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Issue 2006-05, May 2006
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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Holding of Epoetin (EPO) Claims on 72x Bill Types for Dates of Service Prior to January 1, 2005
Provider Types Affected
Providers billing Medicare fiscal intermediaries (FI) for services related to the administration of EPO to Medicare beneficiaries on a 72X type of bill (TOB) for dates of service before January 1, 2005
Provider Action Needed
Impact to You
Because of an internal Medicare systems issue, adjustments are being implemented in order to process claims for EPO services on TOB 72X with a date of service prior to January 1, 2005.
What You Need to Know
If claims are submitted for EPO with a date of service prior to January 1, 2005, they will be held for payment until system changes are implemented on June 5, 2006.
What You Need to Do
Make certain that your billing staffs are aware of this change.
Additional Information
If you have questions, please contact your Medicare intermediary at their toll-free number, which may be found at http://www.cms.hhs.gov/apps/contacts/  on the Centers for Medicare & Medicaid Services (CMS) Web site.
MLN Matters MM4319, which relates to CR4319, can be found at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM4319.pdf  on the CMS Web site.
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: SE0623
Related Change Request (CR) #: N/A
Related CR Release Date: N/A
Effective Date: N/A
Related CR Transmittal #: N/A
Implementation Date: N/A
Additional Information Provided by Empire Medicare Services
Reason code 36398 will suspend ESRD claims (type of bill 72X) billed with EPO prior to January 1, 2005. After system changes are completed, suspended claims will be released.
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