The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
October 2010 J1 A/B MAC Medicare Advisory
The October 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/ls/J1B~89JPXZ8868?opendocument
Claim Status Category and Claim Status Codes Update
This J1 A/B MAC MLN Matters article (CR7158) explains that the Claim Status
Codes and Claim Status Category Codes for use by Medicare Contractors, as
well as several additional items, will be posted to the Washington
Publishing Company Web site on or about November 1, 2010. Included in the
code lists are specific details, including the date when a code was added,
changed or deleted. Medicare Contractors will implement these changes on
January 3, 2011. Providers are encouraged to review the information and to
share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89KQCJ6463?opendocument
J1 Open Draft LCD Meeting: California, October 19, 2010
Share with your staff - Palmetto GBA J1 A/B MAC will host an Open Draft
Local Coverage Determination (LCD) meeting in California, October 19, 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/ls/J1B~7TKQ3P7107?opendocument
October Update to the 2010 Medicare Physician Fee Schedule Database
(MPFSDB)
This J1 A/B MAC MLN Matters article (CR7112) amends payment files issued to
Medicare Contractors based upon the 2010 Medicare Physician Fee Schedule
Final Rule. Medicare Contractors will not search their files to either
retract payment for claims already paid or to retroactively pay claims that
were processed prior to implementation of CR 7112. However, Contractors
will adjust claims brought to their attention. Providers are encouraged to
review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89KQA55235?opendocument
Eligible Physicians and Non-Physician Practitioners who need to Enroll in
the Medicare Program for the Sole Purpose of Ordering and Referring Items
and Services for Medicare Beneficiaries
This J1 Part B MLN Matters article (CR7097) announces that physicians and
non-physician practitioners will need to enroll in the Medicare program so
they can order and refer items and services for Medicare beneficiaries. The
enrollment requirement is specified in the article. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89KQ6F6732?opendocument
J1 Part B Accepts Redetermination Reqeusts via Fax October 1
Share with your staff - Effective October 1, 2010, Palmetto GBA will begin
accepting Part B redetermination requests via fax. No special preparation
is necessary for redetermination requests submitted via fax. All currently
required elements are necessary to be present for faxed requests. You may
fax your J1 Part B Redetermination requests to (803) 462-3914.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89LRFJ3001?opendocument
2011 Annual Update for the Health Professional Shortage Area (HPSA) Bonus
Payments
This J1 A/B MAC MLN Matters article (CR7139) alerts providers that the
annual HPSA bonus payment 2011 file will be made available by the Centers
for Medicare & Medicaid Services (CMS) to your Medicare Contractor on
November 15, 2010. This file will be used for Health Professional Shortage
Area (HPSA) bonus payments on applicable claims with dates of service on or
after January 1, 2011, through December 31, 2011. Providers are encouraged
to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89KQME0048?opendocument
National Correct Coding Initiative (NCCI) Tool
The National Correct Coding Initiative (NCCI) packages, or 'bundles,'
reimbursement for some services under Medicare. NCCI identifies code pairs
that are never reimbursed separately and code pairs that can only be
reimbursed separately in certain circumstances (identified by the
appropriate modifier). Please use the NCCI tool to determine if the service
you are submitting is bundled with another service.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89QGRF8716?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, September 30, 2010
Friday, September 24, 2010
ASH, CMA, & 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/5774.aspx. This edition features:
• Health Reform Law Passes SIx-Month Milestone: Initial Reforms Begin to Take Effect
• Register for ASH Webinar Series on Thrombosis
• ASH Comments on Proposed HIPAA Modifications: Recommends Flexibility During Implementation
• AHRQ Technology Assessment on Off-Label Cancer Treatment Incorporates ASH Comments to Address Concerns
• CMS Introduces Webpage Dedicated to ICD-9/10 Transition in a CMS Version 5010 Environment
• CMS Publishes October 2010 ASP and NOC Pricing FIles and Crosswalks
• Register for the 52nd ASH Annual Meeting by November 4
****CMA NEWS****
The California Medical Association's (CMA) CMA Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
• CMA Files Lawsuit Against Blue Shield for Bogus Physician Rating System
• There's Still Time to Claim Your Share of the $350M UnitedHealth Settlement
• CMA Advocacy Results in Changes to UnitedHealthcare Coverage Determination Guideline
• CMA Receives Grant for Electronic Health Records Support
• Federal EHR Incentives: Do You Qualify?
• CMA Tells IOM That Medicare Rates Must Reflect Regional Costs
****PALMETTO/J1MAC NEWS****
PECOS Dark Days
Due to scheduled maintenance, the Internet-based Provider Enrollment, Chain
and Ownership System (PECOS) will be unavailable from Wednesday, September
29, 2010, through Sunday, October 3, 2010. Internet-based PECOS allows
physicians, non-physician practitioners, providers and other suppliers to
enroll or make a change to their existing Medicare enrollment information
over the Internet.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89CLB68565?opendocument
2011 Annual Update of Healthcare Common Procedure Code System (HCPCS) Codes
for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update
This J1 A/B MAC MLN Matters article (CR7159) provides the 2011 annual
update of Healthcare Common Procedure Coding System (HCPCS) Codes for
Skilled Nursing Facility Consolidated Billing (SNF CB) and how the updates
affect edits in Medicare claims processing systems. Physicians and
providers are advised that, by the first week in December 2010, new code
files will be posted on the Centers for Medicare & Medicaid Services (CMS)
Web site. Note that this site will include new Excel and PDF format files.
It is important and necessary for the provider community to view the
‘General Explanation of the Major Categories’ PDF file located at the
bottom of each year’s FI/A/B MAC update listed on the CMS Web site in order
to understand the Major Categories, including additional exclusions not
driven by HCPCS codes. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89BNAE2184?opendocument
Tenth 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 tenth
national education call on September 29, 2010, regarding implementation of
HIPAA Version 5010 and D.0 transaction standards for Medicare
Fee-for-Service (FFS). This session will focus on the TA1, 999 and 277CA
transactions. Subject matter experts will review Medicare FFS specific
changes as well as general information to help the audience prepare for the
transition. The presentation will be followed by a question and answer
session.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89DFW21218?opendocument
Update to the Healthcare Provider Taxonomy Codes (HPTC) - January 1, 2011
In this article, the Centers for Medicare and Medicaid Services (CMS) has
released the summary of changes reflected in the Health Care Provider
Taxonomy Code (HPTC) list. A/B MACs will update their HPTC tables with this
new version effective on January 1, 2011. Providers are encouraged to
review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89GLU94224?opendocument
Provider Medicare Voluntary Refunds: Immediate Offset Requests Terminated
This article announces that, as of October 1, 2010, Palmetto GBA will no
longer allow providers to request 'immediate offset' as a payment method
relating to voluntary/self-disclosed Medicare overpayments. Providers must
submit a check made payable to Palmetto GBA or Medicare with the
overpayment refund form. If the check payee is addressed differently, the
check will be returned to the provider. Overpayment refund forms received
without check payment will be processed under established collection
procedures mandated by the Centers for Medicare & Medicaid Services (CMS).
Providers are encouraged to review the information and to share with their
staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89DRTZ7213?opendocument
Further 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)
Change Request (CR) 7032 provides additional instructions to clarify
instructions previously sent or not implemented correctly, and to set up a
process to follow when corrective actions must be developed and implemented
for Out Of Balance situations. This announces that the Centers for Medicare
& Medicaid Services (CMS) is in the process of implementing the next
version of the HIPAA Transaction 835 standard – referred to as 835v5010 in
this document. The Secretary of the Department of Health and Human Services
(DHHS) has adopted ASC X12 version 5010 and NCPDP version D.0 as the next
HIPAA standard for HIPAA covered transactions. The final rule was published
on January 16, 2009. Providers are encouraged to review the information and
to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89HJL77718?opendocument
J1PCC to Close on September 24
The J1PCC will be closed for training on Friday, September 24, 2010, from
11 a.m. to 3 p.m. (PDT). The Call Center will re-open at 3 p.m. PDT.
Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/89JR771328?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/5774.aspx. This edition features:
• Health Reform Law Passes SIx-Month Milestone: Initial Reforms Begin to Take Effect
• Register for ASH Webinar Series on Thrombosis
• ASH Comments on Proposed HIPAA Modifications: Recommends Flexibility During Implementation
• AHRQ Technology Assessment on Off-Label Cancer Treatment Incorporates ASH Comments to Address Concerns
• CMS Introduces Webpage Dedicated to ICD-9/10 Transition in a CMS Version 5010 Environment
• CMS Publishes October 2010 ASP and NOC Pricing FIles and Crosswalks
• Register for the 52nd ASH Annual Meeting by November 4
****CMA NEWS****
The California Medical Association's (CMA) CMA Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
• CMA Files Lawsuit Against Blue Shield for Bogus Physician Rating System
• There's Still Time to Claim Your Share of the $350M UnitedHealth Settlement
• CMA Advocacy Results in Changes to UnitedHealthcare Coverage Determination Guideline
• CMA Receives Grant for Electronic Health Records Support
• Federal EHR Incentives: Do You Qualify?
• CMA Tells IOM That Medicare Rates Must Reflect Regional Costs
****PALMETTO/J1MAC NEWS****
PECOS Dark Days
Due to scheduled maintenance, the Internet-based Provider Enrollment, Chain
and Ownership System (PECOS) will be unavailable from Wednesday, September
29, 2010, through Sunday, October 3, 2010. Internet-based PECOS allows
physicians, non-physician practitioners, providers and other suppliers to
enroll or make a change to their existing Medicare enrollment information
over the Internet.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89CLB68565?opendocument
2011 Annual Update of Healthcare Common Procedure Code System (HCPCS) Codes
for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update
This J1 A/B MAC MLN Matters article (CR7159) provides the 2011 annual
update of Healthcare Common Procedure Coding System (HCPCS) Codes for
Skilled Nursing Facility Consolidated Billing (SNF CB) and how the updates
affect edits in Medicare claims processing systems. Physicians and
providers are advised that, by the first week in December 2010, new code
files will be posted on the Centers for Medicare & Medicaid Services (CMS)
Web site. Note that this site will include new Excel and PDF format files.
It is important and necessary for the provider community to view the
‘General Explanation of the Major Categories’ PDF file located at the
bottom of each year’s FI/A/B MAC update listed on the CMS Web site in order
to understand the Major Categories, including additional exclusions not
driven by HCPCS codes. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89BNAE2184?opendocument
Tenth 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 tenth
national education call on September 29, 2010, regarding implementation of
HIPAA Version 5010 and D.0 transaction standards for Medicare
Fee-for-Service (FFS). This session will focus on the TA1, 999 and 277CA
transactions. Subject matter experts will review Medicare FFS specific
changes as well as general information to help the audience prepare for the
transition. The presentation will be followed by a question and answer
session.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89DFW21218?opendocument
Update to the Healthcare Provider Taxonomy Codes (HPTC) - January 1, 2011
In this article, the Centers for Medicare and Medicaid Services (CMS) has
released the summary of changes reflected in the Health Care Provider
Taxonomy Code (HPTC) list. A/B MACs will update their HPTC tables with this
new version effective on January 1, 2011. Providers are encouraged to
review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89GLU94224?opendocument
Provider Medicare Voluntary Refunds: Immediate Offset Requests Terminated
This article announces that, as of October 1, 2010, Palmetto GBA will no
longer allow providers to request 'immediate offset' as a payment method
relating to voluntary/self-disclosed Medicare overpayments. Providers must
submit a check made payable to Palmetto GBA or Medicare with the
overpayment refund form. If the check payee is addressed differently, the
check will be returned to the provider. Overpayment refund forms received
without check payment will be processed under established collection
procedures mandated by the Centers for Medicare & Medicaid Services (CMS).
Providers are encouraged to review the information and to share with their
staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89DRTZ7213?opendocument
Further 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)
Change Request (CR) 7032 provides additional instructions to clarify
instructions previously sent or not implemented correctly, and to set up a
process to follow when corrective actions must be developed and implemented
for Out Of Balance situations. This announces that the Centers for Medicare
& Medicaid Services (CMS) is in the process of implementing the next
version of the HIPAA Transaction 835 standard – referred to as 835v5010 in
this document. The Secretary of the Department of Health and Human Services
(DHHS) has adopted ASC X12 version 5010 and NCPDP version D.0 as the next
HIPAA standard for HIPAA covered transactions. The final rule was published
on January 16, 2009. Providers are encouraged to review the information and
to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89HJL77718?opendocument
J1PCC to Close on September 24
The J1PCC will be closed for training on Friday, September 24, 2010, from
11 a.m. to 3 p.m. (PDT). The Call Center will re-open at 3 p.m. PDT.
Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/89JR771328?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, September 16, 2010
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
Don’t Delay - Send In Your CERT Documentation Immediately!
If you have received a request from the CERT Review Contractor to submit
documentation, please be advised that the deadline is quickly approaching.
Time is running out so please respond by submitting the requested
documentation to the CERT Review Contractor by Tuesday, September 21. You
should forward the documentation to the designated contact information
provided in the letter from the CERT Review Contractor. We urge you to
respond and share this information with the appropriate staff within your
organization.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~894PHR3517?opendocument
Open Draft LCD Meetings October 2010
Share with your staff - Palmetto GBA J1 A/B Medicare Administrative
Contractor (MAC) has scheduled Open Draft Local Coverage Determination
(LCD) meetings in California, Nevada and Hawaii for October 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/ls/J1B~7YDPHY0633?opendocument
Workshop: Issues Related to Accountable Care Organizations
On October 5, 2010, the Federal Trade Commission (FTC) will co-host a
workshop on several issues associated with Accountable Care Organizations
(ACOs), organizations authorized by the new Affordable Care Act that seek
to deliver high-quality and efficient health care services to consumers.
The workshop, which will be held at CMS Headquarters in Baltimore,
Maryland, is free and open to the public.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~895ELV5346?opendocument
CMS Makes Information about Physician Fee Schedule Payment Rates More
Accessible
CMS has updated and enhanced the Medicare Physician Fee Schedule Lookup to
allow the user to: download search results into a CSV file, modify search
criteria without starting over, search on all available types of
information at the same time (Pricing Information, Payment Policy
Indicators, Relative Value Units and Geographical Practice Cost Index), and
sort and view results table columns in ascending or descending order.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~896HMB1802?opendocument
CMS to Host Listening Session Regarding Confidential Feedback Reports and
the Implementation of a Value-Based Payment Modifier for Physicians
CMS will host a listening session on September 24 as part of the transition
to a value-based purchasing program for services of physicians and certain
other professionals, as well as other related provisions under the Patient
Protection and Affordable Care Act (ACA). The ACA contains provisions that
continue and expand the Physician Feedback Program and also require
implementation of a value-based payment modifier to the Fee-for-Service
physician fee schedule. The purpose of the listening session is to solicit
comments on approaches being considered as CMS implements these provisions.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~896HNZ5433?opendocument
Implementation of the PWK (Paperwork) Segment for X12N Version 5010
This J1 A/B MAC MLN Matters article (CR7041) announces the implementation
of the PWK (paperwork) segment for X12N Version 5010. The PWK segment
provides the ‘linkage’ between electronic claims and additional
documentation which is needed for claims adjudication. Although the PWK
segment allows for an electronic submission of additional documentation,
this preliminary implementation will only allow for submission of
additional documentation via mail and fax. Providers are encouraged to
review the information and share it with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~896S543018?opendocument
J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes for National Coverage
Determinations
The HCPCS Codes and the associated ICD-9 Codes for Stem Cell
Transplantation National Coverage Determination (NCDs) have been added to
the list of J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes for National
Coverage Determinations. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7RCMMD8585?opendocument
J1 Part B LCDs Revised
Share with your staff - Multiple J1 Part B LCDs have been revised. To view
these LCDs, go to the ‘LCDs and NCDs’ Web page under the Medical Policies
section of the J1 Part B Web site.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~899NK26615?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****
Don’t Delay - Send In Your CERT Documentation Immediately!
If you have received a request from the CERT Review Contractor to submit
documentation, please be advised that the deadline is quickly approaching.
Time is running out so please respond by submitting the requested
documentation to the CERT Review Contractor by Tuesday, September 21. You
should forward the documentation to the designated contact information
provided in the letter from the CERT Review Contractor. We urge you to
respond and share this information with the appropriate staff within your
organization.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~894PHR3517?opendocument
Open Draft LCD Meetings October 2010
Share with your staff - Palmetto GBA J1 A/B Medicare Administrative
Contractor (MAC) has scheduled Open Draft Local Coverage Determination
(LCD) meetings in California, Nevada and Hawaii for October 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/ls/J1B~7YDPHY0633?opendocument
Workshop: Issues Related to Accountable Care Organizations
On October 5, 2010, the Federal Trade Commission (FTC) will co-host a
workshop on several issues associated with Accountable Care Organizations
(ACOs), organizations authorized by the new Affordable Care Act that seek
to deliver high-quality and efficient health care services to consumers.
The workshop, which will be held at CMS Headquarters in Baltimore,
Maryland, is free and open to the public.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~895ELV5346?opendocument
CMS Makes Information about Physician Fee Schedule Payment Rates More
Accessible
CMS has updated and enhanced the Medicare Physician Fee Schedule Lookup to
allow the user to: download search results into a CSV file, modify search
criteria without starting over, search on all available types of
information at the same time (Pricing Information, Payment Policy
Indicators, Relative Value Units and Geographical Practice Cost Index), and
sort and view results table columns in ascending or descending order.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~896HMB1802?opendocument
CMS to Host Listening Session Regarding Confidential Feedback Reports and
the Implementation of a Value-Based Payment Modifier for Physicians
CMS will host a listening session on September 24 as part of the transition
to a value-based purchasing program for services of physicians and certain
other professionals, as well as other related provisions under the Patient
Protection and Affordable Care Act (ACA). The ACA contains provisions that
continue and expand the Physician Feedback Program and also require
implementation of a value-based payment modifier to the Fee-for-Service
physician fee schedule. The purpose of the listening session is to solicit
comments on approaches being considered as CMS implements these provisions.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~896HNZ5433?opendocument
Implementation of the PWK (Paperwork) Segment for X12N Version 5010
This J1 A/B MAC MLN Matters article (CR7041) announces the implementation
of the PWK (paperwork) segment for X12N Version 5010. The PWK segment
provides the ‘linkage’ between electronic claims and additional
documentation which is needed for claims adjudication. Although the PWK
segment allows for an electronic submission of additional documentation,
this preliminary implementation will only allow for submission of
additional documentation via mail and fax. Providers are encouraged to
review the information and share it with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~896S543018?opendocument
J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes for National Coverage
Determinations
The HCPCS Codes and the associated ICD-9 Codes for Stem Cell
Transplantation National Coverage Determination (NCDs) have been added to
the list of J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes for National
Coverage Determinations. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7RCMMD8585?opendocument
J1 Part B LCDs Revised
Share with your staff - Multiple J1 Part B LCDs have been revised. To view
these LCDs, go to the ‘LCDs and NCDs’ Web page under the Medical Policies
section of the J1 Part B Web site.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~899NK26615?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, September 10, 2010
ASH, ACCC, CMA, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Centers (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2010/ACCConnect-9-8-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• Two New Educational Offerings on ACCC's CE Blackboard
• Meet Us in St. Louis!
• ACCC Submits Comments to CMS on 2011 Proposed Hospital Outpatient Prospective Payment System Rule
• Heard on ACCC's ListServ: Referrals/Pre-authorizations for Outpatient Chemotherapy
• CMS Offers National Provider Call on ICD-10 Implementation in a 5010 Environment
• For Women with BRCA Mutations, Prophylactic Surgery Reduces Cancer Risk
****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/Practice/Practice-Updates/5709.aspx. This edition features:
• Earn CME Credits from Blood
• CMS Offers Incentive Payments for Participation in HIT and Quality Initiatives
• CMS to Host Conference Call on ICD-10 Implementation
• CMS Releases Quarterly Update to Correct Coding Initiative Edits
• Legislative & Judicial Action Concerning Embryonic Stem Cell Research
• Register for ASH Webinar Series on Thrombosis
• Register for the 52nd ASH Annual Meeting by November 4
****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:
• CME Certification Forms Are In the Mail
• Modesto Physician Appointed to California Medical Board
• Applications Now Available for California's New Preexisting Condition Insurance Plan
• More Health Reform Provisions Take Effect September 23
• CMA Comments on the 2011 Medicare Physician Payment Rule
• Blue Shield Pulls Out of Healthy Families in 15 Counties
• Blue Cross Extends Healthy Families Continuity of Care Plan for Physicians in Most Counties
• Legislature Passes Bill Banning Rescissions
• Bill Protecting Kids' Access to Vaccines Goes to Governor's Desk
****PALMETTO/J1MAC NEWS****
J1 Part B LCDs Revised
Share with your staff - The following J1 Part B Local Coverage
Determinations (LCDs) have been revised: Botulinum Toxin Types A and B
Policy L28242 and Implantable Infusion Pump for Treatment of Chronic
Intractable Pain L28268.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~88VPX33722?opendocument
J1 Part B 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/ls/J1B~7QWPBL3352?opendocument
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 16.3,
effective October 1, 2010
This J1 Part B MLN Matters article (CR7081) 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 July 2010. Providers are encouraged to review the information and
to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~88VQ9Z0600?opendocument
J1 Provider Outreach and Education Event Calendar
MACtoberfest, Palmetto GBA J1's largest educational and networking event of
the year, is coming soon! Space is limited for this popoular event, so
secure your spot and register today. Also check out our new multi-month
Event Calendar on the J1 Part A or Part B Web site.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7TAL2C7131?opendocument
J1 Part B LCDs: Revised
The following J1 Part B Local Coverage Determinations (LCDs) have been
revised: Botulinum Toxin Types A and B Policy L28242 and Magnetic Resonance
Angiography (MRA) of the Head and Neck, Chest, Abdomen and Pelvis, Lower
Extremities L28277.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~88MK8T3077?opendocument
Outpatient Services: Incorrect Denials
This article announces that Palmetto GBA began denying certain procedure
codes in July 2009 that were performed in outpatient hospital settings. In
May 2010, it was determined that the Hospital OPPS 'inpatient-only' list
did not apply to Medicare Part B and that these claims were denied in
error. Palmetto GBA has corrected its claims processing system to reflect
this change and it is currently adjusting claims that were denied based on
this list. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~88WQSS0201?opendocument
Revisions to Claims Processing Instructions for Services Rendered in Place
of Service Home
This J1 Part B MLN Matters article (CR6947a) was revised on September 1,
2010, to reflect a revised CR 6947, which was re-issued on August 31, 2010.
The article was revised to show a new CR release date, transmittal number
and Web address for accessing CR 6947. This article announces a requirement
that Contractors now enter the address of where services were performed,
including the ZIP Code, on claims for anesthesia services and every service
payable under the Medicare Physician Fee Schedule (MPFS) for services
provided in all places of service, including Home. This change will be
effective for claims that are submitted on the 5010 version of the ANSI
X12N 837P electronic form that are processed by Medicare on or after
January 1, 2011, and on the paper Form CMS 1500 with dates of service on or
after January 1, 2011. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~886Q3Y1574?opendocument
Final Reminder: ICD-10 Implementation in a 5010 Environment Follow-Up
National Provider Call
The Centers for Medicare & Medicaid Services (CMS) will host a follow-up
national provider conference call on 'ICD-10 Implementation in a 5010
Environment.' Subject matter experts will review basic information on both
ICD-10 and 5010 and explain how they are interrelated. A question and
answer session will follow the presentations. This event will be held on
Monday, September 13, 2010, from 12 p.m. to 1:30 p.m.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~894ETW2046?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 Centers (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2010/ACCConnect-9-8-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• Two New Educational Offerings on ACCC's CE Blackboard
• Meet Us in St. Louis!
• ACCC Submits Comments to CMS on 2011 Proposed Hospital Outpatient Prospective Payment System Rule
• Heard on ACCC's ListServ: Referrals/Pre-authorizations for Outpatient Chemotherapy
• CMS Offers National Provider Call on ICD-10 Implementation in a 5010 Environment
• For Women with BRCA Mutations, Prophylactic Surgery Reduces Cancer Risk
****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/Practice/Practice-Updates/5709.aspx. This edition features:
• Earn CME Credits from Blood
• CMS Offers Incentive Payments for Participation in HIT and Quality Initiatives
• CMS to Host Conference Call on ICD-10 Implementation
• CMS Releases Quarterly Update to Correct Coding Initiative Edits
• Legislative & Judicial Action Concerning Embryonic Stem Cell Research
• Register for ASH Webinar Series on Thrombosis
• Register for the 52nd ASH Annual Meeting by November 4
****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:
• CME Certification Forms Are In the Mail
• Modesto Physician Appointed to California Medical Board
• Applications Now Available for California's New Preexisting Condition Insurance Plan
• More Health Reform Provisions Take Effect September 23
• CMA Comments on the 2011 Medicare Physician Payment Rule
• Blue Shield Pulls Out of Healthy Families in 15 Counties
• Blue Cross Extends Healthy Families Continuity of Care Plan for Physicians in Most Counties
• Legislature Passes Bill Banning Rescissions
• Bill Protecting Kids' Access to Vaccines Goes to Governor's Desk
****PALMETTO/J1MAC NEWS****
J1 Part B LCDs Revised
Share with your staff - The following J1 Part B Local Coverage
Determinations (LCDs) have been revised: Botulinum Toxin Types A and B
Policy L28242 and Implantable Infusion Pump for Treatment of Chronic
Intractable Pain L28268.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~88VPX33722?opendocument
J1 Part B 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/ls/J1B~7QWPBL3352?opendocument
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 16.3,
effective October 1, 2010
This J1 Part B MLN Matters article (CR7081) 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 July 2010. Providers are encouraged to review the information and
to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~88VQ9Z0600?opendocument
J1 Provider Outreach and Education Event Calendar
MACtoberfest, Palmetto GBA J1's largest educational and networking event of
the year, is coming soon! Space is limited for this popoular event, so
secure your spot and register today. Also check out our new multi-month
Event Calendar on the J1 Part A or Part B Web site.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7TAL2C7131?opendocument
J1 Part B LCDs: Revised
The following J1 Part B Local Coverage Determinations (LCDs) have been
revised: Botulinum Toxin Types A and B Policy L28242 and Magnetic Resonance
Angiography (MRA) of the Head and Neck, Chest, Abdomen and Pelvis, Lower
Extremities L28277.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~88MK8T3077?opendocument
Outpatient Services: Incorrect Denials
This article announces that Palmetto GBA began denying certain procedure
codes in July 2009 that were performed in outpatient hospital settings. In
May 2010, it was determined that the Hospital OPPS 'inpatient-only' list
did not apply to Medicare Part B and that these claims were denied in
error. Palmetto GBA has corrected its claims processing system to reflect
this change and it is currently adjusting claims that were denied based on
this list. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~88WQSS0201?opendocument
Revisions to Claims Processing Instructions for Services Rendered in Place
of Service Home
This J1 Part B MLN Matters article (CR6947a) was revised on September 1,
2010, to reflect a revised CR 6947, which was re-issued on August 31, 2010.
The article was revised to show a new CR release date, transmittal number
and Web address for accessing CR 6947. This article announces a requirement
that Contractors now enter the address of where services were performed,
including the ZIP Code, on claims for anesthesia services and every service
payable under the Medicare Physician Fee Schedule (MPFS) for services
provided in all places of service, including Home. This change will be
effective for claims that are submitted on the 5010 version of the ANSI
X12N 837P electronic form that are processed by Medicare on or after
January 1, 2011, and on the paper Form CMS 1500 with dates of service on or
after January 1, 2011. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~886Q3Y1574?opendocument
Final Reminder: ICD-10 Implementation in a 5010 Environment Follow-Up
National Provider Call
The Centers for Medicare & Medicaid Services (CMS) will host a follow-up
national provider conference call on 'ICD-10 Implementation in a 5010
Environment.' Subject matter experts will review basic information on both
ICD-10 and 5010 and explain how they are interrelated. A question and
answer session will follow the presentations. This event will be held on
Monday, September 13, 2010, from 12 p.m. to 1:30 p.m.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~894ETW2046?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, September 2, 2010
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
2010 MACtoberfest Online Registration Now Open
The 2010 MACtoberfest online registration is now open. Space is limited for
this popular event; so secure your spot today! To register and view
registration details, click on the MACtoberfest database link enclosed.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~867R3X8418?opendocument
IDTF Table for CPT Codes 51725-70555
The revised IDTF Table for CPT Codes 51725-70555 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/ls/J1B~855NCQ1375?opendocument
IDTF Table for CPT Codes 71010-73223
The revised IDTF Table for CPT Codes 71010-73223 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/ls/J1B~855NLU3185?opendocument
IDTF Table for CPT Codes 73500-74775
The revised IDTF Table for CPT Codes 73500-74775 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/ls/J1B~855NQH0567?opendocument
IDTF Table for CPT Codes 75557-76380
The revised IDTF Table for CPT Codes 75557-76380 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/ls/J1B~855NVD7641?opendocument
IDTF Table for CPT Codes 76506-77059
The revised IDTF Table for CPT Codes 76506-77059 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/ls/J1B~855NXN3616?opendocument
IDTF Table for CPT Codes 77072-78876
The revised IDTF Table for CPT Codes 77072-78876 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/ls/J1B~855P3Q7108?opendocument
IDTF Table for CPT Codes 91000-93770
The revised IDTF Table for CPT Codes 91000-93770 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/ls/J1B~855P5Y7260?opendocument
IDTF Table for CPT Codes A9500-Q9967
The revised IDTF Table for CPT Codes A9500-Q9967 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/ls/J1B~855PBP5623?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****
2010 MACtoberfest Online Registration Now Open
The 2010 MACtoberfest online registration is now open. Space is limited for
this popular event; so secure your spot today! To register and view
registration details, click on the MACtoberfest database link enclosed.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~867R3X8418?opendocument
IDTF Table for CPT Codes 51725-70555
The revised IDTF Table for CPT Codes 51725-70555 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/ls/J1B~855NCQ1375?opendocument
IDTF Table for CPT Codes 71010-73223
The revised IDTF Table for CPT Codes 71010-73223 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/ls/J1B~855NLU3185?opendocument
IDTF Table for CPT Codes 73500-74775
The revised IDTF Table for CPT Codes 73500-74775 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/ls/J1B~855NQH0567?opendocument
IDTF Table for CPT Codes 75557-76380
The revised IDTF Table for CPT Codes 75557-76380 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/ls/J1B~855NVD7641?opendocument
IDTF Table for CPT Codes 76506-77059
The revised IDTF Table for CPT Codes 76506-77059 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/ls/J1B~855NXN3616?opendocument
IDTF Table for CPT Codes 77072-78876
The revised IDTF Table for CPT Codes 77072-78876 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/ls/J1B~855P3Q7108?opendocument
IDTF Table for CPT Codes 91000-93770
The revised IDTF Table for CPT Codes 91000-93770 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/ls/J1B~855P5Y7260?opendocument
IDTF Table for CPT Codes A9500-Q9967
The revised IDTF Table for CPT Codes A9500-Q9967 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/ls/J1B~855PBP5623?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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