Provider Types Affected Physicians who submit claims to Medicare carriers and A/B Medicare Administrative Contractors (A/B MACs) Background This article and related Change Request (CR) 5422 provide a reminder for physicians to take note of the quarterly updates to the coding initiatives. The latest package of Correct Coding Initiative (CCI) edits, Version 13.0, effective January 1, 2007, will be available via the CMS Data Center (CDC). Physicians may view the current CCI edits and the current Mutually Exclusive Code (MEC) edits at http://www.cms.hhs.gov/NationalCorrectCodInitEd/ The National Correct Coding Initiative developed by CMS helps promote national correct coding methodologies and controls improper coding. The coding policies developed are based on coding conventions defined in the American Medical Association’s Current Procedural Terminology (CPT) manual, national and local policies, and edits, coding guidelines developed by national societies, analysis of standard medical and surgical practice, and review of current coding practice. The latest package of CCI edits, Version 13.0, is effective on January 1, 2007. This version will include all previous versions and updates from January 1, 1996 to the present and will be organized in two tables:
Additional Information The CCI and MEC file formats will be maintained in the Medicare Claims Processing Manual (Publication 100-04), Chapter 23, Section 20.9, which can be found at http://www.cms.hhs.gov/Manuals/IOM/list.asp#TopOfPage You may see the official instruction (CR5422) issued to your Medicare carrier or A/B MAC by going to http://www.cms.hhs.gov/Transmittals/downloads/R1124CP.pdf If you have questions, please contact your Medicare carrier or A/B MAC, at their toll-free number which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip 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 Disclaimer MLN Matters Number: MM5422 Do you have your NPI? National Provider Identifiers (NPIs) will be required on claims sent on or after May 23, 2007. Every health care provider needs to get an NPI. Learn more about the NPI and how to apply for an NPI by visiting http://www.cms.hhs.gov/NationalProvIdentStand/ Posted: 12/13/2006 CPT codes, descriptions, and other data only are copyright 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.
|
on the Centers for Medicare & Medicaid Services (CMS) Web site. 
on the CMS Web site.
on the CMS Web site.
