Palmetto/J1MAC News

The following information has been received by ANCO.


****PALMETTO/J1MAC NEWS****
Partial Code Freeze Prior to ICD-10 Implementation
At the ICD-9-CM Coordination & Maintenance Committee Meeting (September 15,
2010), it was announced that the committee had finalized the decision to
implement a partial freeze for both ICD-9-CM codes, ICD-10-CM and
ICD-10-PCS codes prior to implementation of ICD-10 on October 1, 2013.
Please share this information with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AKKPG3004?opendocument


November 2010 J1 A/B MAC Medicare Advisory
The November 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~8AGR4T0470?opendocument


ANSI v5010: New Electronic Claim Format Requirements for ANSI 837 v5010
This article is the second in a series regarding implementation of version
5010 as the new standard for all ANSI ASC X12N electronic transactions.
This article outlines the changes to the ANSI 837 Electronic Claim format
from v4010A1 to v5010.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AKJ8B6236?opendocument


Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for
Myelodysplastic Syndrome (MDS)
This J1 A/B MAC MLN Matters article (CR7137) announces (through a National
Coverage Determination (NCD)) that, effective for claims with dates of
service on and after August 4, 2010, Medicare will cover the use of
Allogeneic HSCT for treatment of MDS under Section 1862(a)(1)(E) of The
Social Security Act (the Act) only if provided in the context of a
Medicare-approved clinical study meeting specific criteria under Coverage
with Evidence Development (CED). Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AKPVF7648?opendocument


Counseling to Prevent Tobacco Use
This J1 A/B MAC MLN Matters article (CR7133) announces that the Centers for
Medicare & Medicaid Services (CMS) will cover counseling to prevent tobacco
use for outpatient and hospitalized beneficiaries. Effective for claims
with dates of service on and after August 25, 2010, CMS will cover tobacco
cessation counseling for outpatient and hospitalized Medicare
beneficiaries: 1) Who use tobacco, regardless of whether they have signs or
symptoms of tobacco-related disease; 2) Who are competent and alert at the
time that counseling is provided; and 3) Whose counseling is furnished by a
qualified physician or other Medicare-recognized practitioner. These
individuals who do not have signs or symptoms of tobacco-related disease
will be covered under Medicare Part B when the above conditions of coverage
are met, subject to certain frequency and other limitations. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AKQ361051?opendocument


J1 Part B LCDs Revised
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. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/8ALN4Y2234?opendocument


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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-10-20-2010.html. ANCO is an Institutional Member of ACCC. This edition features:

• Heard on ACCC's ListServ: Cancer Registry Staffing

• ACCC Submits Comments to CMS on Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer

• Incentive Payment Update for PQRI

• Seeking Practitioners Who See Large Numbers of NSCLC Patients


****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:

• State budget does not contain drastic health care cuts

• Register today for the 2010 cervical cancer and HPV vaccine summit

• CMS electronic prescribing incentive payments in the mail

• Next week is health care decisions week; physicians urged to talk to patients about end-of-life wishes


****PALMETTO/J1MAC NEWS****
The 11th 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 11th
national education call regarding Medicare FFS’ implementation of HIPAA
Version 5010 and D.0 transaction standards on October 27, 2010. This
session will focus on the National Council for Prescription Drug Programs
(NCPDP) Version D.0 transaction. 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
Q&A session.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8A8LMF6233?opendocument


2011 Medicare Participation Enrollment & Fee Schedule Information
We are again excited to provide you with a CD-ROM packed full of useful
information, which will include the 2011 Medicare Participation Enrollment
form and other valuable information. We anticipate that the CD-ROM will be
mailed in November 2010 and will contain the following: Announcement,
Resource and contact listing, and CY 2011 Medicare Participation Enrollment
announcement and agreement.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AFF756066?opendocument


J1 Part B LCDs Revised
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. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/8ADRRX7655?opendocument


Incentive Payment Update for 2009 Physician Quality Reporting Initiative
(PQRI)
Incentive payments for the 2009 Physician Quality Reporting Initiative
(PQRI) are available this fall for eligible professionals who met the
criteria for successful reporting. Carriers and Medicare Administrative
Contractors (MACs) will begin processing and distributing 2009 PQRI
incentive payments on October 25, 2010. Distribution of 2009 PQRI incentive
payments is scheduled to be completed by November 12, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8AGM4M8873?opendocument


Notice of New Interest Rate for Medicare Overpayments & Underpayments: 1st
Notification for FY 2011
The Department of the Treasury has notified the Department of Health and
Human Services that the private consumer rate has been changed to 10.75
percent effective October 22, 2010, for Medicare overpayments and
underpayments.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7REKCL2111?opendocument


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Palmetto/J1MAC News

The following information has been received by ANCO.


****PALMETTO/J1MAC NEWS****
Annual PPTN Recertification For J1 Part B Underway
Palmetto GBA has started our annual security recertification invoice
process for Jurisdiction 1 Part B PPTN access. J1 Part B PPTN users will
receive via mail a PPTN recertification notice and invoice. Please respond
promptly so that your PPTN access is not terminated.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89ZQMR2112?opendocument


PC-ACE Pro32 version 2.24 Update File
PC-ACE Pro32 software has been updated to version 2.24 with several CMS
Medicare mandates and enhancements. All PC-ACE Pro32 users must download
and install the attached software update file immediately.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89ZQTX2544?opendocument


2010 - 2011 Seasonal Influenza (Flu) Resources for Health Care
Professionals
This special edition article (SE1031) announces that 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. No
deductible or co-payment/co-insurance applies. All adults 65 and older
should get seasonal flu vaccine. People with Medicare who are under 65 but
have chronic illness, including heart disease, lung disease, diabetes or
end-stage renal disease should get a seasonal flu shot. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8A5NMV3805?opendocument


Results of the 2010 Medicare Contractor Provider Satisfaction Survey
(MCPSS)
This special edition article (SE1030) is informational only and provides a
summary of the findings from the annual MCPSS by the Centers for Medicare &
Medicaid Services (CMS). The MCPSS offers Medicare fee-for-service (FFS)
providers an opportunity to give CMS feedback on their satisfaction,
attitudes, perceptions and opinions about the services provided by their
respective contractor. The MCPSS elicits information from a sample of
hospitals, physicians, skilled nursing facilities (SNFs), home health
agencies, clinical laboratories, and other providers and suppliers.
Providers are encouraged to review the information and to share with their
staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8A5LMV8717?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, CMA, & Palmetto/J1MAC News

The following information has been received by ANCO.


****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) has announced the new Part B Drug Information Guide. Visit http://www.accc-cancer.org/druginfo/ for more information.

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-10-6-2010.html. ANCO is an Institutional Member of ACCC. This edition features:

• ACCC's Successful St. Louis Meeting

• Voice Your Support for the Prostate Act

• Heard on ACCC's ListServ: Physician Supervision Requirements in Radiation Oncology

• 2009 Electronic Prescribing (eRx) Incentive Program Update

• Physician Compare Website: Find Out the Details


****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:

• San Jose Physician James G. Hinsdale, M.D., Elected CMA President

• First Wave of Certified EHRs Announced

• 2010 State Legislative Wrap Up

• Highlights from CMA's 2010 House of Delegates

• Last Call: Act Now on $350M UnitedHealth Settlement


****PALMETTO/J1MAC NEWS****
CMS Quarterly Provider Update
The Quarterly Provider Update is a comprehensive resource published by the
Centers for Medicare & Medicaid Services (CMS) on the first business day of
each quarter. It is a listing of all non-regulatory changes to Medicare
including Program Memoranda, manual changes, and any other instructions
that could affect providers. Regulations and instructions published in the
previous quarter are also included in the Update.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7GLTKN5010?opendocument


Correction to Article: Submitting Claims for Compounded Medication for
Implantable Infusion Pumps
An error was discovered in the article, ‘Submitting Claims for Compounded
Medication for Implantable Infusion Pumps’, which was published to the J1
Web site and the October 2010 J1 Advisory. In the table under the Fentanyl
drug, the amount should be 0.0072 dollars per mcg, rather than 0.072
dollars per mcg. The article with the correct amount will be posted on the
J1 Web site immediately and will be published in the November 2010 J1
Advisory. We apologize for the inconvenience. Please be sure to share with
your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/89RQDS0382?opendocument


Overpayment Refund Form: Medicare Part A and B
A new Overpayment Refund form will be in use. For more information, please
view the article link Provider Medicare Voluntary Refunds: Immediate Offset
Requests Terminated.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~7JBHHJ3014?opendocument


Provider Medicare Voluntary Refunds: Immediate Offset Requests Terminated
The J1 Immediate Offset Request Form has been updated and placed on the J1
Part B Web site. Providers are encouraged to review the information and to
share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89DRTZ7213?opendocument


ANSI v5010: Is Your Practice or Facility Ready for the ANSI Version 5010
Transition
This article is the first in a series regarding implementation of version
5010 as the new standard for all ANSI ASC X12N electronic transactions.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89SQG51700?opendocument


New Medicare Self-Referral Disclosure Protocol
Section 6409(a) of the Affordable Care Act (ACA) ACA requires the secretary
of the Department of Health and Human Services, in cooperation with the
inspector general of the Department of Health and Human Services, to
establish a Medicare self-referral disclosure protocol (SRDP) that sets
forth a process to enable providers of services and suppliers to
self-disclose actual or potential violations of Section 1877 of the Social
Security Act (the Act). The SRDP requires health care providers of services
or suppliers to submit all information necessary for CMS, on behalf of the
secretary, to analyze the actual or potential violation of Section 1877 of
the Act. Section 6409(b) of the ACA, gives the secretary of HHS the
authority to reduce the amount due and owing for violations of Section
1877.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89TMHJ1123?opendocument


Clarification on the Effective Date on the Procedure Status Indicator for
Current Procedural Terminology (CPT) Code 80101
This J1 A/B MAC MLN Matters article (CR7140) clarifies that the effective
date for the change of the procedure status indicator to ‘I’ for Current
Procedure Terminology (CPT) Code 80101 has been set to January 1, 2010, for
all claims and CR 7140 supercedes all other CRs in relation to this issue.
Providers are encouraged to review the information and to share with their
staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89WRXT6724?opendocument


Medicare Fee-For-Service Emergency Policies and Procedures: Questions and
Answers (Qs & As) for All Types of Emergencies and Disasters - Rescission
of CRs 5099, 6146, 6164, 6174, 6209, 6256, 6280, 6284 and 6378
This J1 A/B MAC MLN Matters article (CR6837) is informational only and
advises providers on where to find information regarding Medicare policies
related to emergency guidance for the duration of the emergency, such as
the H1N1 pandemic. As part of its preparedness efforts for an influenza
pandemic, the Centers for Medicare & Medicaid Services (CMS) developed
certain emergency guidance and procedures that may be implemented for the
Medicare fee-for-service (FFS) program in the event of a pandemic or
disaster. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89WRQU7814?opendocument


October is National Breast Cancer Awareness Month
The Centers for Medicare & Medicaid Services (CMS) is asking the provider
community to keep their patients with Medicare healthy by encouraging them
to take advantage of Medicare-covered screening mammograms and other
preventive services covered by Medicare.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89XH971028?opendocument


J1 PCC to Close October 11 in Observance of Columbus Day
The J1 PCC will be closed in observance of Columbus Day on Monday, October
11, 2010. The call center will reopen on Tuesday, October 12, 2010, at 7
a.m. PDT. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/89YLU36474?opendocument


IDTF Table for CPT Codes 77072-78816
The revised IDTF Table for CPT Codes 77072-78816 is now available on the J1
Web site. The CPT Codes 78261, 78262 and 78264 were added to the table.
Providers are encouraged to review the information and to share with their
staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~855P3Q7108?opendocument


CMS Town Hall Meeting on the Physician Compare Web Site
CMS will host a town hall meeting on the Physician Compare Web site.
Section 10331 of the Patient Protection and Affordable Care Act of 2010
requires CMS to establish a Physician Compare Web site containing
information on physicians enrolled in Medicare and other eligible
professionals who participate in the Physician Quality Reporting Initiative
by January 1, 2011. This meeting will be held on October 27, 2010, from 1
p.m. to 5 p.m. EDT in the main auditorium of the central building of the
Centers for Medicare & Medicaid Services or via teleconference. The meeting
is open to the public; however, attendance is limited to space and
teleconference lines available.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89YDPF8307?opendocument


CMS Medicare Quarterly Provider Compliance Newsletter: First Edition
Released
The Medicare Learning Network (MLN) has developed a new educational tool,
the Medicare Quarterly Provider Compliance Newsletter, to advise
physicians, suppliers and other fee-for-service (FFS) providers about how
to avoid common billing errors and other erroneous activities when dealing
with the Medicare program.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89YDPB2738?opendocument


Special Open Door Forum: Physician Quality Reporting Initiative (PQRI) and
Electronic Prescribing (eRx) Incentive Program Updates
The Centers for Medicare & Medicaid Services (CMS) will host a special open
door forum on the 2010 PQRI and Electronic Prescribing eRx Incentive
Program updates on October 19, 2010 from 2 p.m. to 3 p.m. EDT. During this
special open door forum, CMS will discuss: 2009 PQRI and eRx Incentive
Program payment distribution and provide instructions for understanding
these payments; an overview of the 2009 Feedback Report user guides for
PQRI and the eRx Incentive Program; changes to the electronic remittance
advice for eligible professionals receiving PQRI and eRx incentive payments
in 2010; and participation in the 2010 eRX Incentive Program.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89ZJ6G5867?opendocument


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