Washington Report –March/April, 2007 

Bill FinerfrockCapitol Associates

  

CMS Approves NPI Contingency PlanCMS – The Medicare Contingency PlanSurvey Says…..Public Availability of NPI Database?Medicare Trustees Report IssuedActing Medicare Chief Vows To Focus More On Tax CheatsGovernment Accountability Office Releases 3-Year PlanDon’t Blame Him, Don’t Blame Me, Blame that guy behind the TreeCMS Moves Forward with PQRI programKolodner Officially Appointed ONCHIT ChiefCMS Program Transmittals released in March and April 

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CMS Approves NPI Contingency Plan As expected, the Centers for Medicare and Medicaid Services (CMS) has announced a contingency plan for the NPI implementation.  This general announcement applies to ALL health plans.  Each plan, including Medicare and Medicaid, is responsible for announcing their plan specific arrangements.  Below is the Medicare specific plan.   The contingency plan announced by CMS largely follows the recommendations made by the HBMA and the National Committee on Vital and Health Statistics in a letter to HHS Secretary Michael Leavitt.   Details of the announcement are contained in a CMS document entitled, “Guidance on Compliance with the HIPAA National Provider Identifier (NPI) Rule After The May 23, 2007, Implementation Deadline” To view this guidance, visit:http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/NPI_Contingency.pdf on the CMS website.   According to the press release issued at the time of the announcement,  

“The enforcement guidance released today clarifies that covered entities that have been making a good faith effort to comply with the NPI provisions may, for up to 12 months, implement

contingency plans that could include accepting legacy provider numbers on HIPAA transactions in order to maintain operations and cash flows.”

 The final rule establishing the NPI as the standard unique health provider identifier for health care providers was originally published in 2004 and requires all covered entities to be in compliance with its provisions by May 23, 2007, except for small health plans, which must be in compliance by May 23, 2008.

CMS continues to encourage health plans to assess the readiness of their provider communities to determine the need to implement contingency plans to maintain the flow of payments while continuing to work toward compliance.  HBMA encourages all members to make sure their provider clients who have not yet obtained NPIs,  do so immediately, and to use their NPIs in HIPAA transactions as soon as possible.  Applying for an NPI is fast, easy and free.  Visit the National Plan/Provider Enumeration System (NPPES) website at:

https://nppes.cms.hhs.gov/.  

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CMS – The Medicare Contingency Plan Subsequent to the issuance of the industry-wide contingency plan announcement, Medicare issued a Plan specific contingency.   As you read the Medicare contingency plan below, there are a few things worth noting:

1. Medicare will continue to accept "legacy only" claims for some unspecified period of time. How long this "legacy only" time period lasts will be dependent upon how many providers begin submitting claims using either "NPI Only" or "NPI AND legacy".

2. Providers who need to submit an identifier for another provider as part of the Medicare claims submission (i.e. the referring physician's identifier) CAN use the legacy number of that provider through May, 2008.

If you have questions about this, you should contact your local Medicare Contractor. ________________

 Medicare Contingency Policy

For some period after May 23, 2007, Medicare FFS will allow continued use of legacy numbers; it will also accept transactions with only NPIs, and transactions with both NPI and legacy identifiers.

After May 23, 2008, the legacy number will NOT be permitted on any inbound or outbound transaction. Medicare FFS has been assessing health care provider submission of NPIs on claims submitted. As soon as the number of claims submitted with an NPI for primary providers is sufficient to do so, Medicare will begin rejecting claims without an NPI for primary providers following appropriate notice.

In May 2007, Medicare FFS will evaluate the number of submitted claims containing a NPI. If the analysis shows a sufficient number of submitted claims contain a NPI, Medicare will begin to reject claims on July 1, 2007, that do not contain NPIs.

If a sufficient number of claims do not contain NPIs in the May analysis, Medicare FFS will assess compliance in June 2007 and determine whether to begin rejecting claims in August 2007. Medicare FFS will provide advanced notification to providers, Medicare contractors and the shared systems of the date they are to begin rejecting claims when a decision has been made to do so. That date will supersede all dates announced in previous contractor communications.

CMS recognizes that the National Council for Prescription Drug Program (NCPDP) format permits reporting of only one identifier, and will accept either the NPI or legacy number on the NCPDP format until May 23, 2008.

In regard to the remittance advice and the 837 coordination of benefits (COB) transactions, the following will occur until May 23, 2008:

if a claim is submitted with an NPI, the NPI will be sent on the associated 835 remittance advice, otherwise the legacy number will be provided;

if a claim is submitted with an NPI, the 837 coordination of benefits (COB) transaction will contain both the NPI and the legacy number, otherwise the legacy number will be provided.

By May 23, 2008, the X12 270/271 eligibility inquiry/response supported by CMS via Extranet and Internet must contain the NPI.

Once a decision is made to begin requiring NPIs on claims, primary providers i.e., billing, pay-to and rendering providers must be identified by their NPIs or the claims will be rejected once the decision is made as indicated above. Medicare contractors must then use the NPI crosswalk to locate the NPI and associated legacy identifier submitted on the claim for primary providers.

All other providers are considered secondary providers and include referring, ordering, supervising, facility, care plan oversight, purchase service, attending, operating and "other" providers. Legacy numbers are acceptable for secondary providers until May 23, 2008.

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Survey Says….. In 2006, the Centers for Medicare and Medicaid Services began conducting a survey of providers on their level of satisfaction with the Medicare contractors.  The survey covered a range of areas including enrollment, claims adjudication and processing, provider educational material, grievance procedures and more. The results of that survey – huge percentages of providers were very happy with the level of service they were receiving from the Contractors – took many in the billing community by surprise.  At least based upon the anecdotal information we had at HBMA, we were a bit skeptical that the Contractors were doing as good a job as the survey results indicated.   According to the press release announcing the provider satisfaction survey, “85 percent of respondents rated their contractors between 4 and 6 on a 6-point scale.” After several conversations with CMS staff about including billing companies in the survey, it was determined that for a variety of reasons, this would be impractical.  However, HBMA proposed to conduct a shadow survey of HBMA members to get their opinions and then share those results with CMS.   For the past month, HBMA has been conducting an on-line survey using the CMS questionnaire as the basis for the survey.  Over 100 HBMA member companies participated in the survey.  More than 90% of the respondents have been in the billing business for more than 5 years.  Based upon company size, these billing companies were responsible for the filing of 45 Million claims last year for thousands of physicians and group practices.   Based on the survey, 32 % of respondents were less than satisfied with the overall service they received from the Medicare Contractors.  Only 5% were “completely satisfied” on the 6 point scaled used by CMS.   HBMA staff and the GR Committee will be analyzing in greater detail the survey results and will share those results with the CMS staff when the analysis is completed.  We want to thank everyone for participating in this important survey and we will let you know CMS’ reaction to the survey results after we have presented them with our findings. To the top Public Availability of NPI Database? Although CMS acknowledges the importance of making the NPI database available to those entities that need access to this information, there has still been no formal word on when the necessary regulations will be released at the time this report was going to print.   

In conversations with various CMS officials, HBMA staff and representatives have been told that the agency considers making the database publicly available, “A critical aspect of implementing the NPI.”    Due to the issuance of the contingency, HBMA has been told that physicians submitting claims without the NPI of the referring physician will not be disadvantaged because they have been unable to obtain the referring physician’s NPI.  Physicians will be expected to make a “good faith” effort to obtain the NPI of the referring physician.   According to numerous conversations with CMS staff, the agency still plans to make data available from the NPPES system that will assist covered entities in developing the necessary “crosswalks.”For additional information on the NPI, you can go to: http://www.cms.hhs.gov/NationalProvIdentStand/ To the top Medicare Trustees Report Issued

Each year, the Trustees of the Medicare program are charged with issuing a report that analyzes and assesses the financial viability of the Medicare program.  On April 23, 2007, the Medicare Trustees issued their latest report.

According to a press release issued by CMS, the Report shows that “while Medicare’s financial outlook remains troubling, the program’s outlook has improved slightly compared to last year’s estimate.”   Medicare expenditures were $408 billion in 2006, or 3.1 percent of gross domestic product (GDP).  The Trustees estimate that Medicare spending will consume over 11 percent of GDP in 75 years.                                  

Commenting on the Report, HHS Secretary Mike Leavitt (one of the Trustees) said “the report points to the need to act quickly and efficiently to strengthen and improve Medicare, including enactment of the steps proposed in the President’s budget to address Medicare's fiscal health.”

Acting CMS Administrator Leslie Norwalk said “We are already beginning to implement steps to protect Medicare for future generations, Medicare is now providing up-to-date preventive benefits and comprehensive drug coverage and is developing better information on quality and costs of health care to ensure that we pay appropriately for the health care of our beneficiaries.” 

The Trustees estimate that the Medicare Hospital Insurance (HI) Trust Fund is projected to be exhausted in 2019.  The good news is that this is one year later than estimated in last year's report.

Because of continued rapid growth in expenditures for the program as a whole the Trustees have issued a determination of “excess general revenue Medicare funding.”  

This finding automatically triggers a “Medicare funding warning.”  By law, a Medicare funding warning requires the President to propose legislation to respond to the issue within 15 days following the release of the Budget for the next Fiscal Year.  The next Budget President Bush will propose is the 2009 Budget, which is typically released in early February.  This means we can expect the Bush Administration to make significant Medicare proposals in the budget he submits next February (2008).

The law also requires Congress to consider the President’s proposals on an expedited basis. 

One element of this year’s Trustees Report involves the new prescription drug benefit under Medicare Part D.  The Bush Administration is expected to point to with pride, the latest cost projections for Part D are 13 percent lower than estimated in last year’s report (and substantially lower than the original estimates from 2003).

The trustees note that Health Plan bids for 2007 were 10 percent lower than in 2006, as a result of intense competition among plans to attract and retain enrollees and plans’ expectations to further increase use of inexpensive generic drugs, rather than more costly brand-name equivalents.  This news may take some of the steam out of Congressional efforts to require the Bush Administration to engage in price negotiations with pharmaceutical companies. 

Some of the ideas for slowing Medicare expenditures being floated by the Trustees include the following:

Implementing reductions in market basket rates of growth, as proposed in the President’s 2008 Budget, including a proposed 0.4 percent reduction in the growth rate of Medicare payments if Congress does not pass a specific alternative proposal to achieve needed improvements in sustainability;

Increasing the share of program costs paid by the highest-income beneficiaries, as proposed in the 2008 budget;

Pilot-testing quality and efficiency measures and developing strategies to pay more for better results rather than more services; and

Implementing competitive bidding approaches to the delivery of care.

The Medicare Trustees are:

Secretary of the Treasury Secretary of Health and Human ServicesSecretary of LaborSocial Security CommissionerJohn Palmer (Public Trustee appointed by the President)Thomas Saving (Public Trustee appointed by the President)The Administrator of the Centers for Medicare & Medicaid Services, serves as Secretary to the Board of Trustees. 

To the top Acting Medicare Chief Vows To Focus More On Tax Cheats Acting CMS Administrator Leslie Norwalk announced recently that she is considering ways to improve its accounting practices and join the Treasury Department's levy program to collect taxes due from physicians. A Government Accountability Office (GAO) report has revealed that 21,000 Medicare Part B providers owe $1.3 billion in back taxes.  In some cases, the providers owed hundreds of thousands of dollars in unpaid taxes as the same time CMS was paying these physicians hundreds of thousands of dollars in Medicare payments.  According to testimony Norwalk presented before a House Committee, CMS is unable to use the levy program to collect these back taxes because of Medicare’s antiquated accounting system. In her testimony, Norwalk also stated that the agency is reviewing regulatory options to recovering the money owed the government.  CMS was expected to begin discussions with the IRS on developing ways collect this money.  At a minimum, CMS will be reviewing their contracts to ensure that the government agency is not contracting with any tax scofflaws. According to GAO, CMS not only has the ability to work with the IRS on the levy program, but also deny enrollment in the Medicare program to providers with known outstanding IRS claims. According to published reports, the levy program is already used by the Defense Department and if adopted by CMS, would allow the agency to collect 15 percent of a Medicare contractor's incoming revenue in order to pay down outstanding tax debt. The Government Accountability Office has been making this recommendation for over 5 years but it has only been recently that CMS has begun paying attention to this issue. To review a summary of the report, go to: http://www.gao.gov/highlights/d07587thigh.pdf To the top Government Accountability Office Releases 3-Year Plan The Government Accountability Office is the fiscal watchdog of Congress.  This is the agency that reviews various federal programs with a fine tooth comb to find out what government programs work, what doesn’t work, what can be done better and what should be scrapped.  GAO analysts and accountants review everything from the food stamp program to the war in Iraq.   

Although GAO undertakes work at the behest of Congress, the agency attempts to establish goals and objectives on its own – in essence anticipating where the Congress might like to go over the next 3 – 5 years..  Recently, GAO released is strategic plan for the next three years.  This is part of an on-going process of self-evaluation and re-evaluation.    “Forces That Will Shape America’s Future:  Themes from GAO’s Strategic Plan”, describes the agencies proposed goals and strategies for serving the Congress for fiscal years 2007 through 2012. As expected, with the Congress and the nation facing such challenges as the large and growing long-term fiscal imbalance and increased concerns about meeting the health care needs of American citizens, this plan includes bodies of work that address anticipated requests for evaluations of these and other major issues.  According to the report,  

 “Perhaps more disturbing is that our nation’s long-range fiscal outlook remains unsustainable given existing federal commitments and the challenges of caring for a growing elderly population. Consequently, policymakers will be increasingly required to judge what the nation can afford, both now and in the future. In addition, national boundaries are becoming less relevant to policymakers as they address a range of economic, security, social, and environmental issues. At the same time, the composition of our nation’s population is becoming older and more diverse, resulting in a virtual kaleidoscope of demands for federal funds and services. Scientific research and technological developments provide opportunities to improve the lives of U.S. citizens but also raise profound ethical questions for society.

 Underlying the GAO analysis for healthcare is what they describe as the “breathtaking” growth in healthcare expenditures.  From 1990 – 2000, healthcare spending nearly doubled, from approximately $700 Billion to $1.3 Trillion.  And if the current trends continue, GAO estimates that total spending for healthcare will be nearly $3 Trillion by 2010.   In Medicare, it was noted that, “…expenditures for hospital insurance, one component of Medicare, exceeded hospital insurance income (exclusive of interest income) in 2004. Based on these numbers and projected growth, GAO estimates that the Medicare Part A Hospital Insurance Trust Fund will be exhausted by 2018. In order to fulfill it’s charter to Congress, GAO proposes the following work over the next few years: *          evaluate Medicare reform, financing, and operations

*          assess trends and issues in private health insurance coverage*          assess actions and options for improving VA’s and DOD’s health care services*          evaluate the effectiveness of federal programs to promote and protect the public               health*          evaluate the effectiveness of federal programs to prevent, prepare for, and

respond to public health emergencies*          evaluate federal and state program strategies for financing and overseeing long-            term health care;*          assess state experiences and federal oversight in providing health insurance

coverage for low-income populations This is a tall order and the GAO report goes into even greater detail as to how GAO would meet some of these objectives.  If you would like to read the entire report (it is 185 pages) go to: http://www.gao.gov/new.items/d07467sp.pdf To the top Don’t Blame Him, Don’t Blame Me, Blame that guy behind the Tree As billing companies are well aware, the CMS-1500 form is the standard claim form used by a non-institutional providers or suppliers to bill Medicare carriers and durable medical equipment regional contractors.  It is also used for billing of some Medicaid State Agencies and commercial insurers.  The National Uniform Claim Committee (NUCC) is responsible for the maintenance of the CMS-1500 form. The NUCC revised the CMS-1500 in 2006; the new version, CMS-1500 (08-05), was scheduled to replace the current CMS-1500 (12-90) version on April 1, 2007.  According to CMS, it has recently come to their attention that there are incorrectly formatted versions of the revised form being sold by print vendors, specifically the Government Printing Office (GPO). After reviewing the situation, the GPO has determined that the source files they received from the NUCC’s authorized forms designer were improperly formatted.  According to CMS, this resulted in the sale of both printed forms and negatives which do not comply with the form specifications. Given the circumstances, CMS has decided to extend the acceptance period of the Form CMS-1500 (12-90) version beyond the original April 1, 2007 deadline while this situation is resolved.  The CMS press release announcing this delay states,  

“Contractors will be directed to continue to accept the Form CMS-1500 (12-90) until notified by CMS to cease. At present, we are targeting June 1, 2007 as that date.” The following will help you to properly identify which form is which. The old version of the form contains “Approved OMB-0938-0008 FORM CMS-1500 (12-90)” on the bottom of the form (typically on the lower right corner) signifying the version is the December 1990 version. The revised version contains “Approved OMB-0938-0999 FORM CMS-1500 (08-05)” on the bottom of the form signifying the version is the August 2005 version.  The best way to identify if your CMS-1500 (08-05) version forms are correct is by looking at the upper right hand corner of the form. On properly formatted claim forms, there will be approximately a ¼” gap between the tip of the red arrow above the vertically stacked word “CARRIER” and the top edge of the paper. If the tip of the red arrow is touching or close to touching the top edge of the paper, then the form is not printed to specifications. To the top CMS Moves Forward with PQRI program In the waning hours of the 109th Congress, legislation was approved offering a 1.5% bonus to physicians who voluntarily participate in the Physician Quality Reporting Initiative.  The bonus, for those who qualify, will be equivalent to 1.5% of the providers Medicare fee schedule payments for claims submitted after July 1 and before December 31st.   Eligible professionals who participate in the 2007 PQRI program will have access to a CMS analysis of their reported data. Those who successfully report quality measure data on claims for services between July 1 and December 31, 2007, will be eligible for a single consolidated incentive payment in mid 2008. The bonus payment, subject to a cap, is the equivalent of 1.5% of total allowed charges for covered physician fee schedule services provided from July 1 through December 31, 2007.TRHCA section 101 specifies that, for 2007, CMS must use the taxpayer identification number (TIN) as the billing unit, so any bonus incentive payments earned will be paid to the holder of the TIN. For more information on the PQRI program, go to: http://www.cms.hhs.gov/PQRI/35_2008PQRIInformation.asp To the top Kolodner Officially Appointed ONCHIT Chief

 HHS Secretary Mike Leavitt announced the appointment of Robert M. Kolodner, M.D., to head the Office of the National Coordinator for Health Information Technology (ONCHIT).  As was previously reported in the HBMA Washington Report, Kolodner has been serving as the Interim National Coordinator for Health IT since Sept. 20, 2006. Prior to his appointment as ONCHIT Chief, Kolodner served at the Veterans Health Administration where he was Chief Health Informatics Officer.  In making the appointment official, HHS Secretary Michael Leavitt said,  "I appreciate his ongoing commitment to advance the use of health IT to improve the safety, efficiency, and value of health care for consumers and to increase their ability to manage their health, and I look forward to continuing to work closely with him." As the head of ONCHIT, Dr. Kolodner will serve as principal advisor to Secretary Leavitt on all health IT initiatives.  He will also continue to develop, maintain, and direct the implementation of the strategic plan to guide nationwide adoption of interoperable health IT to reduce medical errors, improve quality, and produce greater value in health care.   To the top CMS Program Transmittals released in March and April The following program transmittals were issued by the Centers for Medicare and Medicaid Services between March 1, 2007 and April 23, 2007.   CMS uses transmittals to communicate new or changed policies or procedures that will be incorporated into the CMS Online Manual System. The cover or transmittal page summarizes and specifies the changes.   

Transmittal No. Subject Effective Date

R1225CPMedicare Fee For Service (FFS) National Provider Identifier (NPI) Implementation Contingency Plan

05/23/2007

R1226CP Medicare Program, Correction of Hospice Cap for FYs 2003 and 2004 07/31/2007

R1224CPHome Health Agencies (HHAs) Providing Durable Medical Equipment (DME) in Competitive Bidding Areas

10/01/2007

R25SOMA New Number Series and State Codes for CMS Certification Numbers (formerly OSCAR

10/01/2007

Provider Numbers)

R271OTNRecovery Audit Contractor (RAC)/Other Medicare Contractors Claims Mass Adjustments in VIPS Medicare System (VMS)-Analysis and Design

10/01/2007

R119FM Contractor CROWD Form 5 Completion Changes 10/01/2007

R119FM Contractor CROWD Form 5 Completion Changes 10/01/2007

R1222CP Update of HCPCS Codes for Hemophilia Clotting Factors 10/01/2007

R1221CPCommon Working File (CWF) Duplicate Claim Edit for the Technical Component (TC) of Radiology and Pathology Laboratory Services Provided to Hospital Patients

04/02/2007

R1219CPPart C and D Plan Type Display on the Common Working File (CWF) - This CR rescinds and fully replaces CR 5349

07/02/2007

R118FMRecurring Update Notification for the Notice of New Interest Rate for Medicare Overpayments and Underpayments - 3rd Qtr. FY 2007

04/20/2007

R68NCD Ventricular Assist Devices (VADs 05/14/2007

R198PINew DMEPOS Certificates of Medical Necessity (CMNs) and DME Information Forms (DIFS) for Claims Processing

07/02/2007

R67NCD Blood Brain Barrier Osmotic Disruption for Treatment of Brain Tumors 05/07/2007

R8SS CMS Business Partners System Security Manual 05/01/2007

R197PIMRevise the VIPS Medicare System (VMS) and Medicare Contractor System (MCS) to Expand Files to Include a National Provider Identifier (NPI) for Each Legacy Provider Identifier

07/02/2007

R269OTNInstructions for Fiscal Intermediary Standard System (FISS) and Multi-Carrier System (MCS) Healthcare Integrated General Ledger Accounting System (HIGLAS) Changes

07/02/2007

R1218CP Program Instructions Designating the Competitive Bidding Areas and Product

04/02/2007

Categories Included in the CY 2007 DMEPOS Competitive Bid Program

R1216CP Provider Education for Handling NPI Issues Related to Deceased Providers 04/30/2007

R1211CP Change in the Amount in Controversy Requirement for Federal District Court Appeals 07/02/2007

R267OTN RAC/Other Medicare Contractors Claims Mass Adjustments in FISS 09/04/2007

R68BPAmbulance Fee Schedule - Ground Ambulance Services - Revision to the Specialty Care Transport (SCT) Definition

04/30/2007

R1217CP Update to Internet-Only-Manual (IOM) Publication 100-04, Chapter 18, Section 60.1 07/02/2007

R1215CP Revisions to Form CMS-1500 Submission Requirements 04/30/2007

R268OTNRecovery Audit Contractors (RAC)/Other Medicare Contractors Claims Mass Adjustments in MCS- Analysis and Design

07/01/2007

R196PIMedical Review of Skilled Nursing Facility (SNF) Claims Using the MDS QC System Software

04/30/2007

R1214CP Discontinuance of ASCA Excel spreadsheet maintenance 07/02/2007

R1212CPRequirement for Providing Route of Administration Codes for Erythropoiesis Stimulating Agents (ESAs)

06/29/2007

R1213CP EDI Enrollment and Electronic Claim Record Retention 07/02/2007

R43GI Clarification in Testing Instructions for Definition of "Local Components 07/02/2007

R195PI General Background Information on Individual Practitioners and Certain Part B Services 04/30/2007

R1210CPNew "K" Codes for Oral/Mask for Use with Continuous Positive Airway Pressure Device (CPAP)

07/02/2007

R191PI Provider/Supplier Enrollment Approval Letters 05/23/2007

R266OTN New Contractor Number for CIGNA Government 06/01/2007

Services, LLC-Jurisdiction C DME MAC Workload

R1209CPApril 2007 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes

04/02/2007

R1117CP Reporting of Type of Bill (TOB) 12X for Billing of Diagnostic Mammographies 04/02/2007

R1207CP Competitive Acquisition Program (CAP) for Part B Drugs 04/19/2007

R1208CP Extension for Acceptance of Form CMS-1500 (12-90) 04/02/2007

R1206CP Extracorporeal Photopheresis 04/02/2007

R66NCD Extreacorporeal Photopheresis 04/02/2007

R1204CP

April 2007 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective April 1, 2007, and Revisions to the January 2007 Quarterly ASP Medicare Part B Drug Pricing Files

04/02/2007

R1205CP Instructions for Downloading the Medicare Zip Code File - July 2007 07/02/2007

R1197CP Correction to Change Request (CR) 5404: New Waived Tests 04/02/2007

R1194CPTemporary Addition to the Administrative Simplification Compliance Act (ASCA) Exception List for Medicare Secondary Payer (MSP) Claims

N/A

R265OTN Program Overview: 2007 Physician Quality Reporting Initiative 04/09/2007

R1203CPApril Quarterly Update for 2007 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule

04/02/2007

R1195CP New Waived Tests 04/02/2007

R1201CPQuarterly Update to Correct Coding Initiative (CCI) Edits, Version 13.1, Effective April 1, 2007

04/02/2007

R1202CP Quarterly Update to Medically Unlikely Edits (MUEs), Version 1.1, Effective April 1, 2007 04/02/2007

R1200CPChanges to the Laboratory National Coverage Determination (NCD) Edit Software for April 2007

04/02/2007

R1198CPApril 2007 Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) Specifications Version 8.1

04/02/2007

R1199CPApril 2007 Non-Outpatient Prospective Payment System (Non-OPPS) Outpatient Code Editor (OCE) Specifications Version 22.2

04/02/2007

R67BP 2007 Update to the End Stage Renal Disease Composite Payment Rates 04/02/2007

R264OTNInstructions for Fiscal Intermediary Standard System (FISS) and Multi-Carrier System (MCS) Healthcare Integrated General Ledger Accounting System (HIGLAS) Changes

04/02/2007

R1193CPUse of 9-Digit ZIP codes for Determining the Correct Payment Locality for Services Paid Under the Medicare Physician Fee Schedule (MPFS) and Anesthesia Services

04/02/2007

R1192CP Payment and Billing for Islet Isolation Add-On in National Institutes of Health (NIH) Clinical Trial