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/5460.aspx. This edition features:

• President Signs Physician Payment Adjustment

• CMS Releases Proposed Rule on Medicare Physician Fee Schedule for CY 2011

• Medicare Releases 2011 Proposed Rule for Hospital Outpatient Services

• President Obama Appoints Donald Berwick to Be CMS Administrator

• CMS Addresses Concerns About PECOS Enrollment – Delays Automatic Rejection of Claims

• 2010 PQRI & Electronic Prescribing Incentive Program National Provider Call With Question & Answer Session

• CMS Updates Information About ICD-10


****PALMETTO/J1MAC NEWS****
Electronically Submitted Medicare Secondary Payer (MSP) Claims
Effective July 6, 2010, electronically submitted MSP claims will be
rejected if the Primary Payer’s Allowed Amount is not greater than or equal
to the Primary Payer’s Paid Amount.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/875RBN7285?opendocument


J1 Part B LCDs Revised
The following J1 Part B LCDs have been revised: Cataract Surgery in Adults
L30891, Intensity Modulated Radiation Therapy (IMRT) L28272, Noninvasive
Peripheral Venous Studies L28285, T-wave Alternans Testing L28305 and
Treatment of Ulcers & Symptomatic Hyperkeratoses L28308.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/876Q4K8456?opendocument


Ordering/Referring Provider Information in PECOS
At this time, Medicare contractors (including Palmetto GBA) will not
implement changes that would automatically reject claims based on orders,
certifications and referrals made by providers that have not yet had their
applications approved by July 6, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/876PNE0782?opendocument


Updated: Independent Diagnostic Testing Facilities - Availability of new
2010 Annual Procedure Codes
This Alert announces that a mass adjustment was completed on March 17, 2010
for Northern CA, Southern CA, HI and NV claims that were denied
incorrectly. Per the Contractor Medical Director (CMD) review, certain
services from the 2010 Annual Procedure Codes Update were generally
approved as allowable procedures to be performed in Independent Diagnostic
Testing Facilities (IDTF), as long as all other certifications and
requirements were accomplished. However, these services were not added as
approved in the system at that time. As a result, several claims were
denied incorrectly. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83UNAS7187?opendocument


Updates: Medicare Physician Fee Schedule
On June 23 and June 24, 2010, Palmetto GBA released some payments that werE
based on the reduced fee schedule. We will automatically process
adjustments to these claims. Palmetto GBA is currently processing claims
using the new 2.2 percent update rates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/876P2B4638?opendocument


J1 PCC to Close for Training on July 22
The J1 PCC will be closed for training on Thursday, July 22, 2010, from 7
a.m. to 5 p.m. PST. The Call Center will re-open on Friday, July 23, 2010,
at 7 a.m. PST. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/877QWY2338?opendocument


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