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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