Medicare News Update, Issue 2006-05

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Medicare News Update

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Issue 2006-05, May 2006

CPT five-digit codes, descriptions, and other data only are copyright 2004 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:

A	MM	2006 Revised ANSI X12N 837 Companion Document
H	MM	April 2006 Update of Hospital OPPS
A	MM	April Update to 2006 MPFS
H		Billing Inpatient Hospital Antihemophilia Drug Code J7189
A		Claims RTP with Reason Code 30715
A	JSM	CMS Mailing List Fact Sheet
A	MM	CMS Recovery Audit Contractor Initiative
A	MM	Cultural Competency: A National Health Concern
A		Documenting Medical Necessity for Ambulance Services
A	JSM	Drug Coverage Material–Fact Sheet/Recent Audio Conference
H	MM	Expansion of Coverage for PTA-Revised
H, S	MM	Expansion of Glaucoma Screening Services
H	MM	External Counterpulsation (ECP) Therapy
A		FISS Screen and Provider Online Manual Changes
H, E	MM	Holding EPO Claims on 72X Bill Types
H	MM	Inpatient Admission Not Medically Necessary
H	JSM	Intern and Resident Information System (IRIS) Program
H		LCD and Article Revisions for May 2006
H	MM	Microvolt T-wave Alternans (MTWA) Diagnostic Testing
A	MM	Part D Drug Benefit in an LTCH
H, S, O	MM	Power Mobility Devices
H, E		PS&R Update – ESRD Providers
A		Reason Code File Update
A	JSM	Redesigned NPI Web Page
S	MM	RHC and FQHC Services in an SNF
S		SNF – Helpful Hints for Avoiding Denials
S		SNF Adjustments for Changing HIPPS Code
H	MM	Source Admission Code “D”
A	MM	Streamline Drug Coverage Material Available
A	MM	Surrogate UPINs
S		Three-Day Qualifying Stay for SNF Admission
A		Upcoming Change to Provider Bulletin Format
S		Upcoming Medicare SNF Training
A		Upcoming Medicare Training
A	MM	Update of Chapter 24 – EDI Support Requirements
A		Web Site Quick Tips
A		What’s Preventing Your Electronic Claim from Being Accepted?

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.empiremedicare.com.

Telephone Directory

Automated IVR Inquiries

1 (877) 567-7205

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Saturdays 9:00 a.m. to 2:00 p.m.
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Tuesday - Thursday 8:00 a.m. to 4:00 p.m.

Beneficiary Inquiries:
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1-800-MEDICARE (1-800-633-4227)

TTY for the Hearing-Impaired:

1 (877) 486-2048

Integrated Electronic Services (IES) Technical Help Desk:
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1 (866) 889-7322

Medicare Fraud Hotline:
To report fraud and abuse in the Medicare and Medicaid programs:

1(800) HHS-TIPS/1(800) 447-8477

The Hotline TTY Number for the Hearing-Impaired is:

1(877) 623-6190

Medical Director:
Dr. Ted Triana

1(315) 442-4893