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


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