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/5387.aspx. This edition features:
• SGR Fix Caught in Stalemate Between House and Senate
• ASH Urges CMS to Reconsider the Elimination of Consult Codes
• FDA Grants Accelerated Approval to Nilotinib for the Treatment of Adult Ph+ CML Patients
• FDA Announcement of Pfizer Voluntary Withdrawal of Cancer Treatment Mylotarg from US Market
• ASH Responds to NHI-JDA Joint Leadership Council with Translational and Clinical Research Priorities and Recommendations for Increased Efficiency
• ASH Recommends Hematologic Conditions Be Included in HHS Initiative on Multiple Chronic Conditions
• Medicare Releases Updates of the Quarterly Average Sales Price (ASP)
****PALMETTO/J1MAC NEWS****
Enhancements to Home Health (HH) Consolidated Billing Enforcement
This J1 A/B MAC MLN Matters article (CR6911a) was revised on June 14, 2010,
to reflect the revised CR 6911 that was issued on that date. In this
article, the CR release date and transmittal number were revised. Also,
the Web address for accessing CR 6911 was revised. The article announces
that CMS is updating edit criteria related to the consolidated billing
provision of the Home Health Prospective Payment System (HH PPS). It is
also creating a new file of HH certification information to assist
suppliers and providers subject to HH consolidated billing. Make sure your
billing staff is aware of these changes. Non-routine supplies provided
during a HH episode of care are included in Medicare’s payment to the home
health agency (HHA) and subject to consolidated billing edits as described
in the Medicare Claims Processing Manual. If the date of service for a
non-routine supply HCPCS code that is subject to HH consolidated billing
falls within the dates of a HH episode, the line item was previously
rejected by Medicare systems. Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86PPH33027?opendocument
J1 Part A and Part B LCDs Notice Periods Start June 24
Share with your staff - The notice period will begin on June 24, 2010, for
J1 Part A LCD, Cataract Surgery in Adults L30889 and J1 Part B LCDs,
Cataract Surgery in Adults L30691and Implantable Infusion Pump for
Treatment of Chronic Intractable Pain L28268.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86PQ2X8804?opendocument
The Physician Quality Reporting Initiative (PQRI) and E-Prescribing (eRx)
Medicare Quality Reporting Incentive Programs Manual
This J1 A/B MAC MLN Matters article (CR6935) announces availability of a
new Medicare manual describing the Physician Quality Reporting Initiative
(PQRI) and E-Prescribing (eRx) Incentive Programs. It is important to note
that the manual does not establish new requirements for the PQRI and eRx
programs and changes to the programs are described in the annual MPFS
legislation. This new manual, entitled Physician Quality Reporting
Initiative (PQRI) and E-Prescribing (eRx) Medicare Quality Reporting
Incentive Programs Manual will be Publication 100-22 and will be available
on the Centers for Medicare & Medicaid Services (CMS) Web site. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86QKTM7767?opendocument
Correction to the Claims Processing Internet Only Manual (IOM) to Reinstate
Previous Instructions Regarding Payment Jurisdiction for Reassigned
Services
This J1 Part B MLN Matters article (CR6923) corrects instructions for
reassigned services in the Medicare Claims Processing Manual. CR 6923
reinstates Chapter 1, Section 10.1.1.3 regarding payment jurisdiction for
reassigned services. This section was deleted in error by CR 6627. This CR
also removes an outdated reference in Chapter 35, Section 40 to deleted
Chapter 1, Section 30.2.9.1, which was removed by CR 6733. In CR 6627, the
Centers for Medicare & Medicaid Services (CMS) inadvertently changed the
billing instructions for reassigned services in a way that is not supported
by CMS’s systems or Medicare policy. This CR corrects this error and
reinstates the instructions in place prior to the implementation of CR
6627. Providers are encouraged to review the information and to share with
their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86QLBQ7311?opendocument
Signature Guidelines for Medical Review Purposes
This J1 A/B MAC MLN Matters article (CR6698b) was revised on June 16, 2010,
to include a table excerpt on pages six through seven from CR 6698 that
summarizes signature requirements. This article clarifies for providers how
Medicare claims review contractors review claims and medical documentation
submitted by providers. CR 6698 outlines the new rules for signatures and
adds language for e-prescribing. See the rest of this article for complete
details. These revised/new signature requirements are applicable for
reviews conducted on or after the implementation date of April 16, 2010.
Please note that all signature requirements in CR 6698 are effective
retroactively for Comprehensive Error Rate Testing (CERT) for the November
2010 report period. Providers are encouraged to review the information and
to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86RMPR2435?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, June 27, 2010
Thursday, June 24, 2010
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
J1 Part A and Part B LCDs Comment Periods Start
The comment period of the J1 Part A Local Coverage Determination (LCD),
Ambulance Services DL31250, will begin on July 8, 2010 and end on August
30, 2010. The comment period of the following J1 Part B LCDs will begin on
July 9, 2010 and end on August 30, 2010: Bladder Tumor Markers DL31302 and
Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control DL31287.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86HM4Z6685?opendocument
One-Time Mailing of Solicitation Letter to Physicians and Non-Physician
Practitioners Who Are Currently Enrolled In Medicare But Who Do Not Have
Enrollment Records In The Provider Enrollment, Chain and Ownership System
(PECOS)
This J1 A/B MAC MLN Matters article (CR6842) advises you that your Medicare
contractor will be mailing the letter shown in the attachment to CR 6842 if
you do not have a record in PECOS. The letter will request that you take
the steps to establish such a record and will explain how to do so. It is
important that you maintain your enrollment information to ensure you are
eligible for future Medicare initiatives and incentives. The letter will
explain that Medicare records indicate you do not have an enrollment record
in PECOS because you enrolled in Medicare prior to implementation of PECOS
and you have not submitted any updates or changes to your Medicare
enrollment information in the past six (or more) years. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86HQZQ7533?opendocument
J1 Open Draft LCD Meeting: California, July 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 July 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
J1 Part A and Part B LCDs Comment Periods Start
The comment period of the J1 Part A Local Coverage Determination (LCD),
Ambulance Services DL31250, will begin on July 8, 2010 and end on August
30, 2010. The comment period of the following J1 Part B LCDs will begin on
July 9, 2010 and end on August 30, 2010: Bladder Tumor Markers DL31302 and
Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control DL31287.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86HM4Z6685?opendocument
J1 PCC Closed for Training June 25
The J1 Provider Contact Center (PCC) will be closed for training on Friday,
June 25, 2010, from 11 a.m. to 3 p.m. PST.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86NLDQ5271?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!
****PALMETTO/J1MAC NEWS****
J1 Part A and Part B LCDs Comment Periods Start
The comment period of the J1 Part A Local Coverage Determination (LCD),
Ambulance Services DL31250, will begin on July 8, 2010 and end on August
30, 2010. The comment period of the following J1 Part B LCDs will begin on
July 9, 2010 and end on August 30, 2010: Bladder Tumor Markers DL31302 and
Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control DL31287.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86HM4Z6685?opendocument
One-Time Mailing of Solicitation Letter to Physicians and Non-Physician
Practitioners Who Are Currently Enrolled In Medicare But Who Do Not Have
Enrollment Records In The Provider Enrollment, Chain and Ownership System
(PECOS)
This J1 A/B MAC MLN Matters article (CR6842) advises you that your Medicare
contractor will be mailing the letter shown in the attachment to CR 6842 if
you do not have a record in PECOS. The letter will request that you take
the steps to establish such a record and will explain how to do so. It is
important that you maintain your enrollment information to ensure you are
eligible for future Medicare initiatives and incentives. The letter will
explain that Medicare records indicate you do not have an enrollment record
in PECOS because you enrolled in Medicare prior to implementation of PECOS
and you have not submitted any updates or changes to your Medicare
enrollment information in the past six (or more) years. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86HQZQ7533?opendocument
J1 Open Draft LCD Meeting: California, July 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 July 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
J1 Part A and Part B LCDs Comment Periods Start
The comment period of the J1 Part A Local Coverage Determination (LCD),
Ambulance Services DL31250, will begin on July 8, 2010 and end on August
30, 2010. The comment period of the following J1 Part B LCDs will begin on
July 9, 2010 and end on August 30, 2010: Bladder Tumor Markers DL31302 and
Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control DL31287.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86HM4Z6685?opendocument
J1 PCC Closed for Training June 25
The J1 Provider Contact Center (PCC) will be closed for training on Friday,
June 25, 2010, from 11 a.m. to 3 p.m. PST.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86NLDQ5271?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, June 18, 2010
ACCC, CMA, & 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-6-16-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• SGR Fix: Senate Fails to Act
• PECOS Enrollment Required for Medicare EHR Incentive Program
• CMS Assigns New HCPCS Code for Oforta (Fludarabine Phosphate Tablets)
• New Patient Hotline for Cancer Patients Experiencing Chemotherapy-Induced Nausea and Vomiting
****CMA NEWS****
The California Medical Association (CMA) Alert was published and is available online at http://www.cmaalert.org. This edition features:
• Two physicians win primary bids for California Assembly
• CMA-sponsored bills advance to next stage of legislative process
• CMA creates technical advisory committee on physician-hopsital alignment
• CMS extends Medicare payment hold for three days
• Reminder: PECOS enrollment deadline is July 6, 2010
• DHCS announces fee-for-servcie provider payment delay
• New at CMA On-call: 10 strategies to protect quality through medical staff self-governance
• Blue Cross announces changes to Prudent Buyer contract
• CMA offers free CME webinar on EHR implementation
****PALMETTO/J1MAC NEWS****
Additional Instruction for Implementation of Health Insurance Portability
and Accountability Act of 1996 (HIPAA) Version 5010 for Transaction 835 -
Health Care Claim Payment/Advice and Updated Standard Paper Remit (SPR)
This J1 A/B MAC MLN Matters article (CR6975) alerts providers that,
according to the Administrative Simplification provisions of HIPAA
Regulations, the Secretary of the Department of Health and Human Services
(DHHS) is required to adopt standard electronic transactions and code sets.
CMS is currently in the process of implementing the next version of the
HIPAA Transaction 835 standard – referred to as 835v5010 in this document.
Be sure that you will be compliant with this next HIPAA standard by January
1, 2012. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86FR938701?opendocument
J1 Provider Outreach and Education Event Calendar
The free Webinar on Medicare Secondary Payer is back! Click the link in the
calendar for more details on this J1 Part A online event scheduled at 12:30
p.m. PST, June 22, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
The 2010 Medicare Physician Fee Schedule
The Continuing Extension Act of 2010, enacted on April 15, 2010, extended
the zero percent update to the 2010 Medicare Physician Fee Schedule (MPFS)
through May 31, 2010. At this time, Congress is debating the elimination of
the negative update that took effect June 1, 2010. The Centers for Medicare
& Medicaid Services (CMS) is hopeful that Congressional action will be
taken within the next several days to avert the negative update. CMS is now
directing its contractors to continue holding June 1 and later claims
through Thursday, June 17, lifting the hold on Friday, June 18. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86GMQ77320?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!
****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-6-16-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• SGR Fix: Senate Fails to Act
• PECOS Enrollment Required for Medicare EHR Incentive Program
• CMS Assigns New HCPCS Code for Oforta (Fludarabine Phosphate Tablets)
• New Patient Hotline for Cancer Patients Experiencing Chemotherapy-Induced Nausea and Vomiting
****CMA NEWS****
The California Medical Association (CMA) Alert was published and is available online at http://www.cmaalert.org. This edition features:
• Two physicians win primary bids for California Assembly
• CMA-sponsored bills advance to next stage of legislative process
• CMA creates technical advisory committee on physician-hopsital alignment
• CMS extends Medicare payment hold for three days
• Reminder: PECOS enrollment deadline is July 6, 2010
• DHCS announces fee-for-servcie provider payment delay
• New at CMA On-call: 10 strategies to protect quality through medical staff self-governance
• Blue Cross announces changes to Prudent Buyer contract
• CMA offers free CME webinar on EHR implementation
****PALMETTO/J1MAC NEWS****
Additional Instruction for Implementation of Health Insurance Portability
and Accountability Act of 1996 (HIPAA) Version 5010 for Transaction 835 -
Health Care Claim Payment/Advice and Updated Standard Paper Remit (SPR)
This J1 A/B MAC MLN Matters article (CR6975) alerts providers that,
according to the Administrative Simplification provisions of HIPAA
Regulations, the Secretary of the Department of Health and Human Services
(DHHS) is required to adopt standard electronic transactions and code sets.
CMS is currently in the process of implementing the next version of the
HIPAA Transaction 835 standard – referred to as 835v5010 in this document.
Be sure that you will be compliant with this next HIPAA standard by January
1, 2012. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86FR938701?opendocument
J1 Provider Outreach and Education Event Calendar
The free Webinar on Medicare Secondary Payer is back! Click the link in the
calendar for more details on this J1 Part A online event scheduled at 12:30
p.m. PST, June 22, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
The 2010 Medicare Physician Fee Schedule
The Continuing Extension Act of 2010, enacted on April 15, 2010, extended
the zero percent update to the 2010 Medicare Physician Fee Schedule (MPFS)
through May 31, 2010. At this time, Congress is debating the elimination of
the negative update that took effect June 1, 2010. The Centers for Medicare
& Medicaid Services (CMS) is hopeful that Congressional action will be
taken within the next several days to avert the negative update. CMS is now
directing its contractors to continue holding June 1 and later claims
through Thursday, June 17, lifting the hold on Friday, June 18. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86GMQ77320?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, June 13, 2010
ASH & 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/5291.aspx. This edition features:
• Senate "Extenders" Package Would Restore Medicare Cuts to Physicians, But Passage Still Uncertain
• CMS Hosts National Provider Calls for the PQRI & Electronic Prescribing Incentive Programs and for the ICD-10 Implementation in a 5010 Environment
• Medicare Releases Quarterly Healthcare Common Procedure Coding System Code Changes
• ASH Comments on AHRQ Report on VTE Prophylaxis in Orthopedic Surgery
• ASH Comments on New Burdens on Physicians Placed by E-Prescribing for Controlled Substances Rule
• ASH Urges CMS to Reconsider Its July 6 Deadline for Physician Enrollment in PECOS
• AHRQ Releases Technology Assessments on Off-Label Indications for Cancer Treatment and on Recombinant Factor VIIa
• FTC Delays Enforcement of Red Flags Rule
****PALMETTO/J1MAC NEWS****
Open Draft LCD Meetings July 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 July 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
Change in the Amount in Controversy Requirement for Administrative Law
Judge Hearings and Federal District Court Appeals
The MLN article, Change in the Amount in Controversy Requirement for
Administrative Law Judge Hearings and Federal District Court Appeals, has
been updated based on the Change Request 6894.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7NZKKD5858?opendocument
General Appeals Information
Share with your staff - Palmetto GBA has updated the J1 Part B appeal
levels, amount in controversy thresholds and the time limits for filing an
appeal on our Web site. For more information, view MM6894, Change in the
Amount in Controversy Requirement for Administrative Law Judge Hearings and
Federal District Court Appeals.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y3LL40181?opendocument
Revised Payment Files for the 2010 Medicare Physician Fee Schedule Database
(MPFSDB) and Retroactive Provisions under the Patient Protection and
Affordable Care Act (Publication L 111-148) (the Affordable Care Act)
This J1 A/B MAC MLN Matters article (CR6973a) was revised on May 24, 2010,
to show that Medicare’s implementation date for using the new payment files
is no later than June 1, 2010. This article amends payment files that were
issued to contractors to take into account the 2010 MPFS Final Rule
correction notice that went on display at the Federal Register on May 5,
2010, and retroactive provisions under the Affordable Care Act. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86AMMD7035?opendocument
Updated: Certain Clinical Lab Services Rejected Incorrectly
Share with your staff - A mass adjustment was completed on June 4, 2010,
for electronic claims rejected with remittance advice remark code MA111
processed between April 5 and April 29. A total of 59,974 claims were
adjusted.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/857QVV7435?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!
****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/5291.aspx. This edition features:
• Senate "Extenders" Package Would Restore Medicare Cuts to Physicians, But Passage Still Uncertain
• CMS Hosts National Provider Calls for the PQRI & Electronic Prescribing Incentive Programs and for the ICD-10 Implementation in a 5010 Environment
• Medicare Releases Quarterly Healthcare Common Procedure Coding System Code Changes
• ASH Comments on AHRQ Report on VTE Prophylaxis in Orthopedic Surgery
• ASH Comments on New Burdens on Physicians Placed by E-Prescribing for Controlled Substances Rule
• ASH Urges CMS to Reconsider Its July 6 Deadline for Physician Enrollment in PECOS
• AHRQ Releases Technology Assessments on Off-Label Indications for Cancer Treatment and on Recombinant Factor VIIa
• FTC Delays Enforcement of Red Flags Rule
****PALMETTO/J1MAC NEWS****
Open Draft LCD Meetings July 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 July 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
Change in the Amount in Controversy Requirement for Administrative Law
Judge Hearings and Federal District Court Appeals
The MLN article, Change in the Amount in Controversy Requirement for
Administrative Law Judge Hearings and Federal District Court Appeals, has
been updated based on the Change Request 6894.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7NZKKD5858?opendocument
General Appeals Information
Share with your staff - Palmetto GBA has updated the J1 Part B appeal
levels, amount in controversy thresholds and the time limits for filing an
appeal on our Web site. For more information, view MM6894, Change in the
Amount in Controversy Requirement for Administrative Law Judge Hearings and
Federal District Court Appeals.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y3LL40181?opendocument
Revised Payment Files for the 2010 Medicare Physician Fee Schedule Database
(MPFSDB) and Retroactive Provisions under the Patient Protection and
Affordable Care Act (Publication L 111-148) (the Affordable Care Act)
This J1 A/B MAC MLN Matters article (CR6973a) was revised on May 24, 2010,
to show that Medicare’s implementation date for using the new payment files
is no later than June 1, 2010. This article amends payment files that were
issued to contractors to take into account the 2010 MPFS Final Rule
correction notice that went on display at the Federal Register on May 5,
2010, and retroactive provisions under the Affordable Care Act. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86AMMD7035?opendocument
Updated: Certain Clinical Lab Services Rejected Incorrectly
Share with your staff - A mass adjustment was completed on June 4, 2010,
for electronic claims rejected with remittance advice remark code MA111
processed between April 5 and April 29. A total of 59,974 claims were
adjusted.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/857QVV7435?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!
Thursday, June 10, 2010
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
J1 Part B LCDs Update
Share with your staff - The following J1 Part B LCDs have been revised: In
Vitro Chemosensitivity & Chemoresistance Assays L30697 and Physical
Medicine and Rehabilitation Policy L28290.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/868ST27336?opendocument
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 16.2,
effective July 1, 2010
This J1 Part B MLN Matters article (CR6930) provides a reminder for
physicians to take note of the quarterly updates to Correct Coding
Initiative (CCI) edits. The last quarterly release of the edit module was
issued in April 2010. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/863MSV2227?opendocument
Updated Form CMS 1500 Information
This J1 Part B MLN Matters article (CR6929) updates Form CMS 1500
information in the Medicare Claims Processing Manual by removing language
allowing the use of legacy identifiers and making other technical
corrections as a result of that change. As part of this update, providers
are reminded that they are responsible for purchasing their own CMS 1500
forms. Forms can be obtained from printers or printed in-house as long as
the forms follow the specifications approved by the Centers for Medicare &
Medicaid Services (CMS) as developed by the American Medical Association
(AMA). Providers are encouraged to review the information and to share with
their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/864MT86566?opendocument
Get ready for 2010 MACtoberfest October 27-29
Save the date for MACtoberfest, our largest educational and networking
event of the year! Join us October 27-29 in California and receive
Continuing Education Unit (CEU) credits for all the sessions you complete.
Look out for more details on our J1 Part A or Part B Web sites in the next
few weeks.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/867R3X8418?opendocument
J1 PCC Closed for Training Friday, June 11
The J1 Provider Contact Center (PCC) will be closed for training from 11
a.m. to 3 p.m. PST on Friday, June 11, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/867RFC3500?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!
****PALMETTO/J1MAC NEWS****
J1 Part B LCDs Update
Share with your staff - The following J1 Part B LCDs have been revised: In
Vitro Chemosensitivity & Chemoresistance Assays L30697 and Physical
Medicine and Rehabilitation Policy L28290.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/868ST27336?opendocument
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 16.2,
effective July 1, 2010
This J1 Part B MLN Matters article (CR6930) provides a reminder for
physicians to take note of the quarterly updates to Correct Coding
Initiative (CCI) edits. The last quarterly release of the edit module was
issued in April 2010. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/863MSV2227?opendocument
Updated Form CMS 1500 Information
This J1 Part B MLN Matters article (CR6929) updates Form CMS 1500
information in the Medicare Claims Processing Manual by removing language
allowing the use of legacy identifiers and making other technical
corrections as a result of that change. As part of this update, providers
are reminded that they are responsible for purchasing their own CMS 1500
forms. Forms can be obtained from printers or printed in-house as long as
the forms follow the specifications approved by the Centers for Medicare &
Medicaid Services (CMS) as developed by the American Medical Association
(AMA). Providers are encouraged to review the information and to share with
their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/864MT86566?opendocument
Get ready for 2010 MACtoberfest October 27-29
Save the date for MACtoberfest, our largest educational and networking
event of the year! Join us October 27-29 in California and receive
Continuing Education Unit (CEU) credits for all the sessions you complete.
Look out for more details on our J1 Part A or Part B Web sites in the next
few weeks.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/867R3X8418?opendocument
J1 PCC Closed for Training Friday, June 11
The J1 Provider Contact Center (PCC) will be closed for training from 11
a.m. to 3 p.m. PST on Friday, June 11, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/867RFC3500?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!
Thursday, June 3, 2010
ACCC, CMA, & 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-6-2-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• SGR Fix: Good and Bad News
• Share the Wealth of Resources, Earn Dividends
• ASCO Attendees Take Note: All-Star Panel to Explore Expanding Cancer Care
• Follow-up Care for Blood Cancer Survivors: New Educational Webcast
• Heard on ACCC's ListServ: Anthracycline Therapy and Monitoring Cardiac Status
• ACCC's CE Blackboard: New Multiple Myeloma CE Program Available
• Eisai's Investigational Agent Eribulin Mesylate Recieves FDA Priority Review Status
****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:
• Accountable Care Organizations: How Will They Impact Your Practice?
• Blue Shield Physicians: Did You Get A Blue Ribbon?
• CMA Provides Resources to Help Physicians Comply with New Medical Board Signage Regs
• Congress Again Recesses Without Stopping 21% SGR Cut
• Federal Medi-Cal Audits to Begin in August
• State Auditor Finds that MediCal TAR Process Should Be Streamlined
• AMA Sues FTC to Stop Red Flag Rule; FTC Again Delays Implementation
• PECOS Enrollment Deadline Moved Up to July 6, 2010
• DMHC Orders Health Plans to Terminate or Modify Contracts With La Vida Medical Group
• Medicare Fee Schedule Revisions Take Effect June 1
****PALMETTO/J1MAC NEWS****
J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes for National Coverage
Determinations
Share with your staff - The HCPCS Code(s) and the associated ICD-9 Code(s)
for Stem Cell Transplantation National Coverage Determination (NCD) have
been added to the list of J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes
for National Coverage Determinations.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RCMMD8585?opendocument
J1 Provider Outreach and Education Event Calendar
Check out the Palmetto GBA J1 Provider Outreach and Education June Event
Calendar for all the educational opportunities we offer besides the Spring
Workshop Tour.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
E/M Services Review Checklist and Scoresheet Form: New and Established
Patients
Palmetto GBA is pleased to announce the expansion of the online Evaluation
and Management (E/M) Checklist and Scoresheet Form options. Based on the
Current Procedural Terminology (CPT), the expanded tool can now be used for
services rendered to both new and established patients.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83WNBR2836?opendocument
Self-Administered Drugs Exclusion List 2010
Share with your staff - Revision history has been added to the J1 Part B
2010 Self-Administered Drugs Exclusion List. For specific revisions, check
out the Version links at the end of the PDF attachment.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7QWPBL3352?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!
****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-6-2-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• SGR Fix: Good and Bad News
• Share the Wealth of Resources, Earn Dividends
• ASCO Attendees Take Note: All-Star Panel to Explore Expanding Cancer Care
• Follow-up Care for Blood Cancer Survivors: New Educational Webcast
• Heard on ACCC's ListServ: Anthracycline Therapy and Monitoring Cardiac Status
• ACCC's CE Blackboard: New Multiple Myeloma CE Program Available
• Eisai's Investigational Agent Eribulin Mesylate Recieves FDA Priority Review Status
****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:
• Accountable Care Organizations: How Will They Impact Your Practice?
• Blue Shield Physicians: Did You Get A Blue Ribbon?
• CMA Provides Resources to Help Physicians Comply with New Medical Board Signage Regs
• Congress Again Recesses Without Stopping 21% SGR Cut
• Federal Medi-Cal Audits to Begin in August
• State Auditor Finds that MediCal TAR Process Should Be Streamlined
• AMA Sues FTC to Stop Red Flag Rule; FTC Again Delays Implementation
• PECOS Enrollment Deadline Moved Up to July 6, 2010
• DMHC Orders Health Plans to Terminate or Modify Contracts With La Vida Medical Group
• Medicare Fee Schedule Revisions Take Effect June 1
****PALMETTO/J1MAC NEWS****
J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes for National Coverage
Determinations
Share with your staff - The HCPCS Code(s) and the associated ICD-9 Code(s)
for Stem Cell Transplantation National Coverage Determination (NCD) have
been added to the list of J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes
for National Coverage Determinations.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RCMMD8585?opendocument
J1 Provider Outreach and Education Event Calendar
Check out the Palmetto GBA J1 Provider Outreach and Education June Event
Calendar for all the educational opportunities we offer besides the Spring
Workshop Tour.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
E/M Services Review Checklist and Scoresheet Form: New and Established
Patients
Palmetto GBA is pleased to announce the expansion of the online Evaluation
and Management (E/M) Checklist and Scoresheet Form options. Based on the
Current Procedural Terminology (CPT), the expanded tool can now be used for
services rendered to both new and established patients.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83WNBR2836?opendocument
Self-Administered Drugs Exclusion List 2010
Share with your staff - Revision history has been added to the J1 Part B
2010 Self-Administered Drugs Exclusion List. For specific revisions, check
out the Version links at the end of the PDF attachment.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7QWPBL3352?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!
Tuesday, June 1, 2010
ASH & 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/5270.aspx. This edition features:
• Congress Scales Back Physician Payment Plan; Passage Needed Before June 1 to Avert Cuts
• PQRI Reporting Period Begins July 1, 2010 – ASH Encourages Participation
• CMS Provides PQRI 2008 Incentive Payment Adjustments
• Medicare Program Adjusts Payments for 2010
****PALMETTO/J1MAC NEWS****
2010 J1 Mammography Fee Schedule (XLS, 21 KB)
Share with your staff - The 2010 J1 Mammography Fee Schedule has been
updated on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZFTY68431?opendocument
June 2010 J1 A/B MAC Medicare Advisory
The June 2010 J1 A/B MAC Medicare Advisory is now available on the J1 Web
site. Providers are encouraged to review the information and to share with
their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/85TLBL6446?opendocument
Clinical Review Judgment
This J1 A/B MAC MLN Matters article (CR6954) updates the Medicare Program
Integrity Manual by adding a new section (3.14 - Clinical Review Judgment),
which clarifies existing language regarding clinical review judgments and
also requires that Medicare Claim Review Contractors instruct their
clinical review staffs to use the clinical review judgment process when
making complex review determinations about a claim. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/85UM5C8153?opendocument
Information Regarding the Holding of June 2010 Claims for Services Paid
Under the 2010 Medicare Physician Fee Schedule
The Continuing Extension Act of 2010, enacted on April 15, 2010, extended
the zero percent (0%) update to the 2010 Medicare Physician Fee Schedule
(MPFS) through May 31, 2010. The Centers for Medicare & Medicaid Services
(CMS) believes Congress is working to avert the negative update scheduled
to take effect June 1, 2010. To avoid disruption in the delivery of health
care services to beneficiaries and payment of claims for physicians,
non-physician practitioners, and other providers of services paid under the
MPFS, CMS has instructed its contractors to hold claims containing services
paid under the MPFS (including anesthesia services) for the first 10
business days of June.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/85UNF53517?opendocument
Medically Unlikely Edits (MUE): Change Request 6712
These are the updated instructions for Change Request 6712, Medically
Unlikely Edits (MUE). The instructions are being posted because there will
not be an MLN Matters article that addresses this subject matter. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZNTJ54702?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!
****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/5270.aspx. This edition features:
• Congress Scales Back Physician Payment Plan; Passage Needed Before June 1 to Avert Cuts
• PQRI Reporting Period Begins July 1, 2010 – ASH Encourages Participation
• CMS Provides PQRI 2008 Incentive Payment Adjustments
• Medicare Program Adjusts Payments for 2010
****PALMETTO/J1MAC NEWS****
2010 J1 Mammography Fee Schedule (XLS, 21 KB)
Share with your staff - The 2010 J1 Mammography Fee Schedule has been
updated on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZFTY68431?opendocument
June 2010 J1 A/B MAC Medicare Advisory
The June 2010 J1 A/B MAC Medicare Advisory is now available on the J1 Web
site. Providers are encouraged to review the information and to share with
their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/85TLBL6446?opendocument
Clinical Review Judgment
This J1 A/B MAC MLN Matters article (CR6954) updates the Medicare Program
Integrity Manual by adding a new section (3.14 - Clinical Review Judgment),
which clarifies existing language regarding clinical review judgments and
also requires that Medicare Claim Review Contractors instruct their
clinical review staffs to use the clinical review judgment process when
making complex review determinations about a claim. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/85UM5C8153?opendocument
Information Regarding the Holding of June 2010 Claims for Services Paid
Under the 2010 Medicare Physician Fee Schedule
The Continuing Extension Act of 2010, enacted on April 15, 2010, extended
the zero percent (0%) update to the 2010 Medicare Physician Fee Schedule
(MPFS) through May 31, 2010. The Centers for Medicare & Medicaid Services
(CMS) believes Congress is working to avert the negative update scheduled
to take effect June 1, 2010. To avoid disruption in the delivery of health
care services to beneficiaries and payment of claims for physicians,
non-physician practitioners, and other providers of services paid under the
MPFS, CMS has instructed its contractors to hold claims containing services
paid under the MPFS (including anesthesia services) for the first 10
business days of June.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/85UNF53517?opendocument
Medically Unlikely Edits (MUE): Change Request 6712
These are the updated instructions for Change Request 6712, Medically
Unlikely Edits (MUE). The instructions are being posted because there will
not be an MLN Matters article that addresses this subject matter. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZNTJ54702?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!
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