Palmetto/J1MAC News

The following information has been received by ANCO.


****PALMETTO/J1MAC NEWS****
The 'Physician Payment and Therapy Relief Act of 2010' Extends 2.2 Percent
Medicare Physician Fee Schedule Update
On November 30, 2010, President Obama signed into law 'The Physician
Payment and Therapy Relief Act of 2010.' This law extends through December
31, 2010, the 2.2 percent update to the Medicare Physician Fee Schedule
(MPFS) that has been in effect for Medicare Physician Fee Schedule (MPFS)
claims with dates of service of June 1, 2010, through November 30, 2010.
Payments for 2010 services under the MPFS will continue without delay.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BQRY48715?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Update to Medicare Deductible, Coinsurance and Premium Rates for 2011
This J1 A/B MAC MLN Matters article (CR7224) provides the Medicare rates
for deductible, coinsurance and premium payment amounts for Calendar Year
(CY) 2011. A beneficiary is responsible for an inpatient hospital
deductible amount, which is deducted from the amount payable by the
Medicare program to the hospital for inpatient hospital services furnished
in a spell of illness. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BPSYJ3265?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Calendar Year (CY) 2011 Annual Update for Clinical Laboratory Fee Schedule
and Laboratory Services Subject to Reasonable Charge Payment
This J1 A/B MAC MLN Matters article (CR 6991) provides instructions for the
CY 2011 clinical laboratory fee schedule, mapping for new codes for
clinical laboratory tests and updates for laboratory costs subject to the
reasonable charge payment. Please share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BRJ3V0164?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Important Information on the Timely Claims Filing Requirement
Effective immediately, all claims for services furnished on or after
January 1, 2010, must be filed with your Medicare contractor no later than
one calendar year (12 months) from the date of service, or Medicare will
deny those claims. If you have Medicare fee-for-service claims with service
dates from October 1, 2009, through December 31, 2009, those claims must be
filed by December 31, 2010, or Medicare will deny those claims. Claims with
service dates from January 1, 2009, to October 1, 2009, keep their original
December 31, 2010 deadline for filing.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BRLA36358?opendocument&utm_source=J1BL&utm_campaign=J1BLs


Information Regarding the Billing of New Q HCPCS Codes for 2010-2011
Seasonal Influenza Vaccines for Medicare Fee-for-Service Providers
Physicians, other practitioners and suppliers may submit their claims with
the new influenza Q HCPCS codes on an individual basis or via the roster
billing process. CMS has instructed Medicare contractors to hold all claims
containing the influenza Q HCPCS codes with dates of service on or after
October 1, 2010, until their systems are able to accept them for
processing. The Medicare contractors’ systems will be ready to process
claims containing the Q HCPCS codes no later than February 7, 2011.
Physicians, other practitioners and suppliers also have the option to hold
their claims containing the new influenza Q HCPCS codes until February 7,
2011.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BRJJC5038?opendocument&utm_source=J1BL&utm_campaign=J1BLs


2010 - 2011 Seasonal Influenza (Flu) Resources for Health Care
Professionals
This special edition article (SE1031b) was revised on November 29, 2010, to
include a reference to MLN Matters article MM7234 (New HCPCS Q-codes for
2010–2011 Seasonal Influenza Vaccines). 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&utm_source=J1BL&utm_campaign=J1BLs


Claim Editing for Ordering/Referring Providers
Note: Please disregard the listserv message for this article that was sent
on December 2, 2010. The statement 'CMS previously announced' was
inadvertently omitted from the December 2 listserv. We apologize for the
inconvenience. Although the article on the J1 Web site is correct, the
listserv was inaccurate and will be replaced with the following message:
This article announces that automated edits for ordering/referring
providers will not be turned on effective January 3, 2011. The Centers for
Medicare & Medicaid Services (CMS) previously announced that, beginning
January 3, 2011, if certain Part B billed items and services require an
ordering/referring provider, and the ordering/referring provider is: 1) Not
in the claim; 2) Is not of a profession that is permitted to order/refer;
or 3) Does not have an enrollment record in the Medicare Provider
Enrollment, Chain and Ownership System (PECOS), the claim will not be paid.
Providers are encouraged to review the information and to share with their
staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8BQKQL6582?opendocument&utm_source=J1BL&utm_campaign=J1BLs


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!