Medicare Monthly Review, Issue 2008-03AB

Content Section

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

March 2008

MMR-2008-03AB

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:

Information Issued by National Government Services for Part A and Part B Providers
Part A (Speciality)	Part B (Speciality)	Location (State Appreviation)	Title
H, S, E	D, P, N	All	Articles Added to “Coverage of Drugs and Biologicals” (Eff. 03/01/08)
H, S, E	D, P, N	All	Drug Articles Added to “Coverage of Drugs and Biologicals” (Eff. 12/01/07)
A	A	All	Electronic Data Interchange
A	A	CT, DE, NY	M2 Migration Cutover Date Extended
H, S	D, P, N	All	Medical Policy Update – Biologic Products for Wound Treatment
A	A	All	National Government Services Post Office Consolidation
H, S, O	H	All	Physical Therapy Services Impacting National Government Services CERT
A	A	All	Protected Health Insurance Information on Password Reset Requests

Information Issued by National Government Services for Part A Providers
Part A (Speciality)	Location (State Appreviation)	Title
A	MA	Appeals of Recovery Audit Contractor Decisions
A	CT, MA, ME, NH, RI, VT	HIGLAS
H , S	NY, CT, DE	Part A New York, Connecticut, and Delaware Retired LCDs
H , S	All	Part A Retired Local Coverage Determinations
A	All	Revised PS&R Request Forms and Procedures
A	IL, IN, KY, OH	What’s New?

Information Issued by National Government Services for Part B Providers
Part B (Speciality)	Location (State Appreviation)	Title
A	NJ & NY	Electronic Submission of Medicare Secondary Payer Claims
A	NY	Medicare Electronic Submitters Part B New York New Provider Numbering Format
A	All	New National Provider Identifier Reporting Edits
P, N	NY, NJ	Part B New Jersey and New York Retired Local Coverage Determinations

Information Issued by CMS Pertaining to Part A and Part B Providers
Part A (Speciality)	Part B (Speciality)	Location (State Appreviation)	Title
H, S	L, P, N	All	Clinical Laboratory Service Competitive Bidding Demonstration (CR5772)
A	A	All	Emergency Update to the 2008 MPFS Database (CR5902)
H	D, P, N, Z	All	Erythropoiesis Stimulating Agents in Cancer/Related Neoplastic Conditions (CR5818)
A	A	All	Extension of Dates of Service Eligible for PSA Bonus Payment (CR5937)
A	A	All	Fee-for-Service Legacy Provider IDs Prohibited after NPI Required Date (CR5858)
H	P, W	All	HCPCS Code V2787 for Astigmatism-Correcting Intraocular Lens (CR5853)
A	A	All	Implementation of NPI: Seconded in a Series of MLN Articles (SE0555-Rescinded)
A	A	All	Legislative Change Affecting the 2008 MPFS and Open Enrollment (CR5944)
H, S	L, P, N	All	New Test for the Automated Multi-Channel Chemistry Code (CR5874)
H, E	D, P, N	All	Reporting Hct and HGB on All claims for Erythropoiesis Stimulating Agents, Implementation of New Modifiers for Non-ESRD ESA (CR5699-Revised)
A	A	All	Revision to Certification for Hospital Services Covered by SMI (CR5684–Rescinded)
H	P, N	All	Smoking and Tobacco Use Cessation Counseling Billing Code Update (CR5878)
H	P, N	All	Summary of Policies in the 2008 MPFS and Telehealth Originating Site (CR5895)
H	F, P, S	All	Update of HCPCS Codes for Ambulatory Surgical Centers (CR5211-Revised)

Information Issued by CMS Pertaining to Part A Providers
Part A (Speciality)	Title
P	Billing Instructions for Payment for Hospice Care Based on Location (CR5745)
M	Correction to Low Utilization Payment Adjustment Add-on Payment Under the Refined Home Health Prospective Payment System (CR5877)
M	Home Health Prospective Payment System Refinement and Rate Update (CR5879)
H	January 2008 Update to the Hospital Outpatient Prospective Payment System (CR5912)
H	Legislative Change to the 75 Percent Rule for Inpatient Rehabilitation Facilities (JSM-08178)
H	Modification of Payment Window Edits in CWF for Line Item Date of Service (CR5880)
H, M	New Value Code to Report Patient Prior Payments (CR5882)
H	Notifying Medicare Patients about Lifetime Reserve Days (SE0663)
P	Reporting Additional Data on Hospice Claims (CR5567-Revised)
P	Reporting Hospice Services in Greater Line Item Detail (CR5245-Revised)
F, R	Rural Health Clinic and Federally Qualified Health Center Rate Increase (CR5896)
H	Update to Common Working File Edits 7284 and 7548 (CR5907)
H, S	Update to CWF to Allow Posting of SNF and Swing Bed Claims to Beneficiary Spell of Illness When Qualifying Stay Criteria Are Not Met (CR5872)

Information Issued by CMS Pertaining to Part B Providers
Part B (Speciality)	Title
A, S	Additional Payable HCPCS “C” Drug Codes in Ambulatory Surgical Centers (CR5885)
A, S	Ambulatory Surgical Centers Claims Process Manual Clarification (CR5026-Revised)
A	Amending the List for Determination of Medically Accepted Indication for Off-Label Uses of Drugs and Biologicals in an Anti-Cancer Chemotherapeutic Regimen (CR5870)
L, P	Changes to Independent Lab Billing for Technical Component of Pathology Services
A	Coordination of Benefits Agreement Medigap Claim-Based Crossover (CR5837-Revised)
A	Critical Dates for Medicare Fee-for-Service Implementation of NPI (SE0802)
A	Instructions Related to Compliance Standards for Independent Diagnostic Facilities (CR5856)
A	Medicare, Medicaid and State Children’s Health Insurance Program (SCHIP) Extension Act of 2007 (MMSEA) Changes to Independent Laboratory Billing for the Technical Component (TC) of Physician Pathology Services (CR5943)
A, S	Revised Payment System for Ambulatory Surgical Centers in CY 2008 (Se0742-Revised)

Provider Outreach and Education Training Seminars
Contract	Location (State Abbreviations)	Title
A	NY, CT, DE, RI, NH, VT, MA, ME	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!!!
B	NY	Part B New York Providers: Don’t Miss Out on Upcoming Medicare Training… Save These Dates!!!

This key is provided as a convenience to alert providers/suppliers to articles with topics that may pertain to their particular field. This key is not a guarantee that information in other articles will not also apply. It is each provider’s/supplier’s responsibility to become familiar with the contents of each newsletter.

Part A Key: A-All Providers, C-Community Mental Health Centers (CMHC), E-Renal Dialysis (ESRD) Providers, F-Federally Qualified Health Centers (FQHC), H-Hospitals, M-Home Health Providers,
O-Comprehensive Outpatient Rehabilitation Facilities (CORF) and Outpatient Physical Therapy Providers, P-Hospice Providers, R-Rural Health Center (RHC), 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, Q-Mental Health R-Radiology, S-Surgery, T-Nephrology, U-Urology, V-Chiropractor, W-Ophthalmology & Optometry, X-Podiatry, Y-Radiation Z-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.