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September 2005
Services Not Provided Within the United States- September 27, 2005

National Modifier and Condition Code To Be Used To Identify Disaster Related Claims- September 26, 2005

Holding Claims with Diagnosis Code 585.6 for ESRD- September 23, 2005

Hurricane Katrina Waiver for 3-Day Hospital Stay Requirement- September 23, 2005

October 2005 Quarterly Fee Schedule Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)- September 20, 2005

October 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)- September 20, 2005

Fiscal Intermediary (FI) Notice to Providers, Intern and Resident Information System (IRIS) Programs on the Centers for Medicare and Medicaid Services (CMS) Web Site- September 20, 2005

Financial Liability for Services Subject to Home Health Consolidated Billing- September 14, 2005

October Update to the 2005 Medicare Physician Fee Schedule Database- September 14, 2005

October 2005 Outpatient Prospective Payment System Outpatient Code Editor (OPPS OCE) Specifications Version 6.3- September 13, 2005

Adjusting Claims- New Procedure- September 13, 2005

Billing for Devices Under the Hospital Outpatient Prospective Payment System (OPPS)- September 12, 2005

Enforcement of Hospital Inpatient Bundling: Carrier Denial of Ambulance Claims During an Inpatient Stay- September 12, 2005

CMS Town Hall Meeting Reminder- September 9, 2005

MMA - Appeals of Claims Decisions: Modification to Medicare's Fiscal Intermediary Shared System (FISS)- September 8, 2005

October Update to the 2005 Medicare Physician Fee Schedule Database- September 8, 2005

October 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File and Revisions to April 2005 Quarterly ASP Medicare Part B Pricing File, Effective October 1, 2005- September 8, 2005

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2005- September 8, 2005


August 2005

Important Information for Electronic Billers- August 29, 2005

Medicare Preventive Services- August 24, 2005

MMA - Billing and Claims Processing Instructions for Claims Subject to Expedited Determinations- August 23, 2005

Manual Update on Medical Nutrition Therapy Services- Manualization- August 17, 2005

Fiscal Intermediary Number Change in All Electronic Files- August 22, 2005

The Comprehensive Error Rate Testing (CERT) Process for Handling a Provider's Allegation of Medical Record Destruction- August 17, 2005

October Update to the Medicare Outpatient Code Editor (OCE) Version 21.0 for Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System (Non-OPPS)- August 17, 2005

New Waived Tests Approved by the Food and Drug Administration (FDA) Under Clinical Laboratory Improvement Amendments (CLIA) of 1988- August 16, 2005

Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, and Hepatitis B Virus) and Their Administration at Renal Dialysis Facilities (RDFs)- August 16, 2005

Implementation of the Centers for Medicare & Medicaid Services (CMS) Ruling 05-01 Regarding Presbyopia-Correcting Intraocular Lenses (IOLs) for Medicare Beneficiaries- August 16, 2005

Medicare Announces End of HIPAA Contingency Plan for Claims Submissions- August 16, 2005

MMA - The Medicare Chronic Care Improvement, "Medicare Health Support," Program- August 17, 2005

Medicare Provider Feedback Town Hall Meeting 9/12/05 2-4 p.m. EST- August 09, 2005

New Fiscal Intermediary Edit to Identify Potentially Excessive Medicare Payments- August 08, 2005

Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update and Health Insurance Prospective Payment System (HIPPS) Coding Update Effective January 1, 2006- August 03, 2005

Claim Status Code/Claim Status Category Code Update- August 03, 2005


July 2005

Enforcement of Hospital Inpatient Bundling: Carrier Denial of Ambulance Claims During an Inpatient Stay- July 29, 2005

Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, and Hepatitis B Virus) and their Administration at Renal Dialysis Facilities (RDFs)- July 28, 2005

MMA - The Medicare Chronic Care Improvement, "Medicare Health Support," Program- July 28, 2005

Remittance Advice Remark Code and Claim Adjustment Reason Code Update- July 28, 2005

New Health Professional Shortage Area (HPSA) Modifier- July 28, 2005

Abarelix for the Treatment of Prostate Cancer- July 28, 2005

New HCPCS Codes and System Edits for Supplies and Accessories for Ventricular Assist Devices - Full Replacement of CR3761- July 28, 2005

Message to Nursing Home Administrators on Medicare Prescription Drugs- July 26, 2005

Medicare Program Update to the Hospice Payment Rates,Hospice Cap, Hospice Wage Index and the Hospice Pricer for Fiscal Year 2005- July 26, 2005

Smoking and Tobacco Use Cessation Counseling- July 20, 2005

Expansion of Coverage for Percutaneous Transluminal Angioplasty (PTA)- July 20, 2005

Cochlear Implantation - July 19, 2005

Expansion of Various Alpha and Numeric Fields Within the Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) - July 14, 2005

New Expedited Review Process for Disputed Termination of Medicare Covered Services in a SNF, HHA, CORF and Hospice - July 12, 2005

Non-Physician Practitioner Questions and Answers - July 12, 2005

July 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS) - July 7, 2005

The Pulse of CMS - July 1, 2005

Coverage of Aprepitant for Chemotherapy-Induced Emesis - July 1, 2005

Coverage and Billing for Ultrasonic Stimulators for Nonunion Fracture Healing - July 1, 2005

Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - July 1, 2005

Error in HCPCS subject to Consolidated Billing- July 1, 2005

Adjusting or Canceling Medically Reviewed Claims - July 1, 2005


June 2005

Modification of FISS Edits for Colorectal Cancer Screening Services (HCPCS Codes G0104, G0106, G0107, G0120, and G0328) Furnished at Skilled Nursing Facilities (SNFs) - June 30,2005

The Number of Durable Medical Equipment Pricing Files That Must Be Maintained Online for Medicare - DMERC, FI, and RHHI Only - June 29,2005

July Update to the Medicare Outpatient Code Editor (OCE) Version 20.3 for Bills From Hospitals that are Not Paid Under the Outpatient Prospective Payment System (Non-OPPS) - June 29,2005

Access Process for Beneficiary Eligibility Inquiries/Replies (HIPAA 270/271 Transactions)(Extranet Only)- June 29,2005

New Healthcare Common Procedure Coding System (HCPCS) Drug Codes - June 29, 2005

Anti-Cancer Chemotherapy for Colorectal Cancer - June 29, 2005

Update of Healthcare Common Procedure Coding System (HCPCS) Codes and File Names, Descriptions, and Instructions for Retrieving the 2005 Ambulatory Surgical Center (ASC) HCPCS Additions, Deletions, and Master Listing - June 24, 2005

Mass Adjustment of Certain Transplant Claims - June 23, 2005

Reminder Regarding Medicare Billing Rules for Ambulance Services Rendered to Medicare Patients During an Inpatient Hospital Stay - June 23, 2005

Non-Physician Practitioner Questions and Answers - June 23, 2005

Replacement of Transmission Methods - June 14, 2005

Medicare Remittance Advice (RA) Initiative - June 13, 2005

An Algorithmic Approach to Determine if Mobility Assistive Equipment Is Reasonable and Necessary for Medicare Beneficiaries with a Personal Mobility Deficit (CR 3791 - Mobility Assistive Equipment (MAE)) - June 10, 2005

New Expedited Review Process for Disputed Terminations of Medicare-Covered Services in SNFs, HHAs, CORFs, and Hospices - June 10, 2005

New Educational Products Available - June 10, 2005

Centers for Medicare & Medicaid Services (CMS) Comprehensive Error Rate Testing (CERT) Program - The Importance of Complying with Requests for Claim Documentation - June 10, 2005

Clarifying Manual Instructions for Coding and Payment for Drug Administration Under the Hospital Outpatient Prospective Payment System (OPPS) - June 10, 2005

Smoking and Tobacco Use Cessation Counseling - June 10, 2005

July Quarterly Update to 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement - June 10, 2005

Access Process for Beneficiary Eligibility Inquiries/Replies (HIPAA 270/271 Transactions) (Extranet Only) - June 10, 2005

July 2005 Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) Specifications Version 6.2 - June 10, 2005

National Provider Identifier (NPI) - May 26, 2005

Anti-Cancer Chemotherapy for Colorectal Cancer - May 26, 2005

MMA-CMS' Implementation of Section 1011 of the Medicare Modernization Act-Federal Funding of Emergency Health Services Furnished to Undocumented Aliens - May 26, 2005

CMS Announces the National Provider Identifier (NPI) Enumerator Contractor and Information on Obtaining NPIs - May 24, 2005

Revisions to the Medicare Benefit Policy Manual (Pub 100-02), Chapter 15, Sections 220 and 230 Regarding Therapy Services - May 24, 2005

Posters re Medicare Prescription Drug Coverage Now Available For Display - May 24, 2005

July Update to the 2005 Medicare Physician Fee Schedule Database - May 24, 2005

Fiscal Intermediary (FI) Reporting of Add-on-Payments That Do Not Result in a Specific Increase or Decrease in the Amount Reported as Payable for a Claim or a Service on a Remittance Advice - May 24, 2005

MMA – New April 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File and Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File - May 24, 2005

MMA - Supply Codes and Payments for Immunosuppressive Drugs - May 24, 2005

New Patient Status Code to Define Discharges or Transfers to a Critical Access Hospital (CAH) - May 24, 2005

Payments to Ambulatory Surgery Centers (ASCs) for New CPT Code 66711 - May 24, 2005

Updated Requirements for Autologous Stem Cell Transplantation (AuSCT) for Amyloidosis - May 24, 2005

July Quarterly Update for 2005 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule - May 24, 2005

Revisions to the Medicare Benefit Policy Manual (Pub 100-02), Chapter 15, Sections 220 and 230 Regarding Therapy Services - May 24, 2005

Healthcare Provider Taxonomy Code (HPTC) Update - May 24, 2005

Instructions to Revise the Comprehensive Error Rate Testing (CERT) Shared System Module Including Instructions to Install and Operate the Revised CERT Module for Calculating Fiscal Intermediary (FI) Line Level Error Rates - May 11, 2005

Modification of Roster Billing for Mass Immunizers Billing for Inpatient Part B Services (Type of Bills 12X and 22X) - May 10, 2005

Addition to Chapter 6 of the Medicare Claims Processing Manual - Skilled Nursing Facility (SNF) Inpatient Part A Billing: SNF Prospective Payment System Pricer Software - May 10, 2005

Correction to the Use of Group Codes for the Enforcement of Mandatory Electronic Submission of Medicare Claims - May 10, 2005

Update to Current National Uniform Billing Committee (NUBC) Codes - May 2, 2005

New HCPCS Codes and System Edits for Supplies and Accessories for Ventricular Assist Devices - May 9, 2005

July Quarterly Update for 2005 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule - May 9, 2005

Infusion Pumps: C-Peptide Levels as a Criterion for Use - May 9, 2005

Changes to the Laboratory National Coverage Determination (LCD) Edit Software for July 2005 - May 2, 2005

Sanctioned Provider Update - May 2, 2005

Billing for Hemophilia Blood Clotting Factors - April 29, 2005

Expanded Coverage for PET scans and other Cervical Cancers, New Coding for PET scans, and Billing Requirements for PET Scans for Specific Indications of Cervical and other Cancers - April 29, 2005

Implementation of 2005 Fee Schedule Amounts for Oxygen and Oxygen Equipment - April 29, 2005

Clarification of the Verification Process to be Used to Determine if the Inpatient Rehabilition Facility (IRF) meets the IRF Classification Criteria - April 29, 2005

Billing for the Syringes used in Treatment of End Stage Renal Disease - April 29, 2005

Modified Edits for Matching Claims Data to Beneficiary Records - April 29, 2005

MMA - April 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes - April 12, 2005

New HCPCS Codes for Intravenous Immune Globulin (IVIG) - April 12, 2005

MMA - Revisions to Medicare Appeals Process for Fiscal Intermediaries (CR Title-Appeals Transition - BIPA 521 Appeals) - April 11, 2005

Update to 100-04 and Therapy Code Lists - April 11, 2005

Inpatient Psychiatric Facility Prospective Payment System Training Follow-up Q & A - April 12, 2005

ESRD Conference Call - April 12, 2005

MMA - Clarification for Outpatient Prospective Payment System (OPPS) Hospitals Billing the Initial Preventive Physical Exam (IPPE) - April 08, 2005

MMA - April 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective April 1, 2005, and New January 2005 Quarterly ASP File - April 04, 2005

MMA - Your Important Role - April 1, 2005

Anti-Cancer Chemotherapy for Colorectal Cancer - April 1, 2005


March 2005
Modification to the Fiscal Intermediary Standard System (FISS) Regarding Ambulance Services Billed on 18x and 21x Types of Bill (TOB) - March 31, 2005

Update to Fiscal Year (FY) 2005 Pricer for Inpatient Prospective Payment System (IPPS) Hospitals - March 31, 2005

April Update to the Medicare Outpatient Code Editor (OCE) Specifications Version 20.2 Bills From Hospitals That Are Not Paid Under the Outpatient Prospective Payment System (Non-OPPS) - March 28, 2005

New Contrast Agents Healthcare Common Procedure Coding System (HCPCS) Codes - March 28, 2005

Resubmission of Outpatient Prospective Payment System (OPPS) Services for Eligible Outlier Payment - March 22, 2005

MMA - Expansion of Coverage for Chiropractic Services Demonstration - Information for Outpatient Hospitals and Radiologists - March 22, 2005

MMA - End Stage Renal Disease (ESRD) Composite Payment Rate System Changes - March 22, 2005

Skilled Nursing Facility (SNF) Consolidated Billing (CB) as It Relates to Therapy Services - March 22, 2005

Billing for Implantable Automatic Defibrillators for Beneficiaries in a MEdicare Advantage (MA)Plan and Use of the QR Modifier to Identify Patient Registry Participation- Revised from bulletin dated September 29, 2003 - March 21, 2005

Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) - Further Clarifications - March 21, 2005

Further Information Related to Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) - March 21, 2005

MMA - Full Replacement of CR 3572, New Case-Mix Adjusted End Stage Renal Disease (ESRD) Composite Payment Rates and New Composite Rate Exceptions Window for Pediatric ESRD Facilities. CR 3572 Is Rescinded - March 16, 2005

MMA - Diabetes Screening Tests - March 16, 2005

Billing for Blood and Blood Products Under the Hospital Outpatient Prospective Payment System (OPPS) - March 10, 2005

Claims Status Code/Claims Status Category Code Update - March 10, 2005

Correction to Healthcare Common Procedure Coding System (HCPCS) Code A4217 - March 10, 2005

April 2005 Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) Specifications Version 6.1 - March 4, 2005

MMA - Clarification for Change Request (CR) 3267 - March 4, 2005

The Medically Unbelievable Edits - March 3, 2005

Skilled Nursing Facility Consolidated Billing as It Relates to Certain Diagnostic Tests - March 3, 2005

Skilled Nursing Facility Consolidated Billing as It Relates to Clinical Social Workers - March 3, 2005

Medicare Prescription Drug, Improvement, and Modernization Act (MMA) - Skilled Nursing Facility Consolidated Billing and Services of Rural Health Clinics and Federally Qualified Health Centers - March 3, 2005

Tool Available for Registering Patients with Implantable Cardioverter Defibrillators - March 3, 2005

MMA - Skilled Nursing Facility Consolidated Billing as It Relates to Prosthetics and Orthotics - March 3, 2005

MMA - The Facts for Providers Regarding the Medicare Prescription Drug Plans That Will Become Available in 2006 - March 3, 2005

Skilled Nursing Facility Consolidated Billing and Preventive/Screening Services - March 3, 2005

Coordination of Benefits Agreement (COBA) Detailed Error Report Notification Process - March 3, 2005


February 2005
Claims for Dialysis Services: Edits Associated with the Fiscal Intermediary Shared System (FISS) Reason Codes 14600 through 146Z0 and 14601 through 146Z1 (for Value Codes A8 and A9)and FISS Reason Code 31589--Action - February 28, 2005

Extension of Timely Filing Period for Hospice Services to Beneficiaries Enrolled in Medicare Advantage Plans - February 28, 2005

1st Update to the 2005 Medicare Physician Fee Schedule Database - February 11, 2005

Use of 12x Type of Bill (TOB) for Billing Vaccines (Influenza, PPV, and Hep B) and Their Administration - February 11, 2005

Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File - February 14, 2005

Full Replacement of Change Request 3427, Transmittal 342, Issued on October 29, 2004 - Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site - February 11, 2005

Standardization of Fiscal Intermediary Use of Group and Claim Adjustment Reason Codes and Calculation and Balancing of TS2 and TS3 Segment Data Elements - February 10, 2005

Update to 100-04 and Therapy Code Lists - February 10, 2005

CMS Seeks Provider Input on Satisfaction with Medicare Fee for Service Contractor Services - February 8, 2005

Prosthetics & Orthotics Ordered in a Hospital or Home Prior to a Skilled Nursing Facility Admission - February 4, 2005

The Centers for Medicare & Medicaid Services Consolidation of the Claims Crossover Process - February 4, 2005

April 2005 Quarterly Fee Schedule Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) - February 3, 2005

MMA-Medical Review (MR) of Rural Air Ambulance Services - February 1, 2005


January 2005
Replacement of Change Request (CR) 3373 - Payment to Providers/Suppliers Qualified to Bill Medicare for Prosthetics and Certain Custom-Fabricated Orthotics - January 21, 2005

Updating the Common Working File (CWF) Editing for Pap Smear (Q0091) and Adding a New Low Risk Diagnosis Code (V72.31) for Pap Smear and Pelvic Examination - January 28, 2005

Influenza Treatment Demonstration - January 28, 2005

Hospital Outpatient Prospective Payment System (OPPS): Use of Modifiers -52, -73 and -74 for Reduced orDiscontinued Services - January 28, 2005

Revisions and Corrections to the Medicare Claims Processing Manual, Chapter 6, Section 30 and Various Sections in Chapter 15 - January 28, 2005

Modifications to the Online Medicare Secondary Payer Questionnaire - January 28, 2005

MMA-Diabetes Screening Tests - January 21, 2005

Remittance Advice Remark Code and Claim Adjustment Reason Code Update - January 21, 2005

Fiscal Intermediary (FI) Standard Paper Remittance (SPR) Advice Changes - January 21, 2005

April Quarterly Update to 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement - January 28, 2005

Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File - January 26, 2005

Revision of Change Request 2928: Implementation of Payment Safeguards for Home Health Prospective Payment System (HH PPS) Claims Failing to Report Prior Hospitalizations - January 24, 2005

Medicare Drug Benefit and Medicare Advantage Program Final Rule - January 24, 2005

Implementation of 2005 Fee Schedule Amounts for Oxygen & Oxygen Equipment and Male External Catheters - January 21, 2005

Claims Attachment Survey - January 21, 2005

Updated Skilled Nursing Facility (SNF) No Pay File for April 2005 - January 21, 2005

The CMS Doctors' Office Quality Information Technology Demonstrations:Providing Leadership in the Adoption of Electronic Health Records - January 21, 2005

The CMS Recovery Audit Contract Initiative - January 21, 2005

MMA- Drugs Paid by Average Selling Price Beginning 1/1/05 - January 21, 2005

Enforcement of Mandatory Electronic Submission of Medicare Claims - January 21, 2005

Update to Billing Requirements fro FDG-PET Scans for Use in the Differential Diagnosis of Alzheimers Disease and Frontal Temporal Dementia and Updates to FI Billing Requirement for CAH - January 21, 2005

Reporting of Diagnosis Codes for Screening Mammography Claims - January 21, 2005

MMA-January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes - January 14, 2005

X12N Health Care Eligibility Beneficiary Inquiry & Response HIPAA 270/271-Action - January 14, 2005

Medicare Part B Enrollment for TRICARE Eligible Beneficiaries - January 14, 2005

Ambulance Fee Schedule-Medical Conditions List - January 11, 2005

"Q"Codes for Infusion Therapy-Non-OPPS Providers - January 10, 2005

Skilled Nursing Facility Consolidated Billing Furnished Under "Arrangement" with an Outside Entity - January 10, 2005

January 2005 Update to the Medicare Non-OPPS Outpatient Code Editor (OCE) Specifications Version 20.1 for Bills Not Paid Under the OPPS - January 10, 2005

MMA-2005 Drug Administration Coding Revisions - January 10, 2005

Correction to January 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement - January 6, 2005

January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS):Summary of OPPS Outpatient Code Editor (OCE) Data Changes & OPPS PRICER Logic; Changes to Payment of Diagnostic Mammographies - January 6 2005

Interest Payment on clean Claims Not Paid Timely - January 6 2005

Clarification of Medicare's Transfer Policy Under the Inpatient Prospective Payment System - January 6,2005

Full Replacement of CR 3308, Fiscal Intermediary Shared System (FISS) Changes to Allow for Provider Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills - January 5 2005


December 2004
MMA-Initial Preventive Physicial Examination - December 31, 2004

Emergency Update to the 2005 Medicare Physician Fee Schedule Database (MPFSDB) - December 31, 2004

January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Billing for Devices that Do Not Have Transitional Pass-Through Status and that Are Not Classified as New Technology Ambulatory Payment Classification (APCs) Groups - December 29, 2004

Hospital Billing for Repetitive Services - December 29, 2004

Electrocardiographic Services - December 29, 2004

MMA-Diabetes Screening Tests - December 29, 2004

2005 Annual Update for Skilled Nursing Facility (SNF) Consolidated Billing for the Common Working File (CWF) and Medicare Carriers - December 29, 2004

The Pulse of CMS - December 29, 2004

Extension of Interrupted Stay Policy Under Long Term Care Hospital (LTCH) Prospective Payment System (PPS) - December 29, 2004

April 2005 Update of Health Care Claims Status Codes and Health Care Claims Status Category Codes for Use with the Health Care Claim Status Request and Response ASC X12N 276/277 - December 23, 2004

Partial Benefits Exhaust Claims - December 22, 2004

MMA- Coverage of Routine Costs of Clinical Trials Involving Investigational Device Exemption (IDE) Category A Devices - December 22, 2004

Emergency Change to Carrier Instructions for the End Stage Renal Disease(ESRD) 50/50 Rule Implementation - December 22, 2004

MMA-Cardiovascular Screening Blood Tests - December 22, 2004

January 2005 Update of the Hospital OPPS:Coding and Payment for Drug Administration - December 22, 2004

MMA-Announcement of Medicare Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) Payment Increase- Skilled Nursing Facility Consolidated Billing As It Applies to Services Provided by RHCs and FQHCs - December 22, 2004

The Supplemental Security Income (SSI) Medicare Beneficiary Data for Fiscal Year 2003 for Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) - December 16, 2004

Updated Billing Instructions for Rural Health Clinics and Federally Qualified Health Centers - December 10, 2004

January 2005 OPPS OCE Specifications Version 6.0 - December 10, 2004

2005 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment - December 10, 2004

MMA - Hospice Pre-Election Evaluation and counseling Services - December 10, 2004

MMA - Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) Implementation - December 9, 2004

New ESRD Composite Rates Effective January 1, 2005 - December 9, 2004

Inclusion of Forteo as a Covered Osteoporosis Drug and Clarification of Manual Instructions Regarding Osteoporosis Drugs - December 8, 2004

Hospital OPPS:Misclassified Drugs and Biologicals,Ganciclovir Long Act Implant, Bcg Live Intravesical Vac, and Gallium ga 67; Adjustments Due to Misclassification - December 8, 2004

MMA - Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2005 - December 8, 2004

Annual Update of HCPCS Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) December 3, 2004

End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests December 1, 2004

Change to the Common Working File Skilled Nursing Facility Consolidated Billing Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site December 1, 2004

Instructions for Completion of Form CMS-1450 December 1, 2004

MMA - Section 706 -- Implementation of Coverage of Religious Nonmedical Health Care Institution (RNHCI) Items and Services Furnished in the Home December 1, 2004

CMS Manual System December 1, 2004


November 2004
MMA - Medicare Program: Update to the Prospective Payment System (PPS) for Home Health Agencies for Calendar Year 2005 November 24, 2004

OIG Sanctioned and Reinstated Providers for September to November 2004 November 18, 2004

Change in the Type of Bill for Billing Diagnostic and Screening Mammographies November 16, 2004

Durable Medical Equipment Carrier – Revision to CR 2631 for Durable Medical Equipment Carriers Only November 12, 2004

HIPAA Update November 2004 November 11, 2004

Editing of Hospital and Skilled Nursing Facility (SNFs) Part B Inpatient Services (Full Replacement of Change Request 3366) November 11, 2004

Inappropriate Access to or Use of Electronic Data Interchange (EDI) Transaction Data by Third Party Entities November 11, 2004

MMA-January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective January 1, 2005 November 11, 2004

Update of Healthcare Common Procedure Coding System (HCPCS) Codes and File Names, Descriptions, and Instruction for Retrieving the 2005 Ambulatory Surgical/Surgery Center (ASC) HCPCS Deletions and Master Listing November 9, 2004

Medicare Termination of Beneficiaries With End Stage Renal Disease (ESRD) November 9, 2004

Reminder Notice of the Implementation of the Ambulance Transition Schedule November 9, 2004

Indian Health Service (IHS) or Tribal Hospitals Including Critical Access Hospitals (CAHs) Payment Methodology for Inpatient Social Admissions and Outpatient Services Rendered at a Separate Facility November 8, 2004


October 2004
New Waived Tests October 29, 2004

3rd Update to the 2004 Medicare Physician Fee Schedule Database October 29, 2004

MMA - Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary of New Initiative of Interest to Physicians and Other Health Care Professionals October 29, 2004

MMA - Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary of New Initiative of Interest to Pharmacists and Pharmacy Professionals October 29, 2004

New Policy and Refinements on Billing Non-Covered Charges to Fiscal Intermediaries (FIs) October 29, 2004

Comprehensive Outpatient Rehabilitation Facilities/Outpatient Physical Therapy (CORF/OPT) Edit for Billing Inappropriate Supplies October 29, 2004

Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 11.0, Effective January 1, 2005 October 29, 2004

MMA - Payment for Emergency Medical Treatment and Labor Act (EMTALA)- Mandated Screening and Stabilization Services October 29, 2004

Override of Medicare System Edit for Observation Services Exceeding 48 Hours October 29, 2004

Important News about Flu Shots for Medicare Beneficiaries October 29, 2004

Revision of Common Working File (CWF) Editing for Same-Day, Same- Provider Acute Care Readmissions October 26, 2004

Remittance Advice Remark Code and Claim Adjustment Reason Code Update October 26, 2004

Instructions for Completion of CMS-1450 Billing Form October 19, 2004

Medicare Comprehensive Outpatient Rehabilitation Facility Coverage October 19, 2004

Treatment of Obesity October 19, 2004

Payment Amounts for the Influenza Virus Vaccine (CPT 90658) and the Pneumoccocal Vaccine (CPT 90732) When Payment is Based on 95 Percent of the Average Wholesale Price (AWP) October 19, 2004

Crossover Patients in New Long Term Care Hospitals (LTCH) October 11, 2004

Full Replacement of CR 3415, 3rd Update to the 2004 Medicare Physician Fee Schedule Database. CR 3415 Is Rescinded October 8, 2004

Coverage by Medicare Advantage Organizations for National Coverage Determination (NCD) Services Not Previously Included in the Medicare Advantage’s Capitated Rates October 8, 2004

Clarification of Medicare Secondary Payer (MSP) Rules in Relation to a Temporary Leave of Absence October 4, 2004

Guidance for Part A Providers Switching to Electronic Remittance Advices (ERAs) October 4, 2004

Guidance Regarding Elimination of Standard Paper Remittance (SPR) Advice Notices in the Old Format October 4, 2004


September 2004
MMA-Reasonable Charge Update for 2005 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, Therapeutic Shoes, and Certain Intraocular Lenses September 29, 2004

Editing of Hospital and Skilled Nursing Facility Part B Inpatient Services September 29, 2004

Quality Improvement Organization Condition Codes September 29, 2004

Tubing and Other Supplies Used for the Administration of Separately Payable Drugs September 29, 2004

Update to Medicare, Deductible, Coinsurance, and Premium Rates for Calendar year (CY) 2005 September 29, 2004

MSN Messages and Reason Codes for Mammography September 29, 2004

CMS Pulse Fall 2004 September 29, 2004

Use Condition Code 59 When an ESRD Beneficiary Receives Non-Scheduled or Emergency Dialysis Services at a Non-Primary ESRD Dialysis Facility September 13, 2004

October 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS) September 13, 2004

January Medicare Outpatient Code Editor (OCE) Specifications Version 19.1 R1 for Bills from Hospitals That Are Not Paid Under the Outpatient Prospective Payment System (OPPS) September 13, 2004

Line Item Dates of Service (LIDOS) Edit Implementation October 4, 2004, Change Requests 3031, 3264, & 3337 September 13, 2004

Implementation of Skilled Nursing Facility (SNF) Claim Edits for Therapy Codes Considered Separately Payable Physician Services September 13, 2004

2005 Healthcare Common Procedure Coding System (HCPCS) Annual Update Reminder September 13, 2004

MMA - Use of Group Health Plan Payment System to Pay Capitated Payments to Chronic Care Improvement Organizations Serving Medicare Fee-For-Service Beneficiaries Under Section 721 of the MMA September 13, 2004

MMA-Ambulatory Surgical Center (ASC) Payment Rates and Wage Index Values Remain in Effect for Fiscal Year (FY) 2005 September 7, 2004

MMA-Addition of Physician Assistants, Nurse Practitioners, and Clinical Nurse Specialists as Emergency On-Call Providers for Critical Access Hospitals September 7, 2004

Application of the Medicare Secondary Payer for the Working Aged Provision to Former Spouses and the Medicare Secondary Payer for the Disabled Provision to Former Spouses and Certain Family Members with Coverage Under the Federal Employees Health Benefits (FEHB) Program September 7, 2004

3rd Update to the 2004 Medicare Physician Fee Schedule Database September 7, 2004

Use of Transmission Date in the Service Date Field for Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) Claims September 7, 2004

Skilled Nursing Facility Consolidated Billing September 7, 2004

Medicare Prescription Drug, Improvement, and Modernization Act (MMA) – Skilled Nursing Facility Consolidated Billing and Services of Rural Health Clinics and Federally Qualified Health Centers September 7, 2004

Skilled Nursing Facility Consolidated Billing as it Relates to Certain Diagnostic Tests September 7, 2004

“Incident to” Services September 7, 2004


August 2004
Clarification of Epoetin Alfa (EPO) Billing Procedures and Codes in ESRD - August 26, 2004

Expanded Coverage for PET Scans - August 26, 2004

Role of Physicians in the Home Health Prospective Payment System - August 26, 2004

Guidelines for Medicare Part B Laboratory Testing - August 26, 2004

Psychotropic Drug Use in Skilled Nursing Facilities (SNFs) - August 26, 2004

Durable Medical Equipment Ordered with Surrogate Unique Physician Identification Number (UPIN) - August 26, 2004

Requirements for Payment of Medicare Claims for Foot and Nail Care Services - August 26, 2004

New Diagnosis Code for Influenza Virus Vaccine Claims - August 26, 2004

Pneumococcal Vaccine Payment increase Effective October 1, 2003 - August 26, 2004

3rd Update to the 2004 Medicare Physician Fee Schedule Database - August 26, 2004

Patient Status Code 65 or Implementation of Patient Status Code 65, Discharged/Transferred to a Psychiatric Hospital or Psychiatric Distinct Part Unit of a Hospital - August 25, 2004

Coverage by Medicare Advantage Organizations for National Coverage Determination (NCD) Services Not Previously Included in the Medicare Advantage’s Capitated Rates - August 25, 2004

MMA - Medicare Replacement Drug Demonstration - August 25, 2004

October 2004 Quarterly Update of Home Health Common Procedure Coding System (HCPCS) Codes Used For Home Health Consolidated Billing Enforcement/a> - August 25, 2004

October Quarterly Update for 2004 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule - August 25, 2004

OIG Sanctioned and Reinstated Providers - August 19, 2004

Press Release- Medicare Proposes Payment Rates and Policy Changes for Hospital Outpatient Service - August 16, 2004

The Pulse of CMS - August 16, 2004

MMA-Billing Requirements for Islet Cell Transplantation for Beneficiaries in a National Institutes of Health (NIH) Clinical Trial - August 16, 2004

Autologous Blood-Derived Products for Chronic, Non-Healing Wounds - August 13, 2004

Update to the Frequency of Billing - August 13, 2004

October Update to the Medicare Outpatient Code Editor (OCE) Version 20.0 for Bills from Hospitals That Are Not Paid Under the Outpatient Prospective Payment System (OPPS) - August 6, 2004

October 2004 Outpatient Prospective Payment System Outpatient Code Editor (OPPS OCE) Specifications Version 5.3 - August 6, 2004

Revision of Common Working File (CWF) Editing for Same-Day, Same-Provider Acute Care Readmissions - August 6, 2004

Standardized Responses to Provider Inquiries Regarding the Negotiated National Coverage Determinations (NCDs) Edit Module - August 6, 2004

Cryosurgery of the Prostate - August 6, 2004

Skilled Nursing Facility Consolidated Billing as It Relates to Clinical Social Workers - August 5, 2004

Skilled Nursing Facility Consolidated Billing as It Relates to Prosthetics and Orthotics - August 5, 2004

Skilled Nursing Facility Consolidated Billing and Preventive/Screening Services - August 5, 2004

Skilled Nursing Facility Consolidated Billing as It Relates to Dialysis Coverage - August 5, 2004

Skilled Nursing Facility Consolidated Billing and Erythropoietin (EPO, Epoetin Alfa) and Darbepoetin Alfa (Aranesp - August 5, 2004

Skilled Nursing Facility Consolidated Billing as It Relates to Ambulance Services - August 5, 2004

Skilled Nursing Facility Consolidated Billing as It Relates to Certain Types of Exceptionally Intensive Outpatient Hospital Services - August 5, 2004

OIG Alert About Charging Extra for Covered Services - August 5, 2004

Coverage by Medicare Advantage Organizations for National Coverage Determination (NCD) Services Not Previously Included in Medicare Advantage’s Capitated Rates --- Change Request Revised-see new bulletin dated August 20, 2004 - August 5, 2004

Additional Clarification of Bill Types 22x and 23x Submitted by Skilled Nursing Facilities with Instruction for Involuntarily Moving a Beneficiary Out of the SNF and Ending a Benefit Period - August 3, 2004

Change to Previous Transmittal Regarding the Discontinued Use of Revenue Code 0910 - August 3, 2004

Extension of Interrupted Stay Policy Under Long Term Care Hospital (LTCH) PPS Provider Types Affected - August 3, 2004


July 2004
2005 DMEPOS Pricing File Record Layout Extension and New Pricing Procedures for Certain DMEPOS Items based on Modifiers - July 29, 2004

Update of Health Care Claims Status Codes and Health Care Claims Status Category Codes for Use with the Health Care Claim Status Request and Response ASC X12N 276/277 - July 29, 2004

October 2004 Quarterly Update of Common Healthcare Common Procedure Coding System (HCPCS) Codes used for Skilled Nursing Facility (SNF) Consolidated Billing Enforcement - July 29, 2004

Health Insurance Portability and Accountability Act (HIPAA) X12N837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction - July 27, 2004

Centers for Medicare and Medicaid Services (CMS) Working to Improve Provider Enrollment Process - July 27, 2004

PCOM Minutes July 2004 - July 27, 2004

MMA - Demonstration Project to Clarify the Definition of Homebound - July 26, 2004

Availability of Revised Fact Sheets on Long Term Care Hospital Prospective Payment System - July 22, 2004

Rural Health Fact Sheets - July 22, 2004

MMA - Clarification for CR 3064 - Medicare Secondary Payer (MSP) Policy for Hospital Reference Lab Services and Independent Reference Lab Services - July 22, 2004

Update to the Common Working File Edits for Skilled Nursing Facility (SNF) Consolidated Billing (CB) to Expand the Bypass for Pharmacy Services - July 22, 2004

Clarification for Billing Left Ventricular Assist Devices - July 19, 2004

End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests - July 19, 2004

Change to the Skilled Nursing Facility Consolidated Billing Edits for Ambulance Transports to and from a Diagnostic or Therapeutic Site other than a Hospital - July 19, 2004

Long Term Care Hospital Prospective Payment System (LTCH PPS) Annual Update - July 19, 2004

Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee - July 19, 2004

MMA - Implementation of Section 414 of the Medicare Prescription Drug, Improvement, Modernization (MMA) Act of 2003 - July 14, 2004

Payment Limits for J7308 (Levulan Kerastick) and J9395 (Faslodex) - July 9, 2004


June 2004
Correction to CR 2944, Transmittal 90, Issued on February 6, 2004 - June 30, 2004

MMA - July 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS) - June 30, 2004

MMA - July 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS): Payment for Drugs, Biologicals, and Radiopharmaceuticals - June 30, 2004

Elimination of Regulations for Written Statement of Intent - June 30, 2004

Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - June 30, 2004

Revised Updated Skilled Nursing Facility NO PAY File for July 2004 - June 30, 2004

MMA - Expansion of Policy where Patient is a Member of a Medicare Advantage (MA) Organization for only a Portion of the Billing Period, to Include Inpatient Rehabilitation Facilities (IRF) and Long Term Care Hospitals (LTCH) (MMA section 211(e)) - June 25, 2004

Clarification for Medlearn Matters 3031: Medicare Need for a Specific Line Item Date of Service (LIDOS) for Each Revenue Code on ALL Outpatient and Inpatient Part B Claims - June 21, 2004

The Pulse of CMS Summer 2004 - June 21, 2004

MMA - Nurse Practitioners as Attending Physicians in the Medicare Hospice Benefit - June 21, 2004

Emergency Hospital Outpatient Billing of Epotein Alfa (EPO) and Darbepoetin Alfa (Aranesp) - June 17, 2004

July Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 5.2 - June 11, 2004

July Update to the Medicare Outpatient Code Editor (OCE) Specifications Version 19.2 for Bills from Hospitals that are Not Paid Under the Outpatient Prospective Payment System - June 11, 2004

Reporting Medicare Secondary Payer Information on the Health Insurance Portability and Accountability Act of 1996 X12N 837, Created Via the Free Billing Software - June 8, 2004

MMA-Hospital Outpatient Billing and Payment under Outpatient Prospective Payment System for New Drugs or Biologicals After FDA Approval but Before Assignment of a Product-Specific Drug/Biological HCPCS Code - June 8, 2004

Skilled Nursing Facility Consolidated Billing L Codes – Durable Medical Equipment Regional Carrier and Fiscal Intermediaries - June 8, 2004

Updated Skilled Nursing Facility Help File Available for CY 2004 - June 8, 2004

Skilled Nursing Facility Consolidated Billing: Services Furnished Under an “Arrangement” with an Outside Entity - June 2, 2004


May 2004
Discontinued Use of Revenue Code 0910 - May 26, 2004

Clarification to CR 3069 – New “K” Codes for Wheelchair Cushions - May 25, 2004

MMA - 2nd Update to the 2004 Medicare Physician Fee Schedule Database - May 25, 2004

Use of Group Health Plan Payment System for Medicare Disease Management Demonstration Serving Medicare Fee For Service Beneficiaries - May 25, 2004

New Waived Tests - May 18, 2004

Medicare Secondary Payer - May 18, 2004

Frequently Asked Questions for Bulletin Dated 3/11/2004 – Billing Non-Covered Services - May 18, 2004

July Quarterly Update for 2004 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Fee Schedule - May 13, 2004

Healthcare Common Procedure Coding System Corrections Involving 0040T and A9603 - May 13, 2004

Summer Holiday Schedule - May 13, 2004

Remittance Advice Remark Code and Claim Adjustment Reason Code Update - May 12, 2004

Clarification of Billing for Separately Billable End Stage Renal Disease Drugs - May 12, 2004

MMA - Section 511 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Special Adjustment for Skilled Nursing Facility Prospective Payment System Rates for Acquired Immune Deficiency Syndrome - May 12, 2004

Change to the Skilled Nursing Facility Consolidated Billing Edits for Ambulance Transports to and from an Diagnostic or Therapeutic Site other than a Physician’s Office or Hospital - May 12, 2004

Clarification of Payments and Billing Procedures for Hospitals Subject to the Maryland Waiver - May 10, 2004

MMA - National 1-800-MEDICARE (1-800-633-4227) Implementation (Section 923(d) of MMA) - May 10, 2004

Emergency Correction Regarding Correction to Healthcare Common Procedure Coding System (HCPCS) Codes for Low-Osmolar Contrast Material - May 5, 2004

Reminder to Stop Duplicate Billings - May 5, 2004

Centers for Medicare & Medicaid Services (CMS) Working to Improve Provider Enrollment Process - May 5, 2004

MMA-New Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary for Pharmacists and Other Pharmacy Professionals - May 5, 2004

MMA-New Medicare-Approved Drug Discount Cards and Transitional Assistance Program: A Summary for Physicians and Other Health Care Professionals - May 5, 2004

MMA- Section 937 - Correction of Minor Errors and Omissions Without Appeals - May 5, 2004

MMA - CMS to Increase Payments to Hospitals Reclassified Under Medicare Reform Law - May 5, 2004

Quarterly Update of the Interest Rate for Medicare Overpayments and Underpayments - May 5, 2004

Medicare Providers: Their Vendors, Clearinghouses, or Other Third-Party Billers and the HIPAA/Medicare Contingency Plan - May 5, 2004

New Condition Code for ESRD Facilities and Patient Status Code Changes - May 5, 2004

Arrangements for Physical, Occupational, and Speech-Language Pathology Services - May 5, 2004

Hospital Concerns Regarding Changing of Patient Status Code Due to Common Working File Edit 7272 - May 5, 2004

Update to the Healthcare Provider Taxonomy Codes (HPTCs) Version 4.0 - May 5, 2004

Special Handling of Claims That Contain Healthcare Common Procedure Coding System (HCPCS) Code 93788 - May 4, 2004

Updated SNF NO PAY File for April 2004 - May 4, 2004

Ambulance Claims with Modifier QL or Value Code 32 - May 4, 2004


April 2004
Problem with ELGA - April 29, 2004

2004 Medicare Physician Fee Schedule Increase and Extension of the Annual Participation Enrollment Period - April 23, 2004

The Consolidation of the Claims Crossover Process: Smaller-Scale Initial Implementation - April 22, 2004

Transmittal 49 Implementation Date Extension - April 16, 2004

MMA - April 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS) - April 14, 2004

MMA- New Payment Allowance Percentages for DMERC Drugs - April 14, 2004

MMA-Clarifications to Certain Exceptions to Medicare Limits on Physician Referrals - April 7, 2004

Modification of Requirements in CR 2716, CWF Edits to Ensure Accurate Coding and Payments for Discharge and/or Transfer Policies - April 7, 2004

2004 Jurisdiction List - April 2, 2004

Temporary Hold of Outpatient Claims Subject to the Outpatient Prospective Payment System (OPPS) in April 2004 - April 5, 2004

MMA-Outpatient Clinical Laboratory Tests Furnished by Hospitals with Fewer Than 50 Beds in Qualified Rural Areas - April 2, 2004

January medicare outpatient Code Editor (OCE) Specifications Version 19.1 R1 for Bills from Hospitals That Are Not Paid Under the outpatient Prospective Payment System (OPPS) - April 2, 2004

April Outpatient Code Editor (OCE) Specifications Version 5.1 Used in OPPS - April 2, 2004

Updated policy and Claims Processing Instructions for Ambulaory Blood Pressure Monitoring (ABPM) - April 2, 2004

Reminder: Hospital Discounts Permitted for Indigent, Uninsured, and Underinsured Patients - April 2, 2004

Provider Education Article: national Participating Physician Directory - April 2, 2004

Medicare Payments for Part B Mental Health Services - April 2, 2004

Temporary Hold of Inpatient Claims in April 2004 - April 2, 2004

Quarterly Provider Update - April 2, 2004

MMA - Claims Requiring Adjustment as a Result of April 2004 changes to the Outpatient Prospective Payment System (OPPS) - April 1, 2004

Payment Rate for Fulvestrant (Faslodex) under the Hospital Outpatient Prospective Payment System (OPPS) - April 1, 2004


March 2004
Reminder of the Required Three-day Hospital stay for SNF Admissions - March 25, 2004

MMA Drug Pricing Update--Drug Exceptions - March 25, 2004

Guidance for Handling Revenue code 0910 - March 24, 2004

MMA - April 2004 Changes to the Hospital Outpatient Prospective Payment System (OPPS): Payment for Drugs, Biologicals and Radiopharmaceuticals, Generic versus Brand Name - March 24, 2004

Claims Returned to the Provider Multiple Times for U5606 - March 24, 2004

MMA-Changes to the FY 2004 Graduate Medical Education (GME) Payments as Required by the Medicare Modernization Act of 2003 (MMA), P.L. 108-173 - March 22, 2004

The Pulse of CMS Spring 2004 - March 18, 2004

MMA - New Part B Annual Deductible - March 18, 2004

Medicare Secondary Payer Questionnaire Revisions - March 12, 2004

Payment for Services Provided Under a Contractual Agreement - March 12, 2004

MMA-New Requirements for End Stage Renal Disease (ESRD) Drug Payments - March 12, 2004

Billing Non-Covered Charges - March 11, 2004

Consolidation of the Claims Crossover Process: Additional Common Working File (CWF) Functionality - March 4, 2004

Expansion of Transfer Policy Under Inpatient Prospective Payment System - March 4, 2004

DMERCs and VIPs, Processing NDC Numbers - March 4, 2004

Modification of Requirements in CR 2716, CWF Edits to Ensure Accurate Coding and Payments for Discharge and/or Transfer Policies - March 4, 2004

New Waived Tests -- April 1, 2004 - March 1, 2004

Provider/Supplier Audience Web Page Updates - March 1, 2004

1st Update to the 2004 Medicare Physician Fee Schedule Database - March 1, 2004


February 2004
MMA-Implementation of Section 414 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 - February 27, 2004

MMA-Additional Information in Medicare Summary Notices (MSNs) to Beneficiaries about Skilled Nursing Facility (SNF) Benefits - February 27, 2004

Billing Medicare When Veterans Administration Benefits Have Exhausted - February 25, 2004

Additional Guidelines for Implementing the National Council for Prescription Drug Program (NCPDP) Standards under HIPPA - February 25, 2004

Medicare Incentive Payment for Physician Care in Underserved Areas - February 25, 2004

Elimination of the 90 Day Grace Period for Billing Discontinued ICD-9-CM Codes - February 25, 2004

Password Changes - February 19, 2004

The Pulse of CMS - February 19, 2004

Clarification for Inpatient CWF Edits for Patient Status Codes - February 13, 2004

Revised NCD for Thoracic Electrical Bioimpedance - February 12, 2004

New "K" Codes for Wheelchair Cushions - February 12, 2004

Changes in Payment for Services Furnished in Ambulatory Surgical Centers for Fiscal Year 2004 - February 12, 2004

New Condition and Value Codes for CMS 1450 Part A Claims - February 12, 2004

Extension of Coverage to SNFs for Colorectal Cancer Screenings - February 12, 2004

Elimination of the 90-day Grace Period for HCPCS Codes - February 11, 2004

Update to the January 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated billing Enforcement - February 10, 2004

Remittance Advice Remark Code and Claim Adjustment Reason Code Update - February 10, 2004

Medlearn Matters Number: SE0401 - February 6, 2004

Clarification for Inpatient CWF Edits for Patient Status Codes - February 4, 2004

CMS HIPAA UPDATE - February 4, 2004

Emergency Correction to Healthcare Common Procedure Coding System (HCPCS) Codes for Low Osmolar Contrast Material - February 3, 2004

Criteria for Using the CB Modifier - February 3, 2004

Changes to the Laboratory National Coverage Determination (NCD) Edit Software - February 3, 2004

Intravenous Immune Globulin - February 3, 2004

Manual Revised to Expand Payment for (Diabetes Outpatient Self-Management Training)DMT to Home Health Agencies - February 3, 2004


January 2004
Manual Update to Include New CAD Codes - January 30, 2004

Interest Rates - January 30, 2004

Instructions for Diagnosis Code of RAP's to Conform to HIPAA - January 27, 2004

Correction to January 2004 Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement - January 27, 2004

Update on Errors in Skilled Nursery Facility (SNF) NO PAY file - January 27, 2004

Treatment of Certain Dental Claims as a Result of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 - January 27, 2004

Payment Rate for Oxaliplatin (Eloxatin) under the Hospital Outpatient Prospective Payment System (OPPS) - January 23, 2004

New Enrollee Rights, New Provider Responsibilities in M+C program - January 15, 2004

Emergency Correction to the 2004 Healthcare Common Procedure Coding System (HCPCS) File - January 14, 2004

Change in Coding on Medicare Claims for Darbepoetin Alfa (trade name Aranesp) and Epoetin Alfa (trade name Epogen, EPO) For Treatment Of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis. - January 13, 2004

Instructions for Home Health Cost Reporting Processes - January 12, 2004

April Quarterly Update for 2004 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule. - January 12, 2004

Emergency Revised 2004 Update of the DMEPOS and Clinical Laboratory Fee Schedules - January 12, 2004

DDE Screen Modifications - January 12, 2004

Crossover "How it Works" - January 12, 2004

Common Medicare Submitter Claim Testing Problems - January 12, 2004

Physician Evaluation Period for Therapy - January 12, 2004

Renewed Moratorium on Outpatient Rehabilitation Therapy Caps - January 12, 2004

Implementation Date for the 2004 January Release - January 6, 2004

Confidentiality and Disclosure Updates - January 5, 2004


December 2003
Additional Modification Regarding Change Request (CR) 2963: Change in Coding on Medicare Claims for Darbepoetin Alfa (trade name Aranesp) and Epoetin Alfa (trade name Epogen, EPO) For Treatment of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis - December 31, 2003

New Basis for Medicare Drug Payment Amounts under Part B – Amendment of Instructions Specified in Transmittal AB-02-174 - December 31, 2003

New National Coverage Decision Screens - December 31, 2003

January Outpatient Code Editor (OCE) Specifications Version 5.0 - December 30, 2003

January Medicare Outpatient Code Editor (OCE) Specifications Version 19.1 For Bills from Hospitals That Are Not Paid Under the Outpatient Prospective Payment System (OPPS) - December 29, 2003

January 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS) - December 29, 2003

Fecal-Occult Blood Tests (FOBT) - December 29, 2003

Temporary HCPCS Codes – FIs and Carriers (including DMERCs) - December 29, 2003

Therapy Caps - December 18, 2003

Revised SNF NO PAY File—Effective January 1, 2004X - December 16, 2003

Revenue Code 068X - December 15, 2003

Non-System Change Requests Issued - December 12, 2003

Clarification of Mammography Annual Screening Examination - December 8, 2003

Remittance Advice Remark Code and Claim Adjustment Reason Code Update - December 4, 2003

837I Companion Guide (Date of revision: 12/02/2003) - December 2, 2003

Physical, Occupational and Speech Therapy Moratorium---URGENT - December 5, 2003

Clarification of Mammography Annual Screening Examination - December 8, 2003


November 2003
Medicare Beneficiary Health Insurance Claim Number (HIC#) Prefixes And Suffixes - November 26, 2003

Updates to the Financial Limitations on Rehabilitation Services - November 20, 2003

Crosswalks to CMS Internet Only Manuals - November 18, 2003

Ventricular Assist Devices for Destination Therapy - November 17, 2003

Consolidation of the Medicare Coordination Benefits Contractor - November 17, 2003

Ambulance Claims with Modifier QL or Value Code 32 - November 12, 2003

New Coverage of Lung Volume Reduction Surgery (LVRS) & Submission of Claims for Medicare+Choice Plans for LVRS - November 12, 2003

Fee Schedule Update for 2004 for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) - November 12, 2003

HOLIDAY SCHEDULE for NOVEMBER & DECEMBER 2003 - November 12, 2003

Annual Update of HCPCS used for Home Health Consolidated Billing Enforcement - November 10, 2003

Provider Performed Microscopy of Fecal Leukocyte Examination - November 4, 2003

Implementation of Payment Safeguards for Home Health Prospective Payment System Claims Failing to Report Prior Hospitalizations - November 4, 2003

New Waived Tests - November 4, 2003

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 1, 2004 - November 4, 2003


October 2003
Medicare 2004 Deductible and Coinsurance - October 30, 2003

Changes to the End Stage Renal Disease (ESRD) Network Organizations - October 28, 2003

Changes to the End Stage Renal Disease (ESRD) Network Organizations - October 28, 2003

Manual Changes in the Claims Processing Manual 100-04 for Heart Acquisition Charges & National Coverage Determinations Expansion for the Ventricular Assist Device (VAD) - October 28, 2003

Billing Instructions for Claims for Ventricular Assist Devices (VADS) for Beneficiary in a Medicare+Choice (M+C) Plan - October 28, 2003

Guidance Regarding Claims Containing Healthcare Common Procedure Coding System (HCPCS) Codes K0622 through K0626 - October 21, 2003

ICD-9 Procedure Code Reporting - October 7, 2003

Clarification for billing under the 2300 Provider Number by Hospital-Based Renal Dialysis Facilities (RDF) - October 7, 2003

This section has been revised to instruct DMERCS to review medical documentation as well as the beneficiary claims history when processing Advance Determination of Medicare Coverage (ADMC) requests. - October 7, 2003

Core Elements and Required Statements for a Valid Privacy Authorization - October 7, 2003

New Waived Tests – October 1, 2003 - October 7, 2003

Reminder Notice of the Implementation of the Ambulance Transition Schedule - October 2, 2003

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September 2003
Revision to Attachment 2 in CR 2880 (Modifier and Condition Code for Providers to Use When Billing for Implantable Automatic Defibrillators for Beneficiaries in a Medicare+Choice Plan) - September 29, 2003

New Diagnosis Code for Influenza Virus Vaccine Claims - September 29, 2003

HIQA & ELGA - September 11, 2003

ESRD Network Manual - September 25, 2003

The New Online CMS Manual System Announcement - September 22, 2003

Payment Amount for the Influenza Virus Vaccine (CPT 90658 and CPT 90659) when Payment is Based on 95 Percent of the Average Wholesale Price (AWP) - September 22, 2003

Virtual Colonoscopy - September 18, 2003

October Medicare Outpatient Code Editor (OCE) Specifications Version 19.0 For Bills From Hospitals That Are Not Paid Under the Outpatient Prospective Payment System (OPPS) - September 15, 2003

Billing Guidelines for Outpatient Rehabilitation Services - September 15, 2003

Bexxar Coverage/Payment Criteria - September 15, 2003

Guidelines for Skilled Nursing Facility (SNF) Consolidated Billing - September 3, 2003

Correction to Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement - September 3, 2003

October 2003 Update of the Hospital Outpatient Prospective Payment System (OPPS) - September 3, 2003


August 2003
Update to Health Care Claims Status Category Codes and Health Care Claim Status Codes for Use with the Health Care Claim Status Request and Response ASC X12N 276/277 - August 28, 2003

Fiscal Year (FY) 2004 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH), and Other Bill Processing Changes - August 28, 2003

Levocarnitine for Use in the Treatment of Carnitine Deficiency in ESRD Patients - August 25, 2003

Guidelines for Medicare Part B Laboratory Testing - August 25, 2003

Addition of Three New International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Diagnosis Codes to be Effective as Part of the October 1, 2003, ICD-9-CM Update. - August 25, 2003

Payment for the Fecal Leukocyte Examination Under a Clinical Laboratory Improvement Amendments of 1988 (CLIA) Certificate for Provider-Performed Microscopy (PPM) Procedures During CY 2003 - August 25, 2003

Payment Rate for Oxaliplatin (Eloxatin) under the Hospital Outpatient Prospective Payment System (OPPS) - August 22, 2003

Pneumococcal Vaccine Payment Increase Effective October 1, 2003 - August 22, 2003

October Outpatient Code Editor (OCE) Specifications Version (V4.3) - August 12, 2003

Final Update to the 2003 Medicare Physician Fee Schedule Database - August 12, 2003

Adjustment to the Rural Mileage Payment Rate for Ground Ambulance Services - August 11, 2003

Claims Processing and Payment of Incomplete Screening Colonoscopies - August 8, 2003

Payment Denial for Medicare Services furnished to Alien Beneficiaries Who are Not Lawfully Present in the United States - August 8, 2003

Review of Form CMS-1450 (previously Form HCFA-1450) for Inpatient and Outpatient Bills - August 8, 2003

Clarification on Billing Requirements for Pre-Admission Diagnostic Services Treated As Inpatient Services for Non-OPPS Providers. - August 4, 2003

Third Clarification of Medicare Policy Regarding the Implementation of the Ambulance Fee Schedule - August 4, 2003

Revision to Skilled Nursing Facility (SNF) NO PAY File - August 4, 2003

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July 2003
Codes not recognized by Medicare - July 31, 2003

Non Reportable Codes - July 31, 2003

Frequency of Billing - July 31, 2003

Clarification Regarding Coverage of Hyperbaric Oxygen (HBO) Therapy for the Treatment of Diabetic Wounds of the Lower Extremities - July 30, 2003

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 1, 2003 - July 30, 2003

Reporting of Revenue Codes Under the Outpatient Prospective Payment System (OPPS) - July 24, 2003

Diagnosis Code for Screening Pap Smear and Pelvic Examination Services - July 24, 2003

October Quarterly Update for 2003 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule - July 24, 2003

Payment Problems Related to the Medicare Physician Fee Schedule (MPFS) Delay - July 18, 2003

Addition of Patient Status Code 43, Deletion of Patient Status Codes 71 and 72, and Information on New Patient Status Code 65 - July 17, 2003

Remittance Advice Remark and Reason Code Update - July 17, 2003

Medicare Program–Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2004 - July 17, 2003

Quarterly Update of Healthcare Common Procedure Coding System (HCPCS) Codes Used for Home Health Consolidated Billing Enforcement - July 17, 2003

October 2003 Quarterly Update for Skilled Nursing Facility (SNF) Consolidated Billing - July 17, 2003

1. Disclosure of Information Requirements Related to Hospice Claims 2. Correction: Coverage and Billing Requirements for Electrical Stimulation for the Treatment of Wounds - July 11, 2003

Delay in Implementation of Outpatient Therapy Caps to September 1, 2003 - July 8, 2003

Payment Update for Long-term Care Hospital Prospective Payment System Rate Year 2004 - July 1, 2003

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June 2003
1. Positron Emission Tomography (PET) Scans 2. Revision to CR 2573, Transmittal A-03-013, dated February 14, 2003: 3-Day Payment Window Refinements Under the Short-Term Hospital Inpatient Prospective Payment System - June 25, 2003

1. Coverage of Compression Garments in the Treatment of Venous Stasis Ulcers 2. Nurse Practitioner Services Under Medicare Hospice - June 25, 2003

July 2003 Update of the Hospital Outpatient Prospective Payment System (OPPS) - June 19, 2003

Reminder that Skilled Nursing Facility (SNF) and Hospital Swing Bed Providers Are To Submit a Claim whenever the Beneficiary Ceases to Require a Skilled Level of Care - June 16, 2003

National Participating Physician Directory - June 12, 2003

1. Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 1, 2003 2. July Outpatient Code Editor (OCE) Specifications Version (V4.2) - June 10, 2003

Centers for Medicare & Medicaid Services (CMS) Quarterly Provider Update - June 3, 2003

Medicare Fee-for-Service (FFS) Contractor Guidance on the HIPAA Privacy Rule Business Associate Provisions - June 3, 2003

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May 2003
Financial Limitation of Claims for Outpatient Rehabilitation Services - May 29, 2003

Mammography Computer Aided Detection (CAD) Equipment - May 29, 2003

1. Food and Drug Administration (FDA) Approval of Drug-Eluting Coronary Artery Stent(s) 2. July Quarterly Update for 2003 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule - May 22, 2003

Second Update to the 2003 Medicare Physician Fee Schedule Database - May 22, 2003

Memorial Day Holiday Schedule 2003 - May 22, 2003

Clarification of Bill Types 22x and 23x Submitted by Skilled Nursing Facilities (SNFs) - May 22, 2003

Clarification of the Criteria for a Valid Written Statement of Intent (SOI) To File a Medicare Claim - May 22, 2003

Frequency of Billing – 1. Hospital Manual Update 2. SNF Manual Update 3. Intermediary Manual Update May 22, 2003

Magnetic Resonance Angiography (MRA) - Intermediary Manual and Coverage Issues Manual and Hospital Manual Updates May 22, 2003

End Stage Renal Disease (ESRD) Coordination Period Autologous Stem Cell Transplantation May 15, 2003

Admission Notice To Beneficiaries--Important Message From Medicare (IM) May 15, 2003

Managing Medicare Appeals Workloads in FY 2003 May 15, 2003

New Waived Tests – March 21, 2003 May 15, 2003

Modification to Medicare Timely Filing Edit for Claims Paid Under Certain Prospective Payment Systems May 15, 2003

End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests May 15, 2003

Implementation of the Financial Limitation for Outpatient Rehabilitation Services May 15, 2003

Assigning Liability for Line Items Excluded by Statute on Otherwise Covered Claims – Follow-up to March , 2003 Bulletin May 15, 2003

Review of Form HCFA-1450 for Inpatient and Outpatient Bills May 15, 2003

Notice of Interest Rate for Medicare Overpayments and Underpayments May 8, 2003

HIPAA Provider Outreach Activities - May 2, 2003

(1) Clinical Diagnostic Laboratory Services Other than to Inpatients; (2) Screening Pap Smears and Screening Pelvic Examinations May 1, 2003

Provider-based Status On or After October 1, 2002 - May 1, 2003

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April 2003
(1) Addition of "K" Codes for Surgical Dressings; (2) Addition of Temporary "K" Codes; (3) Addition of Temporary "K" Codes" - April 24, 2003

Ambulance Claims with Modifier QL or Value Code 32 - April 24, 2003

January Medicare Outpatient Code Editor (OCE) Specifications Version 18.1R1 For Bills From Hospitals That are Not Paid Under the Outpatient Prospective Payment System (OPPS) - April 24, 2003

Seminar Notification and On-Line Registration - April 24, 2003

Health Care Claims Status Category Codes and Health Care Claim Status Codes for Use with the Health Care Claim Status Request and Response ASC X12n276/277 - April 17, 2003

(1) Reporting of Common Procedural Terminology (CPT) Code 97014 and Healthcare Common Procedure Coding System (HCPCS) G0283 (2) Coverage and Billing for Percutaneous Image-Guided Breast Biopsy - April 17, 2003

Holding of All Outpatient Claims Containing Revenue Code 964 - April 17, 2003

Procedure for Granting Extensions to File Requests for Appeal Under the New 120-day Timeframe Created by §521 of the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act (BIPA) of 2000 - April 10, 2003

Provider Education Article: "Hospice Care Enhances Dignity and Peace As Life Nears Its End - April 10, 2003

April Outpatient Code Editor (OCE) Specifications Version (V4.1) - April 10, 2003

April 2003 Update of the Hospital Outpatient Prospective Payment System (OPPS) - April 10, 2003

CMS Open Door Initiative - April 10, 2003

Holding of Mammography Claims Reflecting Computer-Aided Detection (CAD) Device Health Care Common Procedure Coding System (HCPCS) Codes - April 7, 2003

Special Handling Instructions for Outpatient Rehabilitation Claims Reflecting Codes Current Procedural Terminology (CPT) 92597 and Health Care Common Procedure Coding System (HCPCS) G0200 - April 7, 2003

(1)Ambulatory Blood Pressure Monitoring(2) Assigning Liability for Line Items Excluded by Statute on Otherwise Covered Claims(3)Intestinal & Multi Visceral Transplants - April 3, 2003

Medicare Payments for Part B Mental Health Services April 3, 2003

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March 2003
Implementation Date for the April 2003 Quarterly Shared Systems Release March 27, 2003

Codes not recognized by Medicare - March 21, 2003

Non-Reportable Codes - March 21, 2003

Medicare Fee for Service Contractor Guidance on the HIPAA Privacy Rule March 20, 2003

Billing Updates for Partial Hospitalization Services Furnished by Hospital Outpatient Departments And Community Mental Health Centers March 20, 2003

Disclosing Information About One Provider or His/Her Claims to Another Provider to Facilitate Proper Billing March 13, 2003

Colorectal Cancer Screening March 13, 2003

Payment Change for the 2003 Medicare Physician Fee Schedule (MPFS) and Further Extension of the 2003 Participation Enrollment Process (2) Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 1, 2003 March 13, 2003

Continuous Home Care Under Medicare Hospice March 13, 2003

Electromagnetic Stimulation- Information for Home Health and Hospice Providers only March 13, 2003

Holding of Claims Containing Healthcare Common Procedure Coding System(HCPCS) Code A9518 and All Outpatient Claims Due to Delay of the April 2003 Outpatient Code Editors (OCEs) March 10, 2003

Special Notice to all Home Health Providers March 5, 2003

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February 2003
Changes in Payment for Certain Services Provided by Outpatient Physical Therapy (OPT) Providers under the Medicare Physician Fee Schedule February 28, 2003

(1) Additional Documentation Request Requirements for ordering Providers of Lab Services; (2) Deep Brain Stimulation for Essential Tremor and Parkinsons Disease February 28, 2003

3 Day Payment Window Refinements Under the Short Term Hospital Inpatient Prospective Payment System February 28, 2003

Correction to Edits Affecting Audiology Services - February 26, 2003

Implementation of the Financial Limitation for Outpatient Rehabilitation Services February 23, 2003

(1) Identifying the Primary Payer Amounts to Send to the Medicare Secondary Pay Module and the Shared System When there are multiple primary payers on electronic and hardcopy claims; (2) Remittance Advice Remark & reason Code Update; (3) Pnuemococcal, Pneumonia, Influenza Virus and Hepatitis B Vaccines Update February 14, 2003

Clarification of 3-Day Payment Window vs. 1 Day Payment Window for hospitals excluded from Inpatient Prospective Payment System (IPPS) February 14, 2003

(1) April Quarterly Update for 2003 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule (2) Noncoverage of Multiple Electroconvulsive Therapy (MECT) February 13, 2003

New Waived Tests – December 17, 2002 February 13, 2003

Second Clarification of Medicare Policy Regarding the Implementation of the Ambulance Fee Schedule February 6, 2003

Pneumococcal, Pneumonia, Influenza Virus and Hepatitis B Vaccines February 4, 2003

January Medicare Outpatient Code Editor (OCE) Specifications Version 18.1 For Bills From Hospitals That Are Not Paid Under the Outpatient Prospective Payment System (OPPS) February 4, 2003

Special Handling of Observation Claims containing HCPCS G0263 and G0264 when reported with revenue code 762 for payment under the outpatient prospective payment system (OPPS) February 4, 2003

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January 2003
Coverage and Billing for Home Prothrombin Time International Normalized Ratio Monitoring for Anticoagulation Management; Eligibility Software Vendors; Ambulatory Surgical Center HCPCS Additions and Deletions for 2003; Implementation Date for the January 2003 Release - January 16, 2003

Deletion of Q codes and Reactivation of CPT codes for Hepatitis B Vaccine - January 16, 2003

2003 Update of the Hospital Outpatient Prospective Payment System (OPPS) - January 16, 2003

Coverage of Hyperbaric Oxygen (HBO) Therapy for the Treatment of Diabetic Wounds of the Lower Extremities - January 16, 2003

Revisions to Common Working File Edits for Skilled Nursing Facility (SNF) Consolidated Billing (CB) to Permit Payment for Certain Diagnostic Services Furnished to Beneficiaries Receiving Treatment for End Stage Renal Disease (ESRD) at an Independent or Provider-Based Dialysis Facility - January 16, 2003

Medicare Physician Fee Schedule (MPFS) Update and the 2003 Participation Enrollment Process - January 9, 2003

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December 2002
Annual Update of HCPCS codes Used for Skilled Nursing Facility Consolidated Billing Enforcement, Updated SNF Help File - December 26, 2002

Hospital Billing for Immnosuppressive Drugs Furnished to Transplant Patients - December 13, 2002

2003 Clinical Lab Fee Schedule dated December 12, 2002

(1) Urgent Provider Message (2) Remittance Advice Coding Update;(3) Hearing Aid Exclusion;(4) Common Working File (CWF), Fiscal Intermediary (FI),and Carrier Edits and Policy Clarification for Peripheral Neuropathy with Loss of Protective Sensation (LOPS) in People with Diabetes - December 12, 2002

Ambulance Fee Schedule Updates for 2003 - December 12, 2002

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November 2002
0001 Revenue Line Direction for the Health Insurance Portability and Accountability Act (HIPAA) Institutional 837 Health Care Claim - November 21, 2002

Update to the Mammography Quality Standard ACT; & Mammography Screening Update - November 28, 2002

Remittance Advice Message for Ambulance Services; & Non-Covered Miles for Ambulance - November 21, 2002

Pnuemococcal Pnuemonia, Influenza Virus and Hepatitis B Vaccines 2003 HCPCS Updates; Promoting Influenza Vaccinations - November 21, 2002

Medicare Deductible and Premium Rates for Calendar year 2003; Changes in Transitional Outpatient Payment for 2003; Medicare Telehealth Update; Levocarnitine for use in the treatment of Carnitine Deficiency in ESRD Patients; Immnuosuppressive Drugs furnished to Transplant Patients; Changes in Requirements for Medicare Low Osmolar Contrast Material under the Outpatient Prospective Payment System - November 27, 2002

New Waived Test - November 21, 2002

Revisions to CWF Editing to Accomodate Home health Partial Episode Payment Claims and Rescheduling of Payment Adjustment Utility - November 21, 2002

Coverage and Billing For Neuromuscular Electrical Stimulation; Deported Merdicare Beneficiaries - November 21, 2002

Coverage and Billing Requirements for Electrical Stimulation for the Treatment of Wounds - November 21, 2002

Advance Beneficiary Notice and DMEPOS Refund Requirements Corrections to PM AB-02-114 - November 22, 2002

Thanksgiving Holiday Schedule 2002 - November 18, 2002

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October 2002
Electronic Patient Records Via Non-Internet Means - October 31, 2002

Clarification Regarding Non Physician Practitioners Billing on Behalf of a Diabetes Outpatient Self-Management Training Services (DSMT) Progarm and the Common Working File Edits for DSMT & Medical Nutrition Therapy - October 31, 2002

October 2002 Update to the Hospital Outpatient Prospective Payment System (OPPS) Correction: This instruction replaces PM A-02-076 CR 2298 issued on August 7, 2002 - October 31, 2002

Home health Agencies Responsibilities Regarding Patient Notification - October 31, 2002

Hospital's responsibilities regarding patient Notification at Discharge Planning and Home Helath Consolidated Billing - October 31, 2002

Medicare Certified Hospices-Clarification of Acceptable Parameters for some Contractual Arrangements - October 31, 2002

Psychotropic Drug Use in Skilled Nursing Facilities - October 31, 2002

Multiple Patient Ambulance Transport - October 31, 2002

Adjusting Claims with Line Item Denials - October 30, 2002

Claims Processing Requirements for Clinical Diagnostic Laboratory Services Based on the Negotiated Rulemakeing - October 28, 2002

Instructions for Implementing the Long Term care Hospital Prospective Payment System - October 23, 2002

Update of Rates and Wage Index for Ambulatory Surgical Center (ASC) Payments Effective - October 1, 2002

Year 2003 Healthcare Common Procedure Coding System (HCPCS) Annual Update Reminder - October 3, 2002

Clarification of Medicare Policy Regarding the Implementation of the Ambulance Fee Schedule - October 3, 2002

Definitions of Ambulance Services - October 3, 2002

Coverage and Billing for Percutaneous Image Breast Biopsy - October 3, 2002

New Electronic Remittance Advice Coding for Home Health Prospective Payment System - October 3, 2002

Claims Processing Requirements for Clinical Diagnostic Laboratory Services Based on the Negotiated Rulemaking - October 3, 2002

Corrections to: Changes to the Hospital Inpatient Prospective Payment Systems and Rates and Cost of Graduate Medical Education as Published in the Federal register , FY 2002 (66 FR 39828, August 1, 2001) and FY 2003 (67 FR 49985, August 1, 2002) - October 2, 2002

The Upcoming Health Insurance Portability and Accountability Act (HIPAA) Deadline - October 1, 2002

Diabetes Self-Management Training (DSMT) - October 1, 2002

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September 2002
Clarification of Provider Billing Requirements Under the Outpatient Prospective Payment System (OPPS) - September 30, 2002

Applicable Bill Types for Ambulance Services (Revenue Code 540) - September 30, 2002

Adjusting Rejected Claims - September 30, 2002

October Medicare Outpatient Code Editor (OCE) Specification version 18.0 Bills from hospitals that are not paid under the Outpatient Prospective Payment System (OPPS) - September 16, 2002

Information on Medicare + Choice (M+C) Private Fee-for-Service Plans - September 5, 2002

Coding Instructions for IN-111 Zevelin and Y-90 Zevalin - September 5, 2002

Updates to Medicare Coverage of Photodynamic Therapy - September 6, 2002

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August 2002
Changes to CWF Edits for Skilled Nursing Facility (SNF) Consolidated Billing (CB) - August 26, 2002

Revised 2002 Provider workshop Schedule - August 22, 2002

Carrier, Durable Medical Equipment Regional Carrier (DMERC), Intermediary and Regional Home Health Intermediary (RHHI) Processing Requirements for Claims Edited by CWF for Medicare Beneficiaries in State or Local Custody Under A Penal Authority - August 20, 2002   Adobe Acrobat

Health Insurance Portability and Accountability Act (HIPAA) Institutional 837 Health Care Claims -DDE Updates - August 20, 2002   Adobe Acrobat

Health Insurance Portability and Accountability Act (HIPAA) Institutional 837 Health Care Claim Additional Implementation Direction - August 16, 2002   Adobe Acrobat

Coding Adequacy of Hemodialysis - August 16, 2002   Adobe Acrobat

Notice of Interest Rate for Medicare Overpayments and Underpayments - August 16, 2002   Adobe Acrobat

ABN's and DMEPOS Refund Requirements /Implementation of Form CMS-131, Advance Beneficiary Notice (ABN), and of Limits on Beneficiary Liability for Medical Equipment and Supplies - August 16, 2002   Adobe Acrobat

October 2002 Update to the Hospital Outpatient Payment System - August 16, 2002   Adobe Acrobat

Admitting Diagnosis for Observation Services for the Outpatient Prospective Payment System (OPPS) - August 16, 2002   Adobe Acrobat

Transition Schedule for Implementation of the Ambulance Fee Schedule - August 16, 2002   Adobe Acrobat

Clarification of the Homebound Status - August 8, 2002   Adobe Acrobat

Further Instructions Regarding Home Health Consolidated Billing - August 8, 2002   Adobe Acrobat

CWF , FI, and Carrier Edits and Policy Clarification for Peripheral Neuropathy with Loss of Protective Sensation (LOPS) in People with Diabetes - August 8, 2002   Adobe Acrobat

October Quarterly Update for 2002 Durable Medical Equipment , Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule - August 8, 2002   Adobe Acrobat

Enhancements to Home Helath Prospective Payment System Claims Processing Instructions - August 5, 2002   Adobe Acrobat

Excluding Hospitals that provide Part B Services to their Inpatients from the Outpatient Prospective Payment System - August 1, 2002   Adobe Acrobat

Applicable Bill types for Ambulance Services (Revenue Code 540) - August 1, 2002   Adobe Acrobat

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July 2002
Payment System for Home health Agencies for FY 2003 - July 18, 2002   Adobe Acrobat

Medicare Program Update to the Hospice Payment Rates, Hospice Cap, Hospital Wage index and the Hospice Pricer for FY 2003 - July 18, 2002   Adobe Acrobat

Revision to Billing for Swing bed Services Under Skilled Nursing Facility Prospective Payment System - July 18, 2002   Adobe Acrobat

Medicare Program Update to the Prospective - July 5, 2002   Adobe Acrobat


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June 2002
Contractor Responsibilities in Implementing Settlement between Sulzer Orthepedics and Centers for Medicare and Medicaid Services (CMS) - June 27, 2002   Adobe Acrobat

July 2002 Update to the Outypatient Prospective Payment System - June 27, 2002   Adobe Acrobat

July Outpatient Code Editor (OCE) Specifications Version (V3.1) - June 27, 2002   Adobe Acrobat

Customer Service Representative Response to Physician & Provider Correct Coding Initiative (CCI) Questions- June 27, 2002   Adobe Acrobat

Payment for Services furnished by Audiologist - June 27, 2002   Adobe Acrobat

Coding Changes for Sodium Hyaluronate - June 27, 2002   Adobe Acrobat

Additional Information Regarding Medicare Payment Allowance for Flu Vaccine - June 27, 2002   Adobe Acrobat

Extended Repayment Schedules (ERS) for the Home Health Providers who received the special Periodic Payment (PIP) - June 27, 2002   Adobe Acrobat

Excluded Foot Care Services - June 27, 2002   Adobe Acrobat

Remittance Advice Coding and Health Insurance Portability and Accountablity Act (HIPAA) Transaction 835v4010 Completion Update - June 27, 2002   Adobe Acrobat

Extension of the Deadline for Hospitals to Make Elections to Reduce Beneficiary Coinsurance for 2002 Under the Outpatient Prospective Payment System (OPPS)

July Medicare Outpatient Code Editor (OCE) Specifications Version 17.2 for Bills from hospitals that are not Paid Under the Outpatient Prospective Payment System (OPPS)

Modification of Common Working File (CWF) A/B Crossover Edit 7111 and "Alert" 7531 - June 13, 2002   Adobe Acrobat

HIPAA Model Compliance Plan and Instructions - June 6, 2002   Adobe Acrobat

Submission of the Swing Bed Minimum Data Set (MDS) Data for Swing Bed Hospitals - June 2, 2002   Adobe Acrobat

New Patient Status Code 64

Clarification to Periodic Interim Payments (PIP) For Home Health

Providers and Clarification on Extension of Due Dates for Filing Provider

Cost Reports

Coverage and Billing of the Diagnosis and Treatment of Peripheral

Neuropathy with Loss of Protective Sensation in People with Diabetes

Additional Clarification for Medical Nutrition Therapy (MNT) Services

Blood Deductible Claims Update - June 2, 2002   Adobe Acrobat

Medicare Coverage of Rehabilitation Services for Beneficiaries with Vision Impairment - June 2, 2002   Adobe Acrobat

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May 2002

Revised Voluntary Refunds to the Medicare Program - May 30, 2002

New Waived Tests - May 23, 2002

Notice of Interest Rate for Medicare Overpayments & Underpayments
Diabetes Self Managament Training Payment - May 23, 2002   Adobe Acrobat

Coverage & related Claims Processing Requirements for PET Scans for Breast Cancer
Coverage and Billing for Home Prothrombin Time International Normalized Ratio Monitoring for Anti-Coagulation Management
Non-Coverage of Perception Sensory Threshold/Nerve Conduction Threshold Test - May 16, 2002   Adobe Acrobat

HIPAA Institutional 837 Health Care Claim-Hospice Direction
Updates to CWF Editing of Intermediary Claims for DME and Prosthetic/Orthotic Devices
HIPAA Institutional 837 Health Care Claim-Home health Direction - May 16, 2002   Adobe Acrobat

Generating Outbound COB X21N 837 when Required Data is missing or invalid - May 9, 2002   Adobe Acrobat

Interaction of ABN's adn Emtala FAQ's and New Source of Provider Information Available on CMS Web Site - May 9, 2002   Adobe Acrobat

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April 2002

HIPAA Health Care Eligibility Benefit Inquiry/Response Transaction Standard - April 25, 2002   Adobe Acrobat

Durable Medical Equipment, Prosthetics, Orthotics & Supplies Fee Schedule, - April 25, 2002   Adobe Acrobat

Skilled Nursing Facility Updates - April 25, 2002   Adobe Acrobat

HIPAA Update, COBC Strike, Outpatient Prospective Payment System, Outpatient Code Editor - April 25, 2002   Adobe Acrobat

Outpatient Code Editor Specifications (Ver 3.0) - April 25, 2002   Adobe Acrobat

Therapy Coverage For Altzheimer's Disease Patients - April 25, 2002   Adobe Acrobat

Standard Operating Procedures (SOP's) for Unlisted HCPCS Codes - April 18, 2002   Adobe Acrobat

CMS Issues Model Plan to Extend Deadline for Compliance with Electronic Transactions - April 11, 2002   Adobe Acrobat

Receipt and Processing of Non covered Charges on other than Part A Inpatient Claims - April 11, 2002   Adobe Acrobat

Coverage and Billing of the Diagnosis and Treatment of Peripheral Neuropathy with Loss of Protective Sensation in People with Diabetes - April 4, 2002   Adobe Acrobat

2002 Update of the Hospital Outpatient Prospective Payment System (OPPS) - April 4, 2002   Adobe Acrobat

Off Label Use of Oral Chemotherapy Drugs Methotrexate and Cyclophosphamide - April 4, 2002   Adobe Acrobat

Billing for Audiologic Function Tests for Beneficiaries that are Patients of a Skilled Nursing Facility - April 4, 2002   Adobe Acrobat

CMS Region III Provider Newsletter ("CHECK-UP") -
April 1, 2002   Adobe Acrobat

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March 2002

Revised Timelines for HIPAA - March 28, 2002   Adobe Acrobat

Conversion of Hospital Swing Bed Facilities to SNF - March 28, 2002   Adobe Acrobat

Maryland Medicare HMO Listing - March 22, 2002   Adobe Acrobat

Provider Education & Training Advisory Council Survey and Training Schedule for 2002 - March 21, 2002   Adobe Acrobat

Payment for Blood Clotting Factors administered to hemophilia inpatients - March 21, 2002   Adobe Acrobat

Payment for Air Ambulance Transportation of Deceased Beneficiary - March 21, 2002   Adobe Acrobat

Notice of Interest Rate - March 21, 2002   Adobe Acrobat

Provider Education Training Activities to Implement Updates to the Ambulance Fee Schedule - March 19, 2002   Adobe Acrobat

Electronic Medicare Provider/Supplier Enrollment Forms - March 14, 2002   Adobe Acrobat

Administrative Policies Related to Processing Claims for Clinical Diagnostic Lab Services - March 14, 2002   Adobe Acrobat

Extended Repayment Schedules for Home Health Agencies Affected by the Interim Payment System - March 7, 2002  Adobe Acrobat

HIPAA Institutional 837 Health Care Claim Implementation Updates - March 7, 2002  Adobe Acrobat

Clarification of Payment Responsibilities of Fee for Service Contractors - March 7, 2002  Adobe Acrobat

New Waived Test - March 7, 2002  Adobe Acrobat

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February 2002

Extended Repayment Schedules - February 28, 2002   Adobe Acrobat

HIPAA 837 Health Care Claim Implementation - February 28, 2002   Adobe Acrobat

Clarification of Payment Responsibilities of Fee-For Service Contractors - February 28, 2002   Adobe Acrobat

New Waived Test - February 28, 2002   Adobe Acrobat

Correction to Edits Affecting Audiology Services - February 26, 2002  Adobe Acrobat

Special Provider Invitation: Hospital Open Door Forum   Adobe Acrobat

Effective date for Q3017 - February 14, 2002   Adobe Acrobat

Open Door Provider Forums/Information on upcoming beneficiary survey on pnuemoccocal & influenza immunizations - February 14, 2002   Adobe Acrobat

HIPAA Delay Q&A - February 14, 2002   Adobe Acrobat

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January 2002

Bulletin for Timely Filing - January 30, 2002   Adobe Acrobat

CY 2002 Prospective Payment Rate Implementation Delay - January 10, 2002   Adobe Acrobat

Amended Production dates for the Provider Statistical & Reimbursement (PS&R) Report & Extension of due date for filing Provider Cost Report - January 10, 2002   Adobe Acrobat

Changes to FY 2001 Nursing & Allied Health Education Payments Policiesas required by the Benefits Improvements & Protection Act of 2000 (BIPA) - January 10, 2002   Adobe Acrobat

Update to Waived Tests - January 10, 2002   Adobe Acrobat

Additional Information Related to Section 212 of the Medicare, Medicaid, & SCHIP Benefits Improvements & protection Act (BIPA) of 2000 - January 10, 2002  Adobe Acrobat

Completion of Home Health Prospective Payment System (HH PPS) Consolidated Billing Enforcement - January 10, 2002  Adobe Acrobat

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December 2001

Modifications to form CMS-339 - December 20, 2001   Adobe Acrobat

Seminar Dates & Christmas and New years Holiday Schedule - December 14, 2001   Adobe Acrobat

HCPCS code Update - December 12, 2001   Adobe Acrobat

Billing for SNF Admissions when a payment ban is imposed - December 12, 2001   Adobe Acrobat

CMS policy for Disclosure of Individually Identifiable information for Provider Telephone Inquiries for medicare Eligibility Information - December 12, 2001   Adobe Acrobat

Medicare Coverage of Screening Pap Smears - December 12, 2001   Adobe Acrobat

January Medicare OCE Specs - December 6, 2001   Adobe Acrobat

The Use of Gamma Cameras and Full Ring & partial Ring positron Emission Scanners - December 6, 2001   Adobe Acrobat

Additional instructions for Implementing IRF - December 6, 2001   Adobe Acrobat

Clarification of payments made to hospital outpatient departments under OPPS - December 6, 2001   Adobe Acrobat

Medicare Coverage of Infusion Pumps - December 5, 2001   Adobe Acrobat

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November 2001

• Notice of Interest Rate for Medicare Overpayments and Underpayments - November 15, 2001   Adobe Acrobat

• Instructions for Billing and Processing of Hospital Outpatient Claims Containing Charges for Epoetin Alfa (EPO), Tradenames: Epogen and Procrit - November 15, 2001   Adobe Acrobat

• Provider Billing and Intermediary Claims Processing for Disaster Related Admissions to Skilled Nursing Facilities (SNF) - November 15, 2001   Adobe Acrobat

• Status of Coordination of Benefits Contractor Operations - November 15, 2001   Adobe Acrobat

• I. Screening Glaucoma Services AND II. Medicare Coverage for the Treatment of Actinic Keratoses - November 15, 2001   Adobe Acrobat

• Correction to Program Memorandum (PM) AB-01-53: Elimination of DMEPOS Fee Schedules for Repair Codes E1340, L4205, L7520, and L8049 - November 15, 2001   Adobe Acrobat

• Medicare Deductible and Premium Rates for Calendar Year 2002 - November 15, 2001   Adobe Acrobat

• Tracking the Number of Diabetes Outpatient Self-Management Training (DSMT) and Medical Nutrition Therapy (MNT) Hours by the Common Working File (CWF) - November 15, 2001   Adobe Acrobat

• External Counterpulsation Devices - November 15, 2001   Adobe Acrobat

• I. Removal of Category Code C1723 from the Pass-Through Device Category List Under the Hospital Outpatient Prospective Payment System (OPPS) AND II. Extension of Moratorium on the Application of the Financial Limitation for Outpatient Rehabilitation Services - November 15, 2001   Adobe Acrobat

• Outpatient Therapeutic Services, and Section 439, Billing for Immunosuppressive Drugs Furnished to Transplant Patients - November 15, 2001   Adobe Acrobat

• Regional Medicare Swing Bed Rates - November 15, 2001   Adobe Acrobat

• Medicare Coverage and Coding for Services Related to Anthrax -- - November 2, 2001   Adobe Acrobat

• Distribution of Revised Form CMS-855s – Medicare Provider/Supplier Enrollment Applications - (Formerly Form HCFA-855) Dated November 1, 2001 - November 1, 2001   Adobe Acrobat

• CMS Relaxes Medicare Secondary payer Instructions for Hospitals, (Part II), Holiday Schedule - November 1, 2001   Adobe Acrobat

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October 2001

• Second Update to the 2001 Medicare Physician Fee Schedule Database - October 29, 2001   Adobe Acrobat

• New Waived Tests - October 25, 2001   Adobe Acrobat

Ambulance Inflation Factor for 2002 AMedicare A FSS Password Changes - October 25,2001

• Year 2002 Healthcare Common Procedure Coding System (HCPCS) Annual Update Reminder - October 25, 2001   Adobe Acrobat

ICD-9-CM Coding for Diagnostic Tests Introduction - October 18, 2001   Adobe Acrobat

Update of Codes and Payments for Ambulatory Surgical Centers (ASCs) - October 18, 2001   Adobe Acrobat

Coverage and Billing of Sacral Nerve Stimulation Coverage - October 18, 2001   Adobe Acrobat

Medicare Secondary Payer (MSP) Policies Relaxed for Hospitals - October 18, 2001   Adobe Acrobat

Guidance Regarding a Change in Reimbursement for Part B Inpatient Ancillary Services - October 18, 2001   Adobe Acrobat

Mammography Screening Updates - October 18, 2001   Adobe Acrobat

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September 2001

Instructions for Implementing and Updating 2002 Payment Amounts for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) - September 27, 2001   Adobe Acrobat

Clarification of Activity Therapy (HCPC G0176) and Patient Education/Training Services (HCPC G0177) Under the Hospital Outpatient Prospective Payment System (OPPS) - September 27, 2001   Adobe Acrobat

Durable Medical Equipment Regional Carrier (DMERC) Denial Code for Durable Medical Equipment (DME) Furnished in Skilled Nursing Facilities (SNFs) - September 20, 2001   Adobe Acrobat

Coordination of Benefit (COB) Emergency Update - September 20, 2001   Adobe Acrobat

• October Outpatient Code Editor (OCE) Specifications Version (V2.3) - September 6, 2001   Adobe Acrobat

Electronic Remittance Advice Changes for HIPAA - September 6, 2001   Adobe Acrobat

CMS Audit and Cost Report Settlement Expectations Program Memorandum A-01-82 - September 1, 2001   Adobe Acrobat

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August 2001

Health Insurance Portability and Accountability Act (HIPAA) Reminders - August 30, 2001   Adobe Acrobat

Adult Liver Transplant - August 30, 2001   Adobe Acrobat

Screening Glaucoma Services Holiday Schedule Special Notes of Clarification - August 23, 2001   Adobe Acrobat

Medicare Secondary Payer (MSP) Frequently Asked Questions and Answers from Attorneys - August 23, 2001   Adobe Acrobat

Instructions for Implementing Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) - August 23, 2001   Adobe Acrobat

Notice of Interest Rate for Medicare Overpayments and Underpayments - August 16, 2001   Adobe Acrobat

Payment for Blood Clotting Factor Administered to Hemophilia Inpatients - August 16, 2001   Adobe Acrobat

New Patient Status Codes - August 15, 2001   Adobe Acrobat

Extension of Due Date for Filing Provider Cost Reports - August 2, 2001   Adobe Acrobat

Revised Guidelines for Processing Claims for Clinical Trial Routine Care Services - August 2, 2001   Adobe Acrobat

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July 2001

Problems With Processing Certain Clinical Diagnostic Laboratory Claims and Other Claims Through the July Outpatient Code Editor (OCE) - July 19, 2001   Adobe Acrobat

New Waived Tests - July 19, 2001   Adobe Acrobat

Skilled Nursing Facility (SNF) Annual Update for FY 2002 - July 19, 2001   Adobe Acrobat

Contractor Updating of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - July 12,2001   Adobe Acrobat

Update of Codes and Payments for Ambulatory Surgical Centers (ASCs) - July 12, 2001   Adobe Acrobat

Medicare Program - Update to the Prospective Payment System (PPS) for Home Health Agencies for FY 2002 - July 12, 2001   Adobe Acrobat

Use of Modifier 25 and Modifier 27 in the Hospital Outpatient Prospective Payment System (OPPS) - July 12, 2001   Adobe Acrobat

Change in Hospice Payment Rates, Update to the Hospice Cap, Revised Hospice Wage Index and Hospice Pricer - July 11, 2001   Adobe Acrobat

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June 2001

Holiday Schedule Drugs and Biologicals (Revision) - June 26, 2001   Adobe Acrobat

Medicare Coverage of Cryosurgery of the Prostate Gland - June 21, 2001   Adobe Acrobat

Diabetes Outpatient Self-Management Training Services - June 21, 2001   Adobe Acrobat

Instructions for Coverage and Billing of Biofeedback Training for the Treatment of Urinary Incontinence - June 21, 2001   Adobe Acrobat

Inclusion of Medicare Paid provider Message and Removal of the Ambulatory Payment Classification (APC) Code from the Medicare Summary Notice (MSN) - June 21, 2001   Adobe Acrobat

Medicare Transitional Pass-Through Payments Under the Hospital Outpatient Prospective Payment System (OPPS) for Pacemakers and Neurostimulators - June 21, 2001   Adobe Acrobat

Screening Pap Smears and Screening Pelvic Examinations - June 21, 2001   Adobe Acrobat

Payment Instructions for Intestinal Transplants Furnished to Beneficiaries Enrolled in Medicare+Choice (M+C) Plans With Dates of Service on or After April 1, 2001, but Before January 1, 2002. - June 7, 2001   Adobe Acrobat

Medicare Coverage Percutaneuos Transluminal Angioplasty (PTA) - June 7, 2001   Adobe Acrobat

Clarification of Provider cost Report Filing Requirements - June1, 2001   Adobe Acrobat

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May 2001

Billing for Audiologic Function Tests For Beneficiaries That Are Patients of a Skilled Nursing Facility (SNF) - May 24, 2001   Adobe Acrobat

Skilled Nursing/Consolidated Billing Seminar Questions and Answers - May 24, 2001   Adobe Acrobat

Revision of Existing Home Health Prospective Payment System (HH PPS) Consolidated Billing Edits - May 24, 2001   Adobe Acrobat

Revision of Medicare Reimbursement for Telehealth Services - May 24, 2001   Adobe Acrobat

Fiscal Intermediary (FI), Durable Medical Equipment Regional Carrier (DMERC) and Common Working File (CWF) Changes Required for Processing Method II Home Dialysis Claims - May 10, 2001   Adobe Acrobat

Clarification to Health Insurance Prospective Payment System (HIPPS) Coding and Billing Instructions - May 10, 2001   Adobe Acrobat

Procedures Subject to Home Health Consolidated Billing
II) Elimination of the Initial Request for Anticipated Payment (RAP)Medicare Summary Notice (MSN)/Explanation of Medicare Benefits
- May 10, 2001   Adobe Acrobat

Form HCFA-1450 For Inpatient And Outpatient Bills
No Legal obligation to pay or provide Services
- May 10, 2001   Adobe Acrobat

Notice of Interest Rate for Medicare Overpayments and Underpayments - May 10, 2001   Adobe Acrobat

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April 2001

Clarification And HCPCS Coding Update: Part B Fee Schedule And Consolidated Billing For Skilled Nursing Facility (SNF) Services - April 19, 2001   Adobe Acrobat

Categories for Use in Coding Devices Eligible for Transitional Pass-Through Payments Under the Hospital Outpatient Prospective Payment System - April 12, 2001   Adobe Acrobat

Intestinal and Multi-Visceral Transplantation - April 30, 2001  Adobe Acrobat

Expanded Coverage of Positron Emission Tomography (PET) Scans and Related Claims Processing Changes - April 27, 2001   Adobe Acrobat

Additional Information on Transitional Pass-Through Devices and Drugs - April 27, 2001   Adobe Acrobat

Further Guidance Regarding Billing Under the Outpatient Prospective Payment System (OPPS) - April 27, 2001   Adobe Acrobat

Implementation of Updates to the Federal Fiscal Year (FY) 2001 - April 26, 2001   Adobe Acrobat

New Waived Tests -- Effective Date of Receipt - April 12, 2001   Adobe Acrobat

New timely Filing Edits Submitting Late Charge Adjustments on claims with MR denials Audit and Reimbursement Reminders - April 12, 2001   Adobe Acrobat

Tests Granted Waived Status Under CLIA - April 12, 2001   

Postacute Care Transfer Policy - April 12, 2001  Adobe Acrobat

Changes to 2001 Clinical Laboratory Fee Schedule Required by the Benefits Improvement and Protection Act (BIPA) of 2000 - April 5, 2001  Adobe Acrobat

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March 2001

Implementation of Benefits Improvement and Protection Act of 2000 (BIPA) Requirements for Drugs and Biologicals covered by Medicare - March 29, 2001  Adobe Acrobat

Payment Revisions for Diagnostic and Screening Mammograms peformed with New Technologies - Effectuated by Benefits Improvements and Protection Act 2000 - March 29, 2001  Adobe Acrobat

April Outpatient Code Editor (OCE) Specifications Version (V2.1) - March 29, 2001  Adobe Acrobat

2001 Payment Limit Update for Ambulance Services - March 22, 2001  Adobe Acrobat

Implementation of Sections 111, 403, and 405 of the Medicare, Medicaid, and SCHIP Benefits and Protection Act of 2000. - March 22, 2001  Adobe Acrobat

New Composite Rates Effective April 1, 2001, through December 31, 2001, and the Application of Exceptions under End Stage Renal Disease Composite Rate System - March 22, 2001   Adobe Acrobat

Impact of the benefits Improvement and protection Act on Devices Eligible for Transitional Pass-Through Payments under the Hospital Outpatient Prospective Payment System - March 22, 2001  Adobe Acrobat

Clarification of the Homebound Definition under the Medicare Home Health Benefit - March 22, 2001  Adobe Acrobat

Verteporfin - March 22, 2001  Adobe Acrobat

Impact of the benefits Improvement and protection Act on Devices Eligible for Transitional Pass-Through Payments under the Hospital Outpatient Prospective Payment System - March 22, 2001  Adobe Acrobat

Medical Review of Certification and Re-certifications of Residents in Skilled Nursing Facilities - March 15, 2001   Adobe Acrobat

Delay of Carrier and Intermediary Actions Required in CRs 1256 and 1323, Consolidated Billing for Skilled Nursing Facility (SNF) Residents, and Fee Schedule for Part B Residents and Outpatients - March 15, 2001   Adobe Acrobat

Completion of Form HCFA 1450 for Inpatient and/ or Outpatient Billing - March 15, 2001  Adobe Acrobat

Billing for Sodium Ferric Gluconate Complex in Sucrose Injection - March 15, 2001   Adobe Acrobat

Colorectal Cancer Screening - March 15, 2001   Adobe Acrobat

Notice of Interest Rate for Medicare Overpayments and Underpayments - March 8, 2001  Adobe Acrobat

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February 2001

Replacement of Prosthetic Devices and Parts - February 22, 2001  Adobe Acrobat

New Waived Tests -- Effective Date of Receipt - February 15, 2001  Adobe Acrobat

Elimination of Time Limit for Coverage of Immunosuppressive Drugs Under Medicare - February 15, 2001  Adobe Acrobat

Changes to Federal Fiscal Year (FY) 2001 Inpatient Hospital Payments As Required By The Benefits Improvement And Protection Act (BIPA) Of 2000 (Public Law 106-554) - February 15, 2001  Adobe Acrobat

Home Health Prospective Payment System (PPS) - February 1, 2001  Adobe Acrobat

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January 2001

Technical Corrections to the January 2001 Update: Coding Information for Hospital Outpatient Prospective Payment System (OPPS) - January 25, 2001  Adobe Acrobat

Adjustments to the Federal Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Rates for FY 2001 - January 25, 2001  Adobe Acrobat

Cervical or Vaginal Smear Tests (Pap Smears) in Calendar Year (CY) 2001 Clinical Diagnostic Laboratory Fee Schedule - January 11, 2001  Adobe Acrobat

Hospital Outpatient Prospective Payment System Pass-Through Payment Corrections for Two Radiopharmaceuticals - January 11, 2001  Adobe Acrobat

Billing Instructions for Partial Hospitalization Services Provided in CMHC's - January 4, 2001  Adobe Acrobat

Inpatient Rehabilitation Facility Prospective Payment System - January 4, 2001  Adobe Acrobat

New ESRD Composite Payment Rates Effective January 1, 2001 - January 4, 2001  Adobe Acrobat

Partial Implementation of Change Request 1119 - January 4, 2001  Adobe Acrobat

Payment for Method II Home Dialysis Supplies - January 4, 2001  Adobe Acrobat

Durable Medical Equipment Reference List and Speech Generating Devices - January 7, 2001  Adobe Acrobat

Heart Transplants - January 7, 2001  Adobe Acrobat

Operating Instructions for Coverage of Non-Implantable Pelvic Floor Electrical Stimulators - January 7, 2001   Adobe Acrobat

Appeals of Medicare Part A/Part B Coverage Determinations - January 7, 2001  Adobe Acrobat

Non-Implantable Pelvic Floor Electrical Stimulator - January 6, 2001  Adobe Acrobat

Glucose Monitoring - January 4, 2001  Adobe Acrobat

Completion of Form HCFA- 1450 For Inpatient and/or Outpatient Billing - January 4, 2001  Adobe Acrobat

COB Contractor Fact Sheet - January 4, 2001  Adobe Acrobat

Conversion to the UB-92 Version 6.0 and Continued Use of Version 5.0-ACTION - January 4, 2001  Adobe Acrobat

Intestinal Transplantation - January 4, 2001  Adobe Acrobat

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December 2000

Instructions for Implementing and Updating 2001 Payment Amounts for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) - December 28, 2000  Adobe Acrobat

Osteogenic Stimulation - December 28, 2000  Adobe Acrobat

Payment of Drugs, Biologicals and Supplies in a Comprehensive Outpatient Rehabilitation Facility (CORF) - December 28, 2000  Adobe Acrobat

Payment For Blood Clotting Factor Administered to Hemophilia Inpatients - December 28, 2000  Adobe Acrobat

Delay Implementation of the Ambulance Fee Schedule - December 28, 2000  Adobe Acrobat

October OCE - December 28, 2000  Adobe Acrobat

Glucose Monitoring Note - December 28, 2000  Adobe Acrobat

Off Label Use of Oral Chemotherapy Drugs Methotrexate and Cyclophosphamide - December 14, 2000   Adobe Acrobat

Patient Disenrolls from Medicare HMO During an Admission - December 14, 2000  Adobe Acrobat

Fee Schedule and Consolidated Billing For Skilled Nursing Facility (SNF) Services - December 14, 2000  Adobe Acrobat

Split Billing for Medicare's Fiscal Year End - December 7, 2000   Adobe Acrobat

Update of Codes and Payments for Ambulatory Surgical Centers (ASCs) - December 7, 2000   Adobe Acrobat

2001 Payment Limit for Ambulance Services - December 7, 2000   Adobe Acrobat

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November 2000

Medicare Deductible and Premium Rates for Calendar Year 2001 - November 23, 2000   Adobe Acrobat

Autologous Stem Cell Transplantation (AuSCT) for Patients with Multiple Myeloma - November 23, 2000   Adobe Acrobat

January 2001 Update: Coding Information for Hospital Outpatient Prospective Payment System (OPPS) - November 23, 2000   Adobe Acrobat

Ambulance Fee Schedule Training - November 17, 2000  Adobe Acrobat

Notice of Interest Rate for Medicare Overpayments and Underpayments - November 16, 2000  Adobe Acrobat

Holiday Schedule - November 13, 2000   Adobe Acrobat

Corrections to Calculation of Inpatient Payment Amounts - November 9, 2000   Adobe Acrobat

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October 2000

Implementation of the Ambulance Fee Schedule - October 26, 2000  Adobe Acrobat

Facility Requirements for Transplantation Centers -INFORMATION ONLY Glucose Tests - October 26, 2000  Adobe Acrobat

Clarification of Fiscal Intermediary (FI) and Durable Medical Equipment Regional Carrier (DMERC) Responsibilities Concerning Home Dialysis Method Election and Claims Processing - October 26, 2000  Adobe Acrobat

Notification to Providers and Suppliers of Transaction and Code Set Rule Promulgated In Accordance With the Health Insurance Portability and Accountability Act (HIPAA) - October 26, 2000  Adobe Acrobat

OPPS Outpatient Code Editor Units Edit #15 - October 20, 2000  Adobe Acrobat

Claims Submitted for Medicare Beneficiaries Participating In Medicare Qualifying Clinical Trials - October 19, 2000  Adobe Acrobat

Urokinase (Abbokinase®) Shortage - October 12, 2000   Adobe Acrobat

Condition Codes 20 & 21 - October 12, 2000   Adobe Acrobat

Technical Corrections to Coding Information for Hospital Outpatient Prospective Payment System (OPPS) - October 12, 2000   Adobe Acrobat

Outpatient Prospective Payment System Questions and Answers - October 12, 2000   Adobe Acrobat

Distinct Part of An Institution as a Skilled Nursing Facility (Correction) - October 5, 2000   Adobe Acrobat

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September 2000

Claim Line Expansion/Line Item Processing/HCFA Common Procedure Coding System - September 21, 2000  Adobe Acrobat

Update 1--Coding Information for Hospital Outpatient Prospective Payment System (OPPS) - September 21, 2000  Adobe Acrobat

Standard Questions and Answers for Beneficiary Inquiries Related to the Hospital Outpatient Prospective Payment System (OPPS); FISS Reason Codes Associated with the Outpatient Prospective Payment System - September 21, 2000   Adobe Acrobat

FISS Reason Codes Associated with Claim Line Expansion and Line Item Processing - September 14, 2000   Adobe Acrobat

Year 2001 HCFA Common Procedure Coding System (HCPCS) Annual Update Reminder - September 28, 2000  Adobe Acrobat

FY 2001 Prospective Payment System (PPS) Hospital and Other Bill Processing Changes - September 28, 2000   Adobe Acrobat

Partial Hospitalization Services and Outpatient Hospital Psychiatric Services - September 28, 2000  Adobe Acrobat

2001 Payment Limit for Ambulance Services - September 21, 2000   Adobe Acrobat

Pancreas Transplants - September 21, 2000   Adobe Acrobat

Outpatient Prospective Payment System Questions and Answers - September 14, 2000   Adobe Acrobat

Verteporfin (Visudyne) - September 14, 2000   Adobe Acrobat

Stem Cell Transplantation - September 21, 2000   Adobe Acrobat

Transfer of Initial Medicare Secondary Payer (MSP) Development Activities to the Coordination of Benefits (COB) Contractor - September 14, 2000   Adobe Acrobat

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August 2000

Notice of New Interest Rates for Medicare Overpayments and Underpayments - August 24, 2000   Adobe Acrobat

Proper Billing of Outpatient Pathology Services under the Outpatient Prospective Payment System (OPPS) - August 24, 2000   Adobe Acrobat

Proper Billing of Units for Intrathecal Baclofen under the Outpatient Prospective Payment System (OPPS) - August 24, 2000   Adobe Acrobat

Interim Process for Certain "Inpatient Only" Code Changes - August 24, 2000   Adobe Acrobat

Important Notice of Outpatient Prospective Payment System Implementation Progress -August 22, 2000   Adobe Acrobat

Payment of Skilled Nursing Facility (SNF) Claims for Beneficiaries Disenrolling from Terminating Medicare+Choice (M+C) Plans Who Have Not Met the 3-Day Hospital Stay Requirement - August 17, 2000   Adobe Acrobat

Revised Outpatient Code Editor (OCE) Specifications for the Outpatient Prospective Payment System (OPPS) - August 17, 2000   Adobe Acrobat

Skilled Nursing Facility (SNF) Annual Update: Prospective Payment System (PPS) Pricer and Health Insurance Prospective Payment System (HIPPS) Coding Changes -August 17, 2000   Adobe Acrobat

Provider Electronic Billing -August 17, 2000   Adobe Acrobat

Coding Information for Hospital Outpatient Prospective Payment System -August 11, 2000   Adobe Acrobat

Advance Beneficiary Notices (ABNs) for Services for Which Institutional Part B Claims Will be Processed by Fiscal Intermediaries -August 3, 2000   Adobe Acrobat

Further Information on the Use of Modifier -25 in Reporting Hospital Outpatient Services -August 3, 2000   Adobe Acrobat

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July 2000

Contractor Updating of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) (4 Addenda Attachments) -July 27, 2000   Adobe Acrobat

Rescinding Change Requests Numbers 1001, 1108, 1116, and 1163 -July 20, 2000

Hospital Outpatient Prospective Payment System (OPPS) Implementation Instructions - July 20, 2000

Ocular Photodynamic Therapy (OPT) - July 13,2000

New Waived Tests - July 13,2000

Revised Outpatient Code Editor (OCE) Specifications for the Outpatient Prospective Payment System (OPPS) - July 13,2000

Outpatient Prospective Payment System Mailing Lists - July 10,2000

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May 2000

Beneficiary Right to Itemized Statement from Medicare Providers or Suppliers - May 31, 2000

Program Memorandum on Written Statements of Intent (SOI) to Claim Medicare Benefits - May 31, 2000

Dark Days for System Availability - May 24, 2000

Notice of New Interest Rate for Medicare Overpayments and Underpayments - May 11, 2000

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April 2000

Payment of Skilled Nursing Facility Claims for Beneficiaries Disenrolling from Terminating Medicare+Choice (M+C) Plans Who Have Not Met the 3-day Stay Requirement - April 28, 2000

Payment for All Comprehensive Outpatient Rehabilitation Facility (CORF) Services Under the Medicare Physician Fee Schedule (MPFS) - April 28, 2000

Revised Outpatient Code Editor (OCE) Specifications for the Outpatient Prospective Payment System (OPPS) - April 28, 2000

Hospital Outpatient Prospective Payment System (OPPS) Implementation Instructions - April 26, 2000

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March 2000

Claim Expansion/Line Item Processing - March 24, 2000

Medicare Disproportionate Share Hospital (DSH) Adjustment Calculation - Allowable Medicaid Days - March 23, 2000

Special Bulletin for all Providers From Your Fiscal Intermediary, Maryland Medicare - March, 2000

Guidance on April Release Implementation - March 29, 2000

Questions and Answers Regarding the Prospective Payment System (PPS) for Outpatient Rehabilitation Services and Physical Medicine Current Procedural Terminology (CPT) Coding Guidance - March 27, 2000

Tests Granted Waived Status Under CLIA - March 8, 2000

Traditional Medicare and Medicare+Choice Plans - March 20, 2000

Partial Hospitalization Services Provided in Community Mental Health Centers - March 17, 2000

Notice of New Interest Rate; Adult Liver Transplantation - February 28, 2000

Claim Expansion/Line Item Processing - REVISED - March 17, 2000

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January 2000

Claim Line Expansion - January 21, 2000

Year 2000 HCFA Common Procedure Coding System (HCPCS) Update - January 12, 2000

Two-Year Moratorium on the Financial Limitation for Outpatient Rehabilitation Services - January 10, 2000

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December 1999

1) Clarification of Medicare Coverage of Abortion Services Instruction
2) Holiday Schedule for Year 2000
- December 29, 1999

Clarification of Modifier Usage in Reporting Outpatient Hospital Services - December 17, 1999

Elimination of HCPC 90669 - December 10, 1999

Coverage of Intermittant Catheterization--
Clarification to Coverage Issues Manual (CIM) §60-9 Durable Equipment Reference List
- December 1, 1999

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November 1999

Announcing the Medicare Year 2000 Deductible and Co-Insurance - November 29, 1999

Education of Medicare Providers on the Adoption of Standard Electronic Health Care Transaction Formats in the United States - November 9, 1999

National Medicare Y2K Testing Week - November 3, 1999

Notice of New Interest Rate for Medicare Overpayments and Underpayments - November 3, 1999

Holiday Schedule - October 27, 1999/November 6, 1999

Provider Bulletins and Intermediary News - November 10, 1999

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October 1999

Holiday Schedule - 1st Notice - October 27, 1999

Deactivation of Inactive Community Mental Health Center Medicare Numbers - October 21, 1999

2000 Payment Limit for Ambulance Services - October 20, 1999

Final Rule Revising and Updating Medicare Policies Concerning Ambulance Services - October 20, 1999

Pancreas Transplant; Enhanced External Counterpulsation; Interest Rate - October 1, 1999

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September 1999

Provider Education Article: National Provider Education and Training Program - September 28, 1999

Provider Education Article: Submitting, Processing, and Paying Y2K Medicare Claims - September 10, 1999

Hand Delivering Documentation - September 10, 1999

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August 1999

Implementation of Calendar Year 2000 Fee Schedules and Pricing Updates - August 27, 1999

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July 1999

Medicare Coverage for Abortion Services - July 12, 1999

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May 1999

Update for 1999 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (dmepos) Fee Schedule - May 3, 1999

Hepatitis C Virus Lookback - May 3, 1999

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March 1999

Changes to HCPCS for Influenza Virus, Pneumonia and Hepatitis B Vaccines - March 29, 1999

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January 1999

Prospective Payment System for Outpatient Rehabilitation Services and Application of Financial Limitation - January 4, 1999

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