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Recent CMS Change Requests for HIV, HPV, FISS Travel Allowan...

Posted on Apr 19 2016 by
Screening for the Human Immunodeficiency Virus (HIV) infection On February 5, CMS released a change request to inform contractors that CMS has determined that the evidence is adequate to conclude that screening of HIV infection for all individuals between the ages of 15-65 years is reasonable and necessary for early detection of HIV and is appropriate for individuals entitled to benefits under Part A or enrolled in Part...

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ICD-10 Updates: The Freeze is Over...

Posted on Apr 19 2016 by
After five years of ICD-10 classification system code freezes, October 1, 2016 will see the system back on the routine cycle for annual updates. On March 9th and 10th, the ICD-10 Coordination and Maintenance committee met to review proposals for both ICD-10-CM and ICD-10-PCS. All PCS codes to date that have been approved as new, revised, and deleted have been compiled into a file for review under the Coordination and...

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Coding Revisions to National Coverage Determinations...

Posted on Apr 19 2016 by
On February 26th, CMS published a One-Time Notification, Transmittal 1630, Change Request 9540. This change request (CR) is the 6th maintenance update of ICD-10 conversions and other coding updates specific to national coverage determinations (NCDs) with   implementation date of July 5, 2016 for all Medicare Contractors The majority of the NCDs included are a result of feedback received from previous ICD-10 NCD...

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Announcement from HHS: The Health Care Industry Cybersecurit...

Posted on Apr 19 2016 by
At HHS, we’re working today with an eye on the horizon. We’re committed to building a health care system that provides better care, spends our health care dollars in smarter ways, and puts patients at the center of their care. Our aim is to strengthen health care so that it works for the health of every American. Our vision for this health care system is one where a patient can easily check their own medical record,...

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Special Edition MLN Matters Articles Regarding Billing Chiro...

Posted on Apr 19 2016 by
On March 16, CMS released three special edition MLN Matters articles on submitting claims to MACs for chiropractic services provided to Medicare beneficiaries. Special edition MLN Matters article SE 1601 helps clarify the CMS policy regarding Medicare coverage of chiropractic services and documentation requirements for the beneficiary’s initial visit and subsequent visits to the chiropractor. Special edition MLN...

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Telehealth Services: Change Request from CMS...

Posted on Apr 19 2016 by
On March 11, CMS released a change request to display the list of telehealth services that were once available through the manual updates to now be displayed via a weblink going forward. CMS is also adding CRNAs to the list of Medicare practitioners who may bill for covered telehealth services. Lastly, the telehealth language has been removed from Pub 100.02, Medicare Benefit Policy Manual, Chapter 15, Section 270 and a...

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Implementation of the Award for Jurisdiction A DME MAC Workl...

Posted on Apr 19 2016 by
On March 11, CMS posted a transmittal stating it awarded Noridian Healthcare Solutions, LLC, a new contract for the administration of Medicare Fee-for-Service claims for DME, prosthetics, orthotics, and supplies in Jurisdiction A. The incumbent is NHIC, Corp. The Jurisdiction A DME MAC serves Medicare beneficiaries who reside in the states of Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey,...

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Substantial revisions to QIO Manual for reviews involving po...

Posted on Apr 19 2016 by
CMS recently released an extensive revision of QIO Manual Chapter 9 related to QIO reviews in cases potentially involving sanction recommendations from the OIG for quality and EMTALA issues. The chapter has been renamed to include the reference to EMTALA. This update supersedes all the information in the October 3, 2003 version of Chapter 9, any previously issued Question & Answer guidance, and any previously issued TOPS,...

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New HCPCS Effective April 1, 2016...

Posted on Apr 19 2016 by
Effective April 1, 2016, nine new HCPCS codes have been created for reporting drugs and biologicals in the ASC setting and have been granted OPPS Pass-Through status. The fact that a drug, device, procedure or service is assigned a HCPCS code and a payment rate under the ASC payment system does not imply coverage by the Medicare program. MACs determine whether a drug, device, procedure, or other service meets all...

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