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MIR-2007-2AB, February 2007
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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January 2007 Non-Outpatient Prospective Payment System (Non-OPPS) Outpatient Code Editor (OCE) Specifications Version 22.1
| Note: This article was revised on January 10, 2007, to reflect that CR5437 was revised by CMS to remove codes A4461, A4463, 77051, 77052, 77055, 77056, and 77057 from the Non-Reportable list. The CR release date, transmittal number, and Web address for accessing CR5437 were changed in this article. All other information remains the same. |
Provider Types Affected
Providers submitting claims to Medicare fiscal intermediaries (FI) for services rendered to Medicare beneficiaries
Provider Action Needed
This article is based on Change Request (CR) 5437 which informs fiscal intermediaries (FI) that the January 2007 Non-Outpatient Prospective Payment System (Non-OPPS) Outpatient Code Editor (OCE) specifications have been updated to ensure correct billing and payment of claims. Be that sure your billing staff are aware of the code changes in CR5437.
Background
The Non-OPPS OCE has been updated with numerous new additions, changes, and deletions to Healthcare Common Procedure Coding System/Current Procedural Terminology (HCPCS/CPT) codes. Rather than duplicate all the additions, deletions and changes in this article, the Centers for Medicare & Medicaid Services directs you to CR5437, which contains the lengthy lists of these items. CR5437 is available at http://www.cms.hhs.gov/Transmittals/downloads/R1150CP.pdf  on the CMS Web site.
Additional Information
If you have any questions, please contact your FI at their toll-free number, which may be found on the CMS Web site at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip. 
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: MM5437 REVISED
Pub. 100-4, Transmittal# R1150CP, CR# 5437
Related CR Release Date: January 10, 2007
Effective Date: January 1, 2007
Implementation Date: January 2, 2007
Flu Shot Reminder
As a respected source of health care information, patients trust their doctors’ recommendations. If you have Medicare patients who haven’t yet received their flu shot, help protect them by recommending an annual influenza and a one time pneumococcal vaccination. Medicare provides coverage for flu and pneumococcal vaccines and their administration. – And don’t forget to immunize yourself and your staff. Protect yourself, your patients, and your family and friends. Get Your Flu Shot. Remember - Influenza vaccination is a covered Part B benefit. Note that influenza vaccine is NOT a Part D covered drug. For more information about Medicare’s coverage of adult immunizations and educational resources, go to CMS’s Web site: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0667.pdf.
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