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) 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) 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: […]

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) acknowledge Medicare coverage of Percutaneous Image-guided Lumbar Decompression (PILD) under the Coverage with Evidence Development (CED) paradigm. Coverage applies for beneficiaries with Lumbar Spinal Stenosis (LSS) enrolled in a CMS-approved prospective longitudinal study. Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R3787CP.pdf Subject: Percutaneous Image-guided Lumbar Decompression (PILD) for […]

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) review changes to the Coordination of Benefits Agreement (COBA) claims crossover process effecting handling in the Common Working File. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R3765CP.pdf Subject: Modifications to the Common Working File (CWF) In Support of the Coordination of Benefits Agreement (COBA) Crossover Process Number: […]

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) remove third party software from the Combined Common Edits/​Enhancements Module (CCEM) and otherwise work with the software and the CCEM to ensure proper integration. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R1842OTN.pdf Subject: Remove HSQLDB from the Combined Common Edits/​Enhancements Module (CCEM) Number: 1842 Title: 10088 Release […]

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) adjust processing claims for oxygen and oxygen equipment under the Medicare Part B benefit for durable medical equipment as per updates to section 130.6 of chapter 20 of the Medicare Claims Processing Manual (Pub.100-04). FullTransmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R3730CP.pdf Subject: Payment for Oxygen Volume Adjustments […]

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) review and utilize a Recurring Update Notification which updates the Hospital Outpatient Prospective Payment System (OPPS) and may require changes to the Healthcare Common Procedure Coding System (HCPCS), Ambulatory Payment Classification (APC), HCPCS Modifier, and Revenue Code. Contractors shall manually add and […]

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) review routine changes to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule for April 2017. Contractors shall implement any changes in pricing and process claims according to the new guidance. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R3729CP.pdf Subject: April Quarterly Update for 2017 […]

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) acknowledge a Recurring Update Notification for the Ambulatory Surgical Center (ASC) Payment System as well as updates to the Healthcare Common Procedure Coding System (HCPCS). Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R3726CP.pdf Subject: April 2017 Update of the Ambulatory Surgical Center (ASC) Payment System Number: 3726 Title: […]