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MIR-2006-10AB, October 2006
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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Mass Adjustment of 22X & 23X Bill Types Containing Healthcare Common Procedure Coding System (HCPCS) G0008, G0009, and G0010 with Dates of Service July 1, 2006 and Greater
Provider Types Affected
Skilled nursing facilities (SNFs) that bill Medicare fiscal intermediaries (FIs) for influenza and Pneumococcal Pneumonia Virus (PPV) vaccines
What You Need to Know
CR4240 (implemented on July 3, 2006), entitled Guidelines for Payment of Vaccine (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, and Hepatitis B Virus), provided guidelines for Medicare fiscal intermediary (FI) payment for these vaccines and for their administration.
In making this change in Medicare’s Fiscal Intermediary Standard System (FISS), the appropriate pricing change needed for HCPCS G0008, G0009, and G0010 (when submitted on 22X & 23X bill types) was omitted.
Therefore, your FIs will be performing a mass adjustment to correct the payment of your claims for these vaccines once the FISS correction is implemented on October 2, 2006. Please note again that the mass adjustment will pertain to 22X and 23X bill types that contain HCPCS G0008, G0009, and G0010 with dates of service between July 1, 2006 and September 30, 2006. You need not take any action to adjust these claims.
Additional Information
If you have any questions, please contact your FI at their toll-free number, which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip  on the CMS Web site.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.
MLN Matters Number: SE0661
Related Change Request (CR) # 4240
Related CR Release Date: N/A
Effective Date: N/A
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