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Recent CMS Change Requests for HIV, HPV, FISS Travel Allowance

April 19, 2016 by Experian Health

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 B.

Effective date: April 13, 2015

Implementation date: March 7, 2016, for non-shared A/B MAC edits; July 5, 2016 for CWF analysis and design; October 3, 2016, for CWF Coding, Testing and Implementation, MCS, and FISS Implementation; January 3, 2017, for Requirement 9403.04.9

View Transmittal R3461CP

View Transmittal R190NCD

Screening for Cervical Cancer with Human Papillomavirus (HPV) testing

On February 5, CMS released a change request stating CMS has determined that for dates of service on or after July 9, 2015, evidence is sufficient to add HPV testing under specified conditions.

Effective date: July 9, 2015

Implementation date: March 7, 2016, for non-shared MAC edits; July 5, 2016, for CWF analysis and design; October 3, 2016, for CWF Coding, Testing and Implementation, MCS, and FISS Implementation; January 3, 2017, for Requirement BR9434.04.8.2

View Transmittal R3460CP

View Transmittal R189NCD

Revision to Fiscal Intermediary Shared System (FISS) lab travel allowance editing to include new specimen collection code G0471

On February 5, CMS released a change request updating FISS reason code 32436 to include HCPCS code G0471 in the list of specimen collection fee codes that will allow the travel allowance to be paid on outpatient claims.

Effective date: April 1, 2016

Implementation date: July 5, 2016, for claims processed on or after

View Transmittal R1619OTN

View MLN Matters article MM9471

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