The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) utilize and apply changes to the FISS system regarding taxonomy codes. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R1876OTN.pdf Subject: Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process Number: 1876 Title: 10155 Release Date: July 27, 2017 Effective Date: January 1, 2018 Implementation […]

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) evaluate CMN and DIF depending upon medical record content and the existence of any errors or omissions, for the purposes of deciding whether denials are appropriate. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R733PI.pdf Subject: Clarification of Certificate of Medical Necessity (CMN) and Durable Medical Equipment […]

Summary: The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) utilize new tests enumerated by CMS with CLIA-covered code files and a QW modifier and evaluate claims according to CMS protocols. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R3812CP.pdf Subject: New Waived Tests Number: 3812 Title: 10198 Release Date: July 27, 2017 Effective Date: October […]

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) observe and work with updates from FISS, a Medicare Part A claims processing system. Contractors shall participate in five 1-hour meetings to discuss testing. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R1874OTN.pdf Subject: Implementation CR: Integrating NLR into the HQR system Number: 1874 Title: 10134 Release […]

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) perform various tasks for FISS analysis. Contractors shall participate in eight weekly 1-hour calls, take meeting minutes and post them in ECHIMP during a given timeline of two days, provide final analysis papers, and otherwise conduct research and comply with CMS […]

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) comply with new requirements for Pub. 100-09, Chapter 6 Medicare Contractor Beneficiary and Provider Communications Manual. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R36COM.pdf Subject: Updates to Pub. 100-09, Chapter 6 Beneficiary and Provider Communications Manual, Chapter 6, Provider Customer Service Program Number: 36 Title: 10168 […]

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) review changes to the Medicare Provider Reimbursement Manual, Part 2, Provider Cost Reporting Forms and Instructions, Chapter 23, Form CMS-276-16. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R1P223.pdf Subject: NA Number: 1 Title: NA Release Date: July 21, 2017 Effective Date: NA Implementation Date: NA Special […]

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) work to accommodate CMS coverage of Hepatitis B screening for non-pregnant, high risk individuals with the appropriate U.S. Food and Drug Administration (FDA) approved/​cleared laboratory tests. The coverage is compliant with Clinical Laboratory Improvement Act (CLIA) regulations. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R3831CP.pdf Subject: […]