2010. The general public is invited to
submit information related to the proposed LCDs for Palmetto GBA's
consideration. To register, please visit our Workshops database. If you
will not be able to come to the meeting, please call (866) 628-8620 with
Conference ID 403971 to particpate.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TKQ3P7107?opendocument


Clinical Laboratory Fee Schedule (CLFS) - Medicare Travel Allowance Fees
for Collection of Specimens
This J1 A/B MAC MLN Matters article (CR6864) updates the Medicare travel
allowance fees for collection of specimens for CY 2010. The Centers for
Medicare & Medicaid Services (CMS) will issue annual updated travel
allowance amounts via a recurring update CR. The travel allowance, which is
intended to cover the estimated travel costs of collecting a specimen is
made only if a specimen collection fee is also payable. The travel codes
allow for such payment either on a per mileage basis or on a flat rate per
trip basis. Providers are encouraged to review the information and to share
with staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83VLP93873?opendocument


Clinical Laboratory Fee Schedule (CLFS) - Special Instructions for Specific
Test Codes (CPT Code 80100, CPT Code 80101, CPT Code 80101QW, G0430,
G0430QW and G0431QW)
This J1 A/B MAC MLN Matters article (CR6852) provides special instructions
for the proper use of specified CPT codes as of April 1, 2010. During CY
2009, effective for January 1, 2010, two new G codes were established, and
it had come to CMS’ attention that some providers were incorrectly using
certain CPT codes. Therefore, CMS created two new G codes to operate in
place of and alongside these existing codes. Providers are encouraged to
review the information and to share with staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83VMBA6011?opendocument


J1 Part B Draft LCD Update
The comment period of the J1 Part B Draft Local Coverage Determination
(LCD), Implantable Infusion Pump for Treatment of Intractable Pain
(DL28268), will begin on April 8 and end on June 1, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83VN9V1837?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!

Wednesday, March 24, 2010

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 available online at http://www.calphys.org/html/news.asp. This edition features:

• Health Reform Takes Important Steps to Cover Uninsured, But Falls Short of Ensuring Access to Doctors

• CMA Submits Comments on Meaningful Use Definition

• CMA President Named to Board of Health Information Exchange Organization

• State Approves Regulations to Expand Scope of Practice for Nonphysicians

• Appeals Court Hears Oral Arguments in Lawsuit Challenging San Francisco's Ban on Sale of Tobacco in Pharmacies

• Blue Cross Extends Healthy Families Continuity of Care Plan, Again

• CMA Launches Free Practice Management Newsletter: Subscribe Today

• There's Still Time to Register for CMA's 13th Annual Health Care Leadership Academy


****CMS NEWS****
The Centers for Medicare and Medicaid Services (CMS) has posted the April 2010 ASP and NOC pricing files and crosswalks. The ASP pricing files for January 2010, October 2009, July 2009, and April 2009 have also been updated. All are available for download at http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/ (see left menu for year-specific links).


The Centers for Medicare & Medicaid Services (CMS) will be hosting its fourth national provider call regarding the implementation of HIPAA Version 5010. There will be a brief presentation given by CMS followed by a Q&A session with CMS subject matter experts. Please note that this call is geared towards vendors, clearinghouses, and providers who are performing their own development of 5010.

Conference call details:

Date: March 24, 2010

Conference Title: HIPAA Version 5010 Fourth National Provider Call

Discussion topics:
· General overview of 5010
· Additional changes to Medicare Fee For Service (FFS)
· Timelines and deadlines
· What you need to do to prepare
· CMS’s approach for new error handling transactions: 999 and 277CA
· Hot Topics:
1. Billing provider address change - P.O. Boxes no longer permitted
2. Discussions on handling Transaction Errata

Time: 2:00 p.m. – 3:30 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.

Registration will close at 2:00 p.m. ET on March 23, 2010, 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://www.eventsvc.com/palmettogba/032410
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.


****PALMETTO/J1 MAC NEWS****
Medicare Remit EasyPrint (MREP) Software for J1 Part B
Medicare Remit EasyPrint (MREP) version 2.7 is available for download.
Please note that the Remittance Advice Remark Codes (RARCs) and Claim
Adjustment Reason Codes (CARCs) must be downloaded from the Washington
Publishing Company (WPC) Web site to be used in conjunction with the
updated MREP Software. You can save time and money by taking advantage of
FREE MREP software now available to view and print the ANSI 835!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7HVMA20718?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!

Friday, March 19, 2010

CMS & PALMETTO/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
The revised Clinical Laboratory Fee Schedule Fact Sheet (January 2010), which provides general information about the Clinical Laboratory Fee Schedule, coverage of clinical laboratory services, and how payment rates are set, is now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/clinical_lab_fee_schedule_fact_sheet.pdf . If you are unable to open the fact sheet, please copy and paste the URL into your Internet browser.


The Centers for Medicare & Medicaid Services (CMS) will be hosting its fourth national provider call regarding the implementation of HIPAA Version 5010. There will be a brief presentation given by CMS followed by a Q&A session with CMS subject matter experts. Please note that this call is geared towards vendors, clearinghouses, and providers who are performing their own development of 5010.

Conference call details:

Date: March 24, 2010

Conference Title: HIPAA Version 5010 Fourth National Provider Call

Discussion topics:
· General overview of 5010
· Additional changes to Medicare Fee For Service (FFS)
· Timelines and deadlines
· What you need to do to prepare
· CMS’s approach for new error handling transactions: 999 and 277CA
· Hot Topics:
1. Billing provider address change - P.O. Boxes no longer permitted
2. Discussions on handling Transaction Errata

Time: 2:00 p.m. – 3:30 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.

Registration will close at 2:00 p.m. ET on March 23, 2010, 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://www.eventsvc.com/palmettogba/032410

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.



The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the following updated 2010 Physician Quality Reporting Initiative (PQRI) educational products to the PQRI webpage at www.cms.hhs.gov/PQRI on the CMS website.
2010 PQRI – Educational Resource Documents - Several new educational resource documents for 2010 PQRI are now available on the "Educational Resources" link of the PQRI website and include the following:
· 2010 PQRI Electronic Health Record (EHR) Reporting Made Simple
· 2010 PQRI Tip Sheet: Satisfactorily Reporting 2010 PQRI Measures
· 2010 PQRI Program Tip Sheet: PQRI Made Simple – Reporting the Preventive Care Measures Group
· 2010 PQRI Fact Sheet: What's New for the 2010 PQRI

2010 EHR-Based Reporting Documents - Several documents related to EHR-based reporting for 2010 PQRI have been updated and are now available on the "Alternative Reporting Mechanisms" page of the PQRI website, which include the following:
· 2010 EHR Measure Specifications
· Updated 2010 EHR Measure Specification Release Notes
· Updated 2010 EHR Downloadable Resource Table
· Updated EHR Data Submission Specifications Utilizing QRDA Release Notes
· Updated EHR Data Submission Specifications Utilizing QRDA Header Errors and Edits
· Updated EHR Data Submission Specifications Utilizing QRDA Body Errors and Edits

2010 PQRI Measures Documents - Several documents related to reporting PQRI measures for 2010 have been updated and are now available on the "Measures Codes"page of the PQRI website, which include the following:
· 2010 Getting Started with Reporting of PQRI Measures Groups
· 2010 PQRI Implementation Guide
· 2010 PQRI QDC Categories
· 2010 PQRI Single Source Master Code Table
· 2010 PQRI Measures Specifications – Release Notes

Qualified Registries for 2010 PQRI and eRx Reporting - An updated list of registries that have become "qualified" to submit quality data to CMS on behalf of their eligible professionals for 2010 PQRI and eRx reporting is now available on the "Alternative Reporting Mechanisms" page of the PQRI website.

Qualified Electronic Health Record (EHR) Vendors for the 2010 PQRI and Electronic Prescribing Incentive Programs - An updated list of EHR vendors and their programs that have been "qualified" to submit quality data to CMS by eligible professionals for 2010 PQRI reporting is now available on the "Alternative Reporting Mechanisms" page of the PQRI website.


The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the following updated 2010 Electronic Prescribing Incentive (eRx) Program educational products to the eRx webpage at www.cms.hhs.gov/ERxIncentive on the CMS website.

2010 eRx – Educational Resource Documents - Several new educational resource documents for 2010 eRx are now available on the “Educational Resources” link of the eRx website and include the following:
· 2010 eRx Incentive Program Fact Sheet: What’s New for the 2010 eRx Incentive Program
· 2010 eRx Incentive Program Made Simple Fact Sheet

2010 EHR-Based Reporting Documents - Several documents related to EHR-based reporting for 2010 eRx have been updated and are now available on the "Alternative Reporting Mechanism" page of the eRx website, which include the following:
· 2010 EHR Downloadable Resource
· Qualified Registries for 2010 PQRI and eRx Reporting
· Qualified Electronic Health Record (EHR) Vendors for the 2010 PQRI and Electronic Prescribing Incentive Programs


****PALMETTO/J1MAC NEWS****
Correction Notice: Feature Article on March 2010 J1 Advisory Cover Page
Contains Incorrect Page Number
The monthly feature article for the March 2010 J1 Medicare Advisory,
‘Billing for Services Related to Voluntary Uses of Advance Beneficiary
Notices of Non-Coverage (ABN),’ was printed with an incorrect page number
on the cover page. The featured article is continued on page 79 rather than
page 75. The Web version of the advisory has been corrected and published
to the J1 Web site. We apologize for any confusion this has caused. Please
be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83CL628122?opendocument


2010 Palmetto GBA J1 Spring Workshop Tour Kicks off April 16
The 2010 Palmetto GBA J1 Spring Workshop Tour is coming soon to a location
near you! The three-month training and education series kicks off on
Friday, April 16. To register or find out more about the workshops, please
log into your Palmetto GBA Workshops database account and register for the
session you wish to attend.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83LR9V7466?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!

Sunday, March 14, 2010

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/5027.aspx. This edition features:

• Senate Passes Seven Month Extension of Current Medicare Physician Payment; Contact the House of Representatives Now to Stop the 21 Percent Cut

• Congressional Negotiations Continue on Health Reform Legislation; Complex Policy Issues and Procedural Tactics in Play

• Information on How the New ESA REMS Program Will Affect MDS Patients

• March is DVT Awareness Month: ASH Recommendations Unveiled to Respond to Public Health Crisis in DVT and PE

• Medicare Publishes New Physician Resources Concerning the Consultation Code Elimination and Physician Payment


****CMS NEWS****
MM6805 – July 2010 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/MM6805.pdf

MM6563 – Billing for Services Related to Voluntary Uses of Advance Beneficiary Notices of Noncoverage (ABNs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6563.pdf


****PALMETTO/J1MAC NEWS****
A More User-Friendly J1 Learning and Education Section
A more user-friendly J1 Learning and Education section is on the way! As
one of our continual efforts to improve our Web site, the structure and the
content of this section will be revised. Look out for the new version in
the next few days.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83EQ2J8711?opendocument


Portable X-Ray Services
This article announces that selected HCPCS codes should be used as a guide
when submitting claims for the set-up and transportation of portable x-ray
equipment to the patient. The transportation charge is not payable unless
the portable x-ray equipment used was actually transported to the location
where the x-ray was taken. Suppliers should not bill for a transport fee
when the x-ray equipment is stored in a facility for use as needed. If the
x-ray is not covered, the transportation and set up will also be
non-covered. Suppliers are encouraged to review the information and to
share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83CSCX8671?opendocument


Billing for Services Related to Voluntary Uses of Advance Beneficiary
Notices of Non-Coverage (ABNs)
This J1 A/B MAC MLN Matters article (CR6563b) was revised on February 22,
2010, to reflect a revised CR6563, which was issued on February 19, 2010.
The article was revised to reflect a new CR release date, transmittal
number and Web address for accessing CR 6563. This article announces recent
instructions for the use of modifiers in association with Advance
Beneficiary Notices (ABN). Specifically, effective April 1, 2010, two HCPCS
level 2 modifiers have been updated to distinguish between voluntary, and
required, uses of liability notices. Providers are encouraged to review the
information and to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83FSJ46884?opendocument


Services Denied for Provider Not Eligible/Deactivated: Liability for
Charges
This article announces that, effective April 1, 2010, when a Medicare
provider has been deactivated for non-billing or when other circumstances
result in your Medicare billing privileges being revoked, the
responsibility for charges denied with message code PR-B7 will change from
patient responsibility to contractual obligation. This also includes
denials for Independent Diagnostic Testing Facilities (IDTF) when the
submitted service does not meet the IDTF's qualifications. These services
will be specified on the Medicare remittance notice with message code
CO-B7. You may not bill the patient for services that are denied as
contractual obligation. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/839M9W6114?opendocument


Unavailability of Internet-Based PECOS Monday, March 29 through Monday,
April 5
Due to scheduled maintenance, Internet-based Provider Enrollment, Chain and
Ownership System (PECOS) will be unavailable from Monday, March 29, 2010
through Monday, April 5, 2010. Internet-based PECOS allows physicians,
non-physician practitioners, providers and other suppliers (except
suppliers of durable medical equipment, prosthetics, orthotics and supplies
(DMEPOS)) to enroll or make a change to their existing Medicare enrollment
information over the Internet.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83GNS66826?opendocument


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Thursday, March 11, 2010

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 available online at http://www.calphys.org/html/news.asp. This edition features:

• Physicians: Are You Compliant with Recent HIPAA Changes?

• CMA Publishes Timely Access Guide for Physicians

• Court Upholds Governor's Furloughs of Medical Board Staff and Shifting of Agency's FUnds to Other State Programs

• Congress Stops SGR Cuts through March 31; CMA Fighting for Permanent Repeal

• Health Reform Update

• CMA's Council of Legislation Convenes to Set Legislative Priorities for 2010

• Reminder: Blue Cross Health Families Continuity of Care Plan Ends 3/31

• Tomorrow is Early Bird Deadline for CMA's 13th Annual Health Care Leadership Academy

• Registration Now Open for CMA's Legislative Leadership Conference

• Patient Cough and Cold Kits Now Available from the CMA Foundation


****CMS NEWS****
As part of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, the Centers for Medicare & Medicaid Services (CMS) administers the Electronic Health Record (EHR) incentive programs under Medicare and Medicaid. CMS prepared a proposed rule on the EHR incentive programs for public comment. This proposed rule includes the definition of meaningful use and other requirements to qualify for incentive payments. The comment period for this proposed rule closes on March 15, 2010. CMS welcomes your comments which may be submitted through http://www.regulations.gov. For additional information on the proposed rule, visit http://www.cms.hhs.gov/Recovery/11_HealthIT.asp on the web. Here you will find fact sheets, presentation materials summarizing the proposed rule, and links to the proposed rule itself.


The Basic Introduction to ICD-10-CM National Provider Conference Call will be conducted on Tuesday, March 23, 2010 from
1:00 p.m. – 2:30 p.m. Eastern Daylight Time. This conference call will provide an overview of ICD-10-CM/PCS requirements and a basic introduction to ICD-10-CM. The following topics will be discussed:
· Requirement to report ICD-10-CM/PCS codes for services provided on or after October 1, 2013.
· ICD-9-CM codes will not be accepted after October 1, 2013 (there will not be a grace period).
· Benefits of ICD-10-CM.
· Key similarities and differences between ICD-9-CM and ICD-10-CM.
· General structure and characteristics of ICD-10-CM.
· New features in ICD-10-CM.
· Setting the record straight about common ICD-10-CM myths and misperceptions.
· Impact of ICD-10-CM on medical record documentation.

Registration information and discussion materials for this conference call can be accessed at
http://www.cms.hhs.gov/ICD10/07_CMS_Sponsored_Calls.asp .


The Medicare Physician Fee Schedule Fact Sheet (March 2010) has been revised to include information about the two month zero percent (0%) update to the 2010 Medicare Physician Fee Schedule (MPFS) effective for dates of service January 1, 2010 through March 31, 2010. This fact sheet, which also provides information about MPFS payment rates and the MPFS payment rates formula, is available in downloadable format from the Centers for Medicare & Medicaid ServicesMedicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/MedcrePhysFeeSchedfctsht.pdf


****PALMETTO/J1MAC NEWS****
Questions and Answers on Reporting Physician Consultation Services
This J1 Special Edition article (SE1010) alerts providers that effective
January 1, 2010, various CPT consultation codes are no longer recognized
for Medicare Part B payment. Effective for services furnished on or after
January 1, 2010, providers should report each E/M service, including visits
that could be described by CPT consultation codes, with an E/M code payable
under the Medicare Physician Fee Schedule (MPFS) that represents where the
visit occurs and that identifies the complexity of the visit performed.
Providers are encouraged to review the information and to share with their
staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/837MM68711?opendocument


Electronic Funds Transfer (EFT) Authorization Agreement Processing
This article announces that Medicare contractors shall not process more
than one Electronic Funds Transfers (EFT) request for a provider or
supplier within a three-month period, unless there is an unusual and
compelling reason to do so. Medicare contractors shall apply this policy
immediately for providers and suppliers who have submitted more than one
EFT change request within the preceding three months. Please be sure to
share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/839NHG2671?opendocument


Basic Introduction to ICD-10-CM National Provider Conference Call
CMS will conduct the 'Basic Introduction to ICD-10-CM National Provider
Conference Call' on Tuesday, March 23, 2010 from 1 p.m. to 2:30 p.m. EDT.
This conference call will provide an overview of ICD-10-CM/PCS requirements
and a basic introduction to ICD-10-CM.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83DNM36051?opendocument


Open Draft LCD Meetings April 2010
Palmetto GBA J1 A/B Medicare Administrative Contractor (MAC) has scheduled
Open Draft Local Coverage Determination (LCD) meetings in California,
Nevada and Hawaii for April 2010. The general public is invited to submit
information related to the proposed LCDs for Palmetto GBA's consideration.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YDPHY0633?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!

Wednesday, March 3, 2010

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
On March 2, 2010, President Obama signed into law the “Temporary Extension Act of 2010.” Among other things, this law extends through March 31, 2010, the zero percent update to the Medicare Physician Fee Schedule that was in effect for claims with dates of service January 1, 2010, through February 28, 2010. Consequently, effective immediately, claims with dates of service March 1 and later which were being held by Medicare contractors will be released for processing and payment. Please keep in mind that the statutory payment floors still apply and, therefore, clean electronic claims cannot be paid before 14 calendar days after the date they are received by Medicare contractors (29 calendar days for clean paper claims).

In addition, the new law extends through March 31, 2010, the exception process for therapy clÄaims reaching the annual cap, retroactive to January 1, 2010. Affected providers may submit claims for exceptions to the annual therapy caps, with dates of service January 1 through March 31, 2010, using the KX modifier, following the pre-January 1, 2010, requirements for therapy cap exceptions.

Please watch your listserv and contractor’s website for more information about the new legislation.


The MLN Matters Special Edition Article #SE1010 entitled, "Questions and Answers on Reporting Physician Consultation Services," has just been released and is available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE1010.pdf on the CMS website. This article is intended for physicians and non-physician practitioners (NPPs) who perform initial evaluation and management (E/M) services previously reported by Current Procedural Terminology (CPT) consultation codes for Medicare beneficiaries and submit claims to Medicare Carriers and/or Medicare Administrative Contractors (MACs) for those services. The article pertains to change request (CR) 6740, which alerts providers that effective January 1, 2010, the CPT consultation codes (ranges 99241-99245 and 99251-99255) are no longer recognized for Medicare Part B payment.


Consequently, MLN Matters Article #MM6740 entitled, "Revisions to Consultation Services Payment Policy," is being revised to clarify language contained in the original CR and to add a reference to MLN Matters Article #SE1010. All other information remains the same. The revised article is available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6740.pdf on the CMS website.


****PALMETTO J1/MAC NEWS****
J1 Provider Outreach and Education Event Calendar
Effective March 1, 2010, Palmetto GBA will switch from Saba Centra 7® to a
new Internet event host, WebEx, for all Web-based training events to offer
our providers a more user-friendly online learning experience. Check out
our March Events calendar in the next few weeks for more detailed event
announcements and technical requirements for attending WebEx events.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?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!