Highmark Medicare Services - A CMS Contractor - ISO 9001:2000 Certified
Basic Search >

Medicare A+B

Electronic Mailing Lists

Subscribe to updates:
 

2008 Medicare Learning Network (MLN) Matters Articles


MLN Matters Articles are a series of national articles designed to inform the physician, provider and supplier community about the latest changes to the Medicare Program. Please use the links below to review the articles realeased by the Centers for Medicare & Medicaid Services (CMS) throughout 2008.

The following MLN Matters articles issued in 2008 are relevant to our regions only.  Visit the CMS MLN Matters page for a complete listing of all MLNs issued nationwide. 

1st Qtr
2nd Qtr
3rd Qtr
4th Qtr

January

April

July

October

February

May

August

November 

March

June

September 

 

 

A, B, or A/B
Date Subject Provider Audience
November 2008
11/18/2008 MM6258 Update to Medicare Deductible, Coinsurance and Premium Rates for 2009  A/B MAC, DME and FI Providers
11/18/2008 MM6123 – Payment of Assistant at Surgery Services in a Method II Critical Access Hospital (CAH)  MAC and FI Providers
11/18/2008 MM6191 – Compendia as Authoritative Sources for Use in the Determination of a "Medically Accepted Indication" of Drugs and Biologicals Used Off-Label in an Anti-Cancer Chemotherapeutic Regimen  A/B MAC, DME and FI Providers
11/18/2008 MM6133 – Discarded Erythropoietin Stimulating Agents (ESAs) for Method I Home Dialysis  A/B MAC and FI Providers
11/18/2008 MM6270 – Fee Schedule Update for 2009 for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)  A/B MAC, DME and FI Providers
11/18/2008 SE0840 – Changes in Medicare Payment for Oxygen and Oxygen Equipment  A/B MAC, DME and FI Providers
11/18/2008 SE0816 – Medicare Payments for Part B Mental Health Services (Revised) Physicians, Providers, and Suppliers
11/13/2008 MM6072 Application of the Hospital Outpatient Quality Data Reporting Program under the Hospital Outpatient Prospective Payment System (OPPS) MAC and FI Providers
11/13/2008 MM6268 – New Hemophilia Clotting Factor and Healthcare Common Procedure Coding System (HCPCS) Code and Terminated Hemophilia Clotting Factor HCPCS Code  MAC and FI Providers
11/13/2008 MM6223 – Update to the Initial Preventive Physical Examination (IPPE) Benefit  A/B MAC and FI Providers
11/13/2008 MM6262 – Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes Used for Home Health Consolidated Billing Enforcement  Physicians, Providers, and Suppliers
11/13/2008 SE0837 – Preparing for a Transition from an FI/Carrier to a Medicare Administrative Contractor (MAC)  Physicians, Providers, and Suppliers
11/13/2008 SE0838 – 2008 - 2009 Influenza (Flu) Season Resources for Health Care Professionals   
11/13/2008 MM6050 – Payment for Implanted Prosthetic Devices for Medicare Part B Inpatients (Revised) MAC and FI Providers
11/13/2008 MM6153 – Influenza Vaccine and the Pneumococcal Vaccine Payment Allowances Based on 95 Percent of the Average Wholesale Price (AWP) (Revised) A/B MAC and FI Providers
11/06/2008 MM6177 Archiving and Retrieving of the Integrated Outpatient Code Editor (IOCE) and the Medicare Code Editor (MCE) for Processing Claims  MAC and  Providers
11/06/2008 MM6153 – Influenza Vaccine and the Pneumococcal Vaccine Payment Allowances Based on 95 Percent of the Average Wholesale Price (AWP)  Physicians, Providers, and Suppliers
11/06/2008 MM6254 – 2009 Annual Update to the Therapy Code List  MAC and  Providers
11/06/2008 MM6218 – Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases  MAC and FI Providers
11/06/2008 MM6250 – Claim Adjustments to Correct Home Health Prospective Payment System (HH PPS) Payment Errors  HHAs and RHHIs Providers
11/06/2008 MM6237 – Reporting National Provider Identifiers (NPI) on claims for Out-of-Jurisdiction Purchased Mammography Preventive Screening and Diagnostic Services  Physicians, Providers, and Suppliers
October 2008  

Return to Top

10/31/2008 MM6212 – New 2008 Medicare Physician Fee Schedule (MPFS) Payment Rates Effective for Dates of Service July 1, 2008, through December 31, 2008 Physicians, Providers, and Suppliers
10/31/2008 MM6233 – Revision to the Reporting Requirements of Qualifying Hospital Stays on Inpatient Skilled Nursing Facility (SNF) and Swing Bed (SB) Claims  SNFs
10/31/2008 SE0836 – Influenza Pandemic Emergency -- The Medicare Program Prepares  Physicians and providers
10/31/2008 MM6213 - Laboratory National Coverage Determination (NCD) Edit Software for October 2008  Physicians and providers
10/23/08

SE0836 – Influenza Pandemic Emergency -- The Medicare Program Prepares 

Physicians and providers
10/23/08

MM6214 – Medicare Payment for Air Ambulance Services Under Section 146(b)(1) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) 

Ambulance providers and suppliers

10/23/08

MM6093 – National Provider Identifier (NPI) for Secondary Providers (REVISED)

All providers
10/23/08

MM5740 – Reasonable Charge Update for 2008 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, and Certain Intraocular Lenses (REVISED)

Physicians, providers, and suppliers
10/23/08

MM6164 – Influenza Pandemic Emergency -- Policies Concerning the Medicare Program (RESCINDED) 

Article rescinded 10.20.08
10/14/08

MM6189 - Fiscal Year (FY) 2009 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, and Inpatient Psychiatric Facility (IPF) PPS Changes 

MAC and  Providers
10/07/08 MM6221 – Reasonable Charge Update for 2009 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, and Certain Intraocular Lenses  Physicians, Providers, and Suppliers
10/07/08 MM6205 – October 2008 Update to the Ambulatory Surgical Center (ASC) Payment System; Summary of Payment Policy Changes  Physicians and ASCs
10/07/08 MM6210 – Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals Vendor Identification Number, Physician Election, and Iron Dextran Payment Update  MAC and  Providers
10/07/08 MM6113 – Ambulance Inflation Factor (AIF) for CY 2009 

Providers, suppliers (ambulance services)

10/07/08 MM6220 – 2009 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) for the Common Working File (CWF), Medicare Administrative Contractors (MACs), Medicare Carriers and Fiscal Intermediaries (FIs)  Physicians, Providers, and Suppliers
10/07/08 MM6213 – Laboratory National Coverage Determination (NCD) Edit Software for October 2008  Physicians, Providers, and Suppliers
10/07/08 MM6164 – Influenza Pandemic Emergency -- Policies Concerning the Medicare Program (RESCINDED) Article rescinded 10.20.08
10/07/08 SE0832 – The ICD-10 Clinical Modification/Procedure Coding System (CM/PCS)—The Next Generation of Coding (REVISED) Physicians, Providers, and Suppliers
10/01/08

SE0832 The ICD-10 Clinical Modification/Procedure Coding System (CM/PCS)—The Next Generation of Coding 

Physicians, Providers, and Suppliers
10/01/08 MM6052 Physician Payment Amounts When Physicians Furnish Excluded Procedures in Ambulatory Surgical Centers (ASCs)  Physicians and ASCs
September 2008  

Return to Top

09/30/08 SE0822  Clarification of Medicare Payment for Routine Costs in a Clinical Trial Providers and suppliers
09/30/08 MM6062 2008 Jurisdiction List for Durable Medical Equipment Prosthetics, Orthotics, and Supply (DMEPOS) Healthcare Common Procedure Coding System (HCPCS) Codes  Providers and suppliers
09.26.08 MM6196 – October 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS)  Providers and suppliers
09.26.08 MM6193 – Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2009  Skilled nursing facilities
09.26.08 MM6183 – Limitation on Recoupment (935) for Provider, Physicians and Suppliers Overpayments (Revised) All providers
09.26.08 MM6178 – Incorporation of Recent Regulatory Revisions into Chapter 10 of the Program Integrity Manual (PIM)  All providers
09.26.08 MM6169 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 14.3, Effective October 1, 2008  Physicians
09.26.08 MM6129 – New Requirement for Ordering/Referring Information on Ambulatory Surgical Center (ASC) Claims for Diagnostic Services (Revised) Providers and carriers
09.19.08 MM6050 - Payment for Implanted Prosthetic Devices for Medicare Part B Inpatients  Providers
09.19.08 SE0833 - Medicare Part B Drug Competitive Acquisition Program (CAP) Postponed for 2009  Physicians

09.17.08 MM6093 – National Provider Identifier (NPI) for Secondary Providers (REVISED) MAC and FI Providers
09.17.08 MM6179 – New Waived Tests  Physicians, Providers, and Suppliers

09.16.08 MM6183 – Limitation on Recoupment (935) for Provider, Physicians and Suppliers Overpayments  Physicians, Providers, and Suppliers
09.16.08 MM6163 – Smoking and Tobacco Use Cessation Counseling Billing Update for Comprehensive Outpatient Rehabilitation Facilities (CORFs) and Outpatient Physical Therapy Providers (OPTs)  MAC and FI Providers

09.16.08 MM6175 – October 2008 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files Physicians, Providers, and Suppliers

09.16.08 MM6185 –Medicare Coverage of Artificial Hearts (REVISED) Physicians, Providers, and Suppliers
09.12.08 & 09.16.08

MM6012 – Revision to the Inpatient Prospective Payment System (IPPS) Post Acute Transfer Policy for Discharges/Transfers to Home Under Care of an Organized Home Health Service Organization in Anticipation of Covered Skilled Care (RESCINDED)

Article rescinded 05.20.08
09.12.08

MM6186 – October 2008 Integrated Outpatient Code Editor (I/OCE) Specifications Version 9.3 

Providers who submit institutional outpatient claims

09.12.08

MM6122 – Indicator for the Technical Component of Purchased Diagnostic Services 

Physicians and suppliers

09.11.08 MM6203 – Delay of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program 

DME MACs

09.11.08 MM6166 – Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2009 MAC and FI Providers

09.11.08 MM6166 – Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2009  MAC and FI Providers

09.11.08 MM6195 – Clinical Laboratory Fee Schedule—Medicare Travel Allowance Fees for Collection of Specimens  MAC and FI Providers

09.11.08 MM6079 – Pneumococcal Pneumonia, Influenza Virus, and Hepatitis B Vaccines  MAC and FI Providers

09.11.08 MM6136 – Revised Form CMS-R-131 Advance Beneficiary Notice of Noncoverage  MAC and FI Providers

09.11.08 MM6185 – Medicare Coverage of Artificial Hearts Physicians, Providers, and Suppliers

09.04.08 MM6180 October Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB)  All Providers

09.04.08 MM6099 – Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) Imaging for Infection and Inflammation  Physicians, Providers, and Suppliers

09.04.08 MM6176 – Update of the Intern-to-Bed Ratio for Method II Teaching Critical Access Hospitals (CAHs)  MAC and FI Providers

09.04.08 MM6150 – 2009 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments  A/B MAC and FI Providers

09.04.08 MM6100 – Physician Signature Requirements for Diagnostic Tests  A/B MAC and FI Providers

09.04.08 MM5849 – Transition of Responsibility for Medical Review from Quality Improvement Organizations (QIOs) (Revised) Hospitals under IPPS & LTCH

09.04.08 MM6125 – Reporting Withholding Due to IRS Federal Payment Levy Program (FPLP) on the Remittance Advice (Revised) A/B MAC and FI Providers

09.04.08 MM6048 – Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA) (Revised) Physicians, Providers, and Suppliers

09.04.08 MM6145 – Screening DNA Stool Test for Colorectal Cancer (Revised) Physicians, Providers, and Suppliers

 

August 2008

 

Return to Top

08.27.08 MM6121 - 2008 Reminder for Roster Billing and Centralized Billing for Influenza and Pneumococcal Vaccinations Physicians, Providers, and Suppliers
08.26.08 MM6125 – Reporting Withholding Due to IRS Federal Payment Levy Program (FPLP) on the Remittance Advice (Revised) All Providers
08.26.08 MM5849 Transition of Responsibility for Medical Review from Quality Improvement Organizations (QIOs) (Revised) Hopital providers
 08.20.08 MM6129 – New Requirement for Ordering/Referring Information on Ambulatory Surgical Center (ASC) Claims for Diagnostic Services ASCs and MAC Proviers
   08.20.08 MM6124 – Revisions to the Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals MAC and Part B Drug Providers
08.20.08 MM6121 – 2008 Reminder for Roster Billing and Centralized Billing for Influenza and Pneumococcal Vaccinations Physicians, Providers, and Suppliers
08.20.08 MM6158 – Part B Drug Competitive Acquisition Program (CAP) Quarterly Drug Update  MAC and Part B Drug Providers
08.20.08 MM6139 Implementation of New Provider Authentication Requirements for Medicare Contractor Provider Telephone and Written Inquiries (Revised) Physicians, Providers, and Suppliers
08.20.08 MM6131 – Implementation of a New Claim Adjustment Reason Code (CARC) No.213. "Non-compliance with the physician self-referral prohibition legislation or payer policy"  Physicians, Providers, and Suppliers
08.20.08 MM6126 Fiscal Year (FY) 2006 Supplemental Security Income (SSI) Data MAC and FI Providers
08.20.08 MM6125 – Reporting Withholding Due to IRS Federal Payment Levy Program (FPLP) on the Remittance Advice Providers
08.20.08 MM6109 – Remittance Advice Remark Code and Claim Adjustment Reason Code Update Physicians, Providers, and Suppliers
08.20.08 MM5849 Transition of Responsibility for Medical Review from Quality Improvement Organizations (QIOs)

IPPS and (LTCH) providers 

08.12.08 MM5683 – Beneficiary Submitted Claims  Physicians, Providers, and Suppliers
08.12.08 MM5993 – Critical Care Visits and Neonatal Intensive Care (Codes 99291 - 99292) (Revised)

Physicians and Qualified Non-Physician Practitioners, MAC

08.12.08 MM6002 Clarification on the Correct Condition Code to Report on Provider Adjustment Requests to Indicate a Health Insurance Prospective Payment System (HIPPS) Code Change SNFs
08.12.08 MM6006 – New Hemophilia Clotting Factor and HCPCS Code Hopital providers
08.12.08 MM6107 – Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Physicians, Providers, and Suppliers
08.12.08 MM6132 – Requirement to Educate Providers Regarding Centers for Medicare & Medicaid Services (CMS) Use of Medicare Cost Report Data All providers
08.12.08 MM6155 – Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index, and the Hospice Pricer for FY 2009 Hospice providers
08.12.08 MM6145 – Screening DNA Stool Test for Colorectal Cancer Physicians, Providers, and Suppliers
08.12.08 MM6036 – Revisions to the Chapter 14 of the Medicare Program Integrity Manual  Physicians, Providers, and Suppliers
08.12.08 MM6138 – Prothrombin Time (PT/INR) Monitoring for Home Anticoagulation Management All providers
08.12.08 MM6007 Manual Revisions to Reflect Special Billing Instructions for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items as a Result of the DMEPOS Competitive Bidding Program (Revised) All providers
08.12.08 MM6042 – Medicare Improvements for Patients and Providers Act of 2008 - Legislative Change to Independent Laboratory Billing for the Technical Component (TC) of Physician Pathology Services  MAC
08.12.08 MM6048 – Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA) (Revised) All providers
08.12.08 SE0816 Medicare Payments for Part B Mental Health Services Providers
08.12.08 SE0829 – CR 5971 Clarification - Signature Requirements Providers
08.12.08 SE0830 – Steps for Individual Eligible Professionals to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports Personally Providers
08.12.08 SE0831 – Steps for Organizations to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports  Providers
08.12.08 SE0747 – Individuals Authorized Access to CMS Computer Services (IACS)- Provider/Supplier Community (IACS-PC): THE FIRST IN A SERIES OF ARTICLES (Revised) All providers
08.12.08 SE0753 – Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC): THE SECOND IN A SERIES OF ARTICLES ON THE IACS (Revised) All providers
08.12.08 SE0754 – Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC): THE THIRD IN A SERIES OF ARTICLES ON THE IACS-PC (Revised) All providers

July 2008

Return to Top
   07.23.08 SE0826 – Important Information on the New Medicare Law – The Medicare Improvements for Patients and Providers Act of 2008  All providers
07.23.08 MM6115 – Hospice Discharge for Cause  Hospice providers
07.23.08 MM6116 – Revision of the Requirements for Denial of Payment for New Admissions (DPNA) for Skilled Nursing Facility (SNF) Billing  SNFs
07.23.08 MM6080 –July 2008 Integrated Outpatient Code Editor (I/OCE) Specifications Version 9.2 (Revised) Providers
07.23.08 MM6128 – Revision to Skilled Nursing Facility (SNF) Common Working File (CWF) Editing
Therapy professionals and providers
07.23.08 MM6061 – Clarifications to Audiology Update Transmittal 1470  Audiologists
  07.23.08 SE0815 –Reminder that Exceptions to Therapy Caps are Restricted as of July 1, 2008  Article rescinded 07.17.08
07.23.08 MM6088 – Pathology Services: Notification of the Sunset for the Payment of Physician Pathology Services for Independent Laboratories  Article rescinded 07.17.08
  07.18.08 MM6048 – Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA) (Revised) All providers
07.18.08 MM6114 – Update-Long Term Care Hospital (LTCH) Prospective Payment System (PPS) for Rate Year (RY) 2009  Long term care hospitals
  07.18.08 MM6137 – Intracranial Percutaneous Transluminal Angioplasty (PTA) with Stenting Physicians and providers
07.18.08 MM5993 – Critical Care Visits and Neonatal Intensive Care (Codes 99291 - 99292) (Revised) Physicians and Qualified Non-Physician Practitioners (NPP)
  07.18.08 MM6007 – Manual Revisions to Reflect Special Billing Instructions for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items as a Result of the DMEPOS Competitive Bidding Program (Revised) All providers
  07.03.08 SE0824 – Clarification of Medicare Bad Debt Policy Related to Accounts at a Collection Agency  All fee for service Hospital and Non-Hospital Providers
07.03.08 MM6077 – Update-Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Rate Year 2009 Providers
07.03.08 MM6081 – Private Contracting/Opting out of Medicare  Physicians and practitioners
  07.03.08 MM6098 – Cardiac Computed Tomographic Angiography (CTA)  All providers
  07.03.08 MM6001 – Medicare Acute Care Episode (ACE) Demonstration. CR 6001 rescinds and fully replaces CR 5767  Hospitals
07.03.08 MM5792 – Payment for Inpatient Hospital Visits - General (Codes 99221 – 99239) (Revised) Physicians and non physician practitioners (NPPs)
  07.03.08 MM6084 – Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2008 (Revised) Clinical diagnostic laboratories
  June 2008   Return to Top
  06.26.08 MM6090 – Claim Status Category Code and Claim Status Code Update  All providers
06.26.08 MM6094 – July 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS)  Providers
06.26.08 MM6095 – July 2008 Update to the Ambulatory Surgical Center (ASC) Payment System; Summary of Payment Policy Changes  Providers
  06.26.08 MM6085 – Screening Pelvic Examination  Physicians and providers
  06.26.08 MM6111 – October Quarterly Update to 2008 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement All providers
06.26.08 MM6060 – New Waived Tests  Providers and suppliers
06.23.08 MM6104 – 2008 Physician Quality Reporting Initiative (PQRI) Establishment of Alternative Reporting Periods and Reporting Criteria (Revised) Physicians
  06.20.08 MM6119 – Phase 2 Manual Revisions for the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (Revised) DMEPOS suppliers
  06.20.08 MM6046 – Inappropriate Denials of Claims for Percutaneous Transluminal Angioplasty (PTA) of Carotid Arteries Concurrent with Stenting Based on Facility Recertification Due Dates  Physicians and hospitals
  06.20.08 MM6112 – Payment for Complex Rehabilitative Power Mobility Device (PMD) Services that Span the Implementation Date of DMEPOS Competitive Bidding Programs in Competitive Bidding Areas (Revised) Suppliers
  06.20.08 MM6091 – Notification of New Quarterly Updates to the Ambulance Fee Schedule Public Use File (PUF)  Ambulance providers and suppliers
  06.20.08 MM6101 – July 2008 Quarterly Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (Revised) Providers and suppliers
06.20.08 MM6075 – New "K" Code for Replacement Interface Material  Providers
06.20.08 MM6086 – Hospitals Exempt from Present on Admission (POA) Reporting (i.e. non-Inpatient Prospective Payment System (IPPS) Hospitals) and the Grouper  IPPS exempt hospitals
  06.20.08 SE0821 – Reminder – Medicare Provides Coverage of Diabetes Screening Tests  All providers
  06.20.08 SE0806 – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: Grandfathering, Repair and Replacement, Mail Order Diabetic Supplies and Advance Beneficiary Notices (ABNs) – The second in a series of articles on the new DMEPOS competitive bidding program. (Revised) Fee-for-Service providers
  06.20.08 SE0807 – Important Exceptions and Special Circumstances that Occur under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: – The third in a series of articles on the new DMEPOS competitive bidding program. (Revised) All providers
  06.20.08 MM5978 – Phase 1 of Manual Revisions to Reflect Payment Changes for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items as a Result of the DMEPOS Competitive Bidding Program and the Deficit Reduction Act of 2005 (Revised) DMEPOS suppliers
06.16.08 MM5993 – Critical Care Visits and Neonatal Intensive Care (Codes 99291 - 99292) (Revised) Physicians and qualified non-physician practitioners
  06.16.08 MM6049 – July 2008 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files  All providers
  06.16.08 MM6084 – Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2008 (Revised) Clinical diagnostic laboratories
  06.16.08 MM6087 – July Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB) (Revised) Physicians and providers
  06.16.08 MM5288 – Incident to Policy Update Article rescinded 05.30.08
  06.10.08 SE0820 – Marketing Rules Reminders for DME Suppliers Including Contract Suppliers under the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (Revised) Durable equipment suppliers
06.10.08 MM6080 – July 2008 Integrated Outpatient Code Editor (I/OCE) Specifications Version 9.2 (Revised) All providers
  06.10.08 MM5996 – Clinical Laboratory Fee Schedule - Medicare Travel Allowance Fees for Collection of Specimens  Clinical laboratories
  06.10.08 MM6023 – Instructions for Institutional Providers and Suppliers Billing Self-Referred Mammography Claims Regarding the Attending/Referring Physician National Provider Identifier (NPI)  Institutional providers and suppliers
06.10.08 MM6030 – Charges to Hold a Bed during Skilled Nursing Facility (SNF) Absence  Skilled nursing facilities
  06.10.08 MM6022 – July Quarterly Update for 2008 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule (Revised) Providers and suppliers
06.09.08 MM6021 – Clinical Laboratory Fee Schedule - New Waived Tests  Clinical diangostic laboratories
06.09.08 MM6053 – Part B Drug Competitive Acquisition Program (CAP) Quarterly Drug Update  Physicians
  06.09.08 MM6087 – July Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB)  Physicians and providers
  06.09.08 SE0805 – Overview of New Medicare Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) – The first in a series of articles on the implementation of this program (Revised) Fee-for-Service providers
  06.09.08 SE0806 – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: Grandfathering, Repair and Replacement, Mail Order Diabetic Supplies and Advanced Beneficiary Notices (ABNs) – The second in a series of articles on the new DMEPOS competitive bidding program (Revised) Fee-for-Service providers
  06.09.08 SE0807 – Important Exceptions and Special Circumstances that Occur under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: – The third in a series of articles on the new DMEPOS competitive bidding program (Revised) All providers
  06.03.08 MM6018 – Date of Service (DOS) for Clinical Laboratory and Pathology Specimens  Providers
  06.03.08 MM5798 – Average Sales Price (ASP) Updates  All providers
  06.03.08 MM5978 – Phase 1 of Manual Revisions to Reflect Payment Changes for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items as a Result of the DMEPOS Competitive Bidding Program and the Deficit Reduction Act of 2005 (Revised) Providers and suppliers
  06.03.08 SE0815 – Reminder that Exceptions to Therapy Caps are Restricted as of July 1, 2008  Article rescinded 07.17.08
06.03.08 MM5890 – Additional Information on Reporting a National Provider Identifier (NPI) for Ordering/Referring and Attending/Operating/Other/Service facility for Medicare Claims Article rescinded 
06.02.08 MM6045 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 14.2, Effective July 1, 2008 Physicians
  06.02.08 MM6026 – VMS Modifications to Implement the Common Electronic Data Interchange (CEDI) System - Part II  Suppliers
  06.02.08 MM6022 – July Quarterly Update for 2008 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule  Providers and suppliers
  06.02.08 SE0805 – Overview of New Medicare Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) – The first in a series of articles on the implementation of this program (Revised) Fee-for-Service providers
  06.02.08 SE0806 – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: Grandfathering, Repair and Replacement, Mail Order Diabetic Supplies and Advanced Beneficiary Notices (ABNs) – The second in a series of articles on the new DMEPOS competitive bidding program. (Revised) Fee-for-Service providers
  06.02.08 SE0807 – Important Exceptions and Special Circumstances that Occur under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: – The third in a series of articles on the new DMEPOS competitive bidding program (Revised) All providers
06.02.08 MM6027 – Correction to Determinations of Early Episodes versus Later Episodes under the Home Health Prospective Payment System (HH PPS) (Revised) Home Health Agencies
  May 2008   Return to Top
05.28.08 MM5815 – New Chapter in Medicare Claims Processing Manual for Independent Diagnostic Testing Facilities (IDTF)  Independent Diagnostic Testing Facilities
05.28.08 MM6027 – Correction to Determinations of Early Episodes versus Later Episodes under the Home Health Prospective Payment System (HH PPS)  Home Health Agencies (HHAs)
05.28.08 MM5991 – Medical and Other Health Services Furnished to SNF Patients  Skilled Nursing Facilities (SNFs)
05.28.08 MM6047 – Revisions to the Billing Requirements for ESRD-Related Epotein Alfa (EPO) and Darbepoetin Alfa (Aranesp) Administrations Provided During Unscheduled or Emergency Dialysis Treatments in the Outpatient Hospital Setting  Hospitals
  05.28.08 MM5288 – Incident to Policy Update (Revised) Article rescinded 05.30.08
  05.28.08 MM5699 – Reporting of Hematocrit or Hemoglobin Levels on All Claims for the Administration of Erythropoiesis Stimulating Agents (ESAs), Implementation of New Modifiers for Non-ESRD ESA Indications, and Reporting of Hematocrit or Hemoglobin Levels on all Non-ESRD, Non-ESA Claims Requesting Payment for Anti-Anemia Drugs (Revised) All providers
05.28.08 MM5860 – Adjusting Inpatient Prospective Payment System (IPPS) Reimbursement for Replaced Devices Offered Without Cost or With a Credit (Revised) All providers
  05.19.08 MM5979 - Assignment of Providers to Medicare Administrative Contractors All providers
05.19.08 MM5950 - Medicare Shared Systems Modifications Necessary to Capture and Crossover Medicaid Drug Rebate Data Submitted on Form UB 04 Paper Claims and Direct Data Entry (DDE) Claims All providers
  05.19.08 MM6009 - July Quarterly Update to 2008 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement All providers
  05.19.08 MM5921 - Therapy Personnel Qualifications and Policies Effective January 1, 2008 Physicians and non physician practitioners
  05.19.08 MM5288 - Incident to Policy Update Article rescinded 05.30.08
05.19.08 MM5867 - Billing Blood and Blood Products All providers who submit claims for blood and blood products
05.19.08 MM5860 - Adjusting Inpatient Prospective Payment System (IPPS) Reimbursement for Replaced Devices Offered Without Cost or With a Credit (Revised) All providers
  05.13.08 MM5288 - Incident to Policy Update Article rescinded 05.30.08
05.13.08 MM5867 - Billing Blood and Blood Products All providers who submit claims for blood and blood products
05.13.08 MM5860 - Adjusting Inpatient Prospective Payment System (IPPS) Reimbursement for Replaced Devices Offered Without Cost or With a Credit All providers
  05.13.08 MM6043 - Blood-Derived Products for Chronic, Non-Healing Wounds All providers
  05.13.08 SEO814 - Provider Authentication by Medicare Provider Contact Centers All providers
05.13.08 MM5972 - Prolonged Services (Codes 99354 - 99359) Physicians and non-physician practitioners
  05.13.08 MM6000 - Ambulance Fee Schedule - Conversion Factor File for CY 2009 Ambulance Inflation Factor (Revised) Ambulance providers and suppliers
05.12.08 MLN Matters Special Edition # SE0805 "Overview of New Medicare Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) (Revised) Medicare Fee-for-Serve providers
05.12.08 MLN Matters Special Edition Article #SE0806 "Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: Grandfathering, Repair and Replacement, Mail Order Diabetic Supplies and Advanced Beneficiary Notices (ABNs) (Revised) Medicare Fee-for-Serve providers
05.12.08 MLN Matters Special Edition Article # SE0807 "Important Exceptions and Special Circumstances that Occur Under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (Revised) All providers
  April 2008   Return to Top
  04.24.08 MM5929 – Establish Pre-Payment Auto-denial Edits in Applicable States for DMEPOS Suppliers of Oxygen and Oxygen Equipment (DME MACs only)  Medicare Durable Medical Equipment Prosthetic, Orthotics & Supplies (DMEPOS) suppliers
  04.24.08 MM5981 – New HCPCS Codes for the April 2008 Update  All providers
  04.22.08 SE0807 – Important Exceptions and Special Circumstances that Occur under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: – The third in a series of articles on the new DMEPOS competitive bidding program.  All providers
  04.22.08 MM5987 – Clinical Laboratory Fee Schedule - Implementation of Section 113 Medicare, Medicaid and State Children’s Health Insurance Program (MMSCHIP) Legislation  Clinical laboratories
04.22.08 MM5835 – Medicare Shared Systems Modifications Necessary to Accept and Crossover to Medicaid National Drug Codes (NDC) and Corresponding Quantities Submitted on CMS-1500 Paper Claims  All providers
04.22.08 MM5985 – Exception to 60-Day Limit on Substitute Physician Billing Arrangements for Physicians Called to Active Duty in the Armed Forces Reserves  Physician members of a reserve component of the Armed Forces
04.22.08 MM5968 – Nursing Facility Services (Codes 99304 - 99318)  Physicians and qualified non-physician practitioners
04.16.08 MM5999 – April 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS)  Providers and suppliers
04.16.08 MM5994 – April 2008 Update to the Ambulatory Surgical Center (ASC) Payment System; Summary of Payment Policy Changes  All providers
04.16.08 MM5971 – CR 5550 Clarification - Signature Requirements  Physicians
  04.16.08 SE0812 – Use of Professional Society Practice Parameters in Properly Providing Allergen Immunotherapy to Medicare Beneficiaries  Physicians and providers
  04.15.08 SE0805 – Overview of New Medicare Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) – The first in a series of articles on the implementation of this program.  Medicare Fee-for-Service (FFS) provider
  04.15.08 SE0806 – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: Grandfathering, Repair and Replacement, Mail Order Diabetic Supplies and Advanced Beneficiary Notices (ABNs) – The second in a series of articles on the new DMEPOS competitive bidding program. Medicare Fee-for-Service (FFS) provider supplying DMEPOS
  04.15.08 SE0811 – Pre-Bidding Activities for the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program  Suppliers of Durable Medical Equipment
04.11.08 MM5961 – Extension of Reasonable Cost Payment for Clinical Laboratory Tests Furnished by Hospitals with Fewer Than 50 Beds in Qualified Rural Areas  Hospitals with fewer than 50 beds
  04.03.08 SE0810 – Announcing the Release of the Revised CMS-855 Medicare Enrollment Applications All providers
04.01.08 MM5969 – April 2008 Integrated Outpatient Code Editor (I/OCE) Specifications Version 9.1 All providers
  04.01.08 MM5982 –April 2008 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files All providers
March 2008   Return to Top
03.26.08 MM5901 – New Contractor Numbers for the States of California, Nevada, Hawaii Including American Samoa, Guam and Northern Marianna Islands -Jurisdiction 1 Part A Medicare Administrative Contractor (MAC) Workload Providers in the States of California, Nevada, and Hawaii, as well as in the American Samoa, Guam and Northern Marianna Islands
03.26.08 MM5904 – New Contractor Numbers for the States of Nevada and Hawaii and also American Samoa, Guam and Northern Marianna Islands -Jurisdiction 1 Part B Medicare Administrative Contractor (MAC) Workload All providers
03.26.08 MM5905 – New Contractor Numbers for the State of California -Jurisdiction 1 Part B Medicare Administrative Contractor (MAC) Workload All providers
  03.26.08 MM5923 – Additional Clarification to Chapter 17, Section 40, Regarding Processing of Drug Claims with the JW Modifier All providers
03.26.08 MM5965 – April 2008 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) Pricer Changes Inpatient rehabilitation facilities
  03.26.08 MM5970 – Website for Additions and Deletions of ZIP Codes Requiring a Plus Four ZIP Code Extension Physicians and providers
  03.26.08 MM5980 – April Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB) Physicians and providers
03.26.08 MM5913 – New Waived Tests All providers
03.26.08 MM5655 – Clarification on Billing for the Oral Three Drug Combination Anti-Emetic (Aprepitant) (Revised) Providers and suppliers
  03.26.08 MM5818 – Erythropoiesis Stimulating Agents (ESAs) in Cancer and Related Neoplastic Conditions (Revised) Providers and suppliers
03.17.08 MM5655 – Clarification on Billing for the Oral Three Drug Combination Anti-Emetic (Aprepitant) (Revised) Providers and suppliers
  03.17.08 SE0804 – Opportunity to Participate in Third Annual Medicare Contractor Provider Satisfaction Survey (MCPSS) Ends in April All providers
03.17.08 MM5792 – Payment for Inpatient Hospital Visits - General (Codes 99221 – 99239) Physicians and non physician practitioners (NPPs)
  03.17.08 MM5942 – Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update
All providers
03.17.08 MM5955 – Changes to the Long Term Care Hospital Prospective Payment System (LTCH PPS) Pricer based on the Medicare, Medicaid and Stat Long Term Care Hospitals
  03.17.08 MM5840 – Manual Updates to Chapter 6, Skilled Nursing Facility (SNF) Inpatient Part A Billing, for No-Payment and Medicare Advantage (MA) Claims Skilled nursing facilities
  03.17.08 MM5910 – Clarification to CR 5744 - Payment Allowance Update for the Influenza Virus Vaccine CPT 90660 and further instruction regarding the Pneumococcal Vaccine Current Procedural Terminology (CPT) 90669 (Revised) All providers
03.17.08 SE0529 – Importance of Supplying Correct Provider Identification Information Required in Items 17, 17a, 24K, and 33 of the Form CMS-1500 (12-90), and the Electronic Equivalent (Revised) All providers
03.17.08 MM5877 – Correction to Low Utilization Payment Adjustment Add-on Payments under the Refined Home Health Prospective Payment System (HH PPS) (Revised) Home Health Agencies
03.11.08 MM5931 – Manualization of Payment for Outpatient End Stage Renal Disease (ESRD) Related Services Physicians
03.06.08 MM5655 – Clarification on Billing for the Oral Three Drug Combination Anti-Emetic (Aprepitant) Providers and suppliers
03.06.08 MM5906 – Collapsing Medicare Provider Transaction Access Numbers (PTANs) to Ensure a One-to-One National Provider Identifier (NPI) Match Providers and suppliers
  03.06.08 MM5717 – Update to Audiology Policies Physicians, non-physician practitioners, audiologists, and speech-language pathologists
03.06.08 MM5926 – Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits Clinical diagnostic laboratories
  03.06.08 MM5947 – Claim Status Category Code and Claim Status Code Update All providers
  03.06.08 MM5204 – Psychological and Neuropsychological Tests (Revised) All providers
  03.06.08 MM5890 – Additional Information on Reporting a National Provider Identifier (NPI) for Ordering/Referring and Attending/Operating/Other/Service facility for Medicare Claims (Revised) Article rescinded 05.30.07
  February 2008   Return to Top
02.29.08 MM5943 – Medicare, Medicaid and State Children’s Health Insurance Program (SCHIP) Extension Act of 2007 (MMSEA) Changes to Independent Laboratory Billing for the Technical Component (TC) of Physician Pathology Services (Revised) Independent laboratories
02.28.08 MM5946 - January 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS) - Manualization All providers
02.26.08 MM5936 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 14.1, Effective April 1, 2008 Physicians
02.26.08 MM5791 – Payment for Hospital Observation Services (Codes 99217 - 99220) and Observation or Inpatient Care Services (Including Admission and Discharge Services - Codes 99234 - 99236) Physicians and qualified nonphysician practitioners
02.26.08 MM5794 – Subsequent Hospital Visits and Hospital Discharge Day Management Services (Codes 99231 - 99239) Physicians and qualified nonphysician practitioners
02.26.08 MM5948 – Part B Drug Competitive Acquisition Program (CAP) Quarterly Drug List Update Physicians
02.26.08 MM5793 – Payment for Initial Hospital Care Services (Codes 99221 – 99223) and Observation or Inpatient Care Services (Including Admission and Discharge Services) (Codes 99234 – 99236) Physicians and qualified nonphysician practitioners
02.26.08 MM5932 – Teaching Physician Requirements for End Stage Renal Disease Monthly Capitation Payment (ESRD MCP) Physicians
  02.26.08 MM5847 – Clarification of Bone Mass Measurement (BMM) Billing Requirements Issued in CR 5521 All providers
  02.26.08 MM5897 – Change in the Amount in Controversy Requirement for Administrative Law Judge Hearings and Federal District Court Appeals All providers
02.26.08 MM5868 – Update to the Implementation Date for Home Health Agencies (HHAs) Providing Durable Medical Equipment (DME) in Competitive Bidding Areas HHAs
02.26.08 MM5898 – Comprehensive Outpatient Rehabilitation Facility (CORF) Billing Requirement Updates for FY 2008 CORFs
  02.26.08 MM5910 – Clarification to CR 5744 - Payment Allowance Update for the Influenza Virus Vaccine CPT 90660 and further instruction regarding the Pneumococcal Vaccine Current Procedural Terminology (CPT) 90669 All providers
  02.26.08 MM5855 – Systems Changes for Prescription Order Numbers for the Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals Physicians
  02.21.08 MM5772 – Implementation of the Medicare Clinical Laboratory Services Competitive Bidding Demonstration Providers and suppliers
  02.21.08 MM5870 – Process for Amending the List of Compendia for Determination of Medically-Accepted Indications for Off-Label Uses of Drugs and Biologicals in an Anti-Cancer Chemotherapeutic Regimen All providers
02.21.08 MM5943 – Medicare, Medicaid and State Children’s Health Insurance Program (SCHIP) Extension Act of 2007 (MMSEA) Changes to Independent Laboratory Billing for the Technical Component (TC) of Physician Pathology Services Independent laboratories
02.21.08 MM5879 – Home Health Prospective Payment System (HH PPS) Refinement and Rate Update for CY 2008 Home Health Agencies
02.21.08 MM5907 – Update to Common Working File (CWF) Edits 7284 and 7548 Indian Health Services or Tribal Hospitals
02.21.08 MM5872 – Update to the Common Working File (CWF) to Allow the Posting of Skilled Nursing Facility (SNF) and Swing Bed (SB) Claims to the Beneficiary’s Spell of Illness When Qualifying Stay Criteria are Not Met All providers
  02.21.08 MM5874 – Clinical Lab: New Automated Test for the Automated Multi-channel Chemistry Code (AMCC) Panel Payment Algorithm Physicians and providers
  02.21.08 MM5818 – Erythropoiesis Stimulating Agents (ESAs) in Cancer and Related Neoplastic Conditions Physicians