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-11-3-2010.html. ANCO is an Institutional Member of ACCC. This edition features:

• CMS Issues Final 2011 HOPPS Rule and Physician Fee Schedule

• Updated Part B Drug Information Guide Available Online

• Take Our Short Survey: Risk Information and ESAs

• Heard on ACCC's ListServ: Infusion Center Staffing

• EHR Incentive Program: Certified Health IT Product List

• Drugs in the News

• November Supplement to Come: Clinical Update on Care in Indolent Lymphoma


****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:

• CMA House of Delegates Adopts ACO Principles

• Has Your Contracted Health Plan or IPA Stopped Paying Claims?

• Medicare Claims Will Not Be Paid If Ordering or Referring Provider is Not in PECOS by January 3, 2011

• CMS PQRI Payments in the Mail

• New Issue of CMA Practices Resources (CPR) Now Available


****PALMETTO/J1MAC NEWS****
ANSI v5010: CMS-1500 to ANSI 837 v5010 Crosswalk
This article is the third in a series regarding implementation of version
5010 as the new standard for all ANSI ASC X12N electronic transactions.
This article includes a crosswalk from the CMS-1500 claim form to the ANSI
837 v5010 electronic claim format.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8ANJA28028?opendocument


Definition of a 'New Patient' for E/M Services
A ‘new patient’ is a patient who has not received any professional
services, such as evaluation and management (E/M) service or other
face-to-face service (e.g., surgical procedure) from the physician or
physician group practice (same physician specialty) within the previous
three years.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~87MH756568?opendocument


Evaluation and Management (E/M) Coding Reminders
This article provides guidance and helpful reminders about submitting
Evaluation and Management services.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~855RZS5055?opendocument


Evaluation & Management (E/M) Coding Reminder: Group Practices
Physicians in the same group practice who are in the same specialty must
bill and be paid as though they were a single physician. If more than one
evaluation and management (face-to-face) service is provided on the same
day to the same patient by the same physician or more than one physician in
the same specialty in the same group, only one evaluation and management
service may be reported unless the evaluation and management services are
for unrelated problems. Instead of billing separately, the physicians
should select a level of service representative of the combined visits and
submit the appropriate code for that level. This article serves as an
important reminder of the long standing policy for physicians in a group
practice. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7RDS6S7664?opendocument


2010 - 2011 Seasonal Influenza (Flu) Resources for Health Care
Professionals
This special edition article (SE1031a) was revised on October 26, 2010, to
include references to MLN Matters® article MM7120 (Influenza Vaccine
Payment Allowances – Annual Update for 2010 – 2011 Season) and to a new
Web-Based Training Module available on Medicare preventive services. In
this article, the Centers for Medicare & Medicaid Services (CMS) reminds
health care professionals that Medicare Part B reimburses health care
providers for seasonal flu vaccines and their administration. Medicare
provides coverage of the seasonal flu vaccine without any out-of-pocket
costs to the Medicare patient. Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8A5NMV3805?opendocument


Annual Clotting Factor Furnishing Fee Update 2011
This J1 A/B MAC MLN Matters article (CR7168) announces that for calendar
year 2011, the clotting factor furnishing fee of $0.176 per unit is
included in the published payment limit for clotting factors. The fee will
be added to the payment for a clotting factor when no payment limit for the
clotting factor is published either on the Average Sales Price (ASP) or Not
Otherwise Classified (NOC) drug. Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8ATPJR8268?opendocument


Twelfth National Education Call on Medicare Fee-For-Service (FFS)
Implementation of HIPAA Version 5010 and D.0 Transactions
The Centers for Medicare & Medicaid Services (CMS) will host its twelfth
national education call regarding Medicare FFS’s implementation of HIPAA
Version 5010 and D.0 transaction standards on November 17, 2010. This
session will focus on the Coordination of Benefits (COB).
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AVG7R7051?opendocument


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