Medicare Monthly Review, Issue 2007-09AB

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	National Government Services, Inc. Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter

September 2007

MMR-200709AB

CPT five-digit codes, descriptions, and other data only are copyright 2006 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS clauses apply.

In This Issue:

Key		Information Issued by National Government Services for Part A Providers
Part A (Speciality)	Location (State Abbreviations)	Title
H, E	All	HCPCS Code A4657 Clarification
H, S, E	IL, IN, KY, OH	LCD Part A Updates for September 1, 2007
H, S, E	All	Reminder for Billing Drug Injections
H	All	Retired Local Coverage Determinations August 31, 2007
A	All	What’s Preventing Your Electronic Claims From Being Accepted

Key		Information Issued by National Government Services for Part B Providers
Part B (Speciality)	Location (State Abbreviations)	Title
A	All	Accessing the CMS Medicare Physician Fee Schedule Database
P, N, V	All	Chiropractic Services – Ordered vs. Referred
A	All	Clarification for Billing Medigap Insurance Information on the CMS-1500 Form
A	NY	Part B New York Standardization of the Multi-Carrier System
A	All	Offset by Fax
H	NJ, NY	Retired Local Coverage Determinations August 31, 2007
N, O, P, R	IN, KY	Revised Local Coverage Determination – Computed Tomography (R18)
P, N	IN, KY	Revised Local Coverage Determination – Erythropoietin Analogues for Non-ESRD Anemia
C, O, P, R	IN, KY	Revised Medical Policy Update – Myocardial Perfusion Imaging
P, N	IN, KY	Revised Medical Policy Update – Psychological Services Covered Under the Incident to Provisions for Physicians and Non-Physicians

KEY			Information Issued by CMS Pertaining to Part A and Part B Providers
Part A (Speciality)	Part B (Speciality)	Location (State Abbreviations)	Title
H, S	P, R	All	Correct Reporting of Diagnosis Codes on Screening Mammography Claims (CR#5050(R))
H	P, O, R	All	Revised Information on PET Scan Coding (CR#5665)
A	A	All	Contractor Provider Satisfaction Survey Shows Positive Results (SE0733)
A	A	All	Claim Status Category Code and Claim Status Code Update (CR#5687)
A	A	All	Medicare’s Implementation of the National Provider Identifier (SE0555)
A	A	All	Annual Update of HCPCS Codes for SNF Consolidated Billing (CR#5696)
H, S	A	All	Date of Service for Laboratory Specimens (CR#5573)
A	A	All	Reasons for Provider Notification of Medicare Claims Disputed/Rejected by Supplemental Payers/Insurers
H	B	All	Revisions to Certification for Hospital Services Covered by Supplementary Medical Insurance as pertains to Ambulance Services (CR#5684)
A	A	All	Important Guidance on the New CMS-1500 and UB-04 Forms (SE0729)
A	A	All	Unsolicited/voluntary Refund Information (CR#3274)

Key		Information Issued by CMS Pertaining to Part A Providers
Part A (Speciality)	Location (State Abbreviations)	Title
H	All	Capturing Days on Which Medicare Beneficiaries Are Entitled to Medicare Advantage in Medicare/Supplemental Security Income (SSI) Fraction (CR#5647)
H, P	All	Institutional Value Code Changes (CR#5411)
H	All	Limitation on Charges for Services in Hospitals to Individuals Eligible for Care Through Indian Health Services (SE0734)
H, S	All	Medicare Part A Skilled Nursing Facility PPS Pricer Update for FY 2008 (CR#5688)
H, E	All	National Monitoring Policy for Erythropoiesis Stimulating Agents (CR#5700)
H	All	Present-on-Admission Indicator (CR#5499)
P	All	Reporting of Additional Data to Describe Services on a Hospice Claim (CR#5567)
A	All	Timeliness Standards for Processing “Other-Than-Clean” Claims (CR#5513)
H	All	Update of HCPCS Code for Hemophilia Clotting Factors (CR#5466)

Key		Information Issued by CMS Pertaining to Part B Providers
Part B (Speciality)	Location (State Abbreviations)	Title
L, P, N	All	Adjustment to CWF Duplicate Claims Edit for Technical Component of Radiology and Pathology Laboratory Services Provided to Hospital Patients (CR#5675)
A	All	Important Notice Regarding Vaccine Administrations in 2008 (SE0723)
A	IN, KY	National Provider Identifier Crosswalk Bypass Logic (JSM-07508)
A	NJ, NY	National Provider Identifier Crosswalk Bypass Logic (JSM-07508)
A	All	New Remark Code for Denying Separately Billed Services (CR#5659)
N	All	Nurse Practitioner (NP) Services and Clinical Nurse Specialist (CNS) Services (CR#5639)
P, N	All	Required Use of Tamper-Resistant Prescription Pads for Outpatient Drugs Prescribed to Medicaid Recipients (SE0736)
P, N	All	Response to Competitive Acquisition Program for Part B Drugs and Biologicals Claims When CWF 69XD Error Code Is Received (CR#5658)

Key		Provider Outreach and Education Training Seminars
Contract	Location (State Abbreviations)	Title
A/B	NH, CT, CA, GA, HI, IL, IN, KY, MI, OH, PA, VA, WV, WI and MA	Don’t Miss Out on Upcoming Medicare Training… Save These Dates!!!
A	NY, CT, DE, RI, NH, VT, ME,and MA	Don’t Miss Out on Upcoming Medicare Training… Save These Dates!!!
B	All	Evaluation and Management Documentation Guidelines Training Now Offered Monthly…Save These Dates!!!
B	NY	Part B New York Providers: Don’t Miss Out on Upcoming Medicare Training…Save These Dates!!!
B	NJ	Part B NJ Providers: Don’t Miss Out on Upcoming Medicare Training…Save These Dates!!!
A/B	IN, KY	Don’t Miss Out on Upcoming Medicare Training… Save These Dates!!!

Part A Key: A-All Providers, C-Community Mental Health Centers (CMHC), E-Renal Dialysis (ESRD) Providers, H-Hospitals, M-Home Health Providers, O-Comprehensive Outpatient Rehabilitation Facilities (CORF) and Outpatient Physical Therapy Providers, P-Hospice Providers, S-Skilled Nursing Facilities (SNF), NA-Not Applicable

Part B Key: A-All Providers, B-Ambulance, C-Cardiovascular, D-DMEPOS, E-Drugs & Biologicals, F-ASC, G-Anesthesia, H-Physical & Occupational Therapy, I-Beneficiaries, J-Insurers, K-Home Health Care, L-Laboratory, M-Medicine, N-Non-Physician Practitioner, O-Nuclear Medicine, P-Physicians, R-Radiology, S-Surgery, U-Urology, V-Chiropractor, W-Ophthalmology, X-Podiatry, Q-Oncology, NA-Not Applicable

Contact Information can be found on each of the National Government Services legacy Web sites which can be accessed though: http://www.NGSMedicare.com.

Medicare policies can be found on our Web site in the Local Coverage Determination section. You can access these through the http://www.NGSMedicare.com homepage. Providers without access to the Internet can request hard copies from National Government Services.

This bulletin should be shared with all health care practitioners and managerial members of the provider staff. Bulletins are available at no cost from our Web site at www.NGSMedicare.com.