CMS Program Transmittals for July



CMS Program Transmittals for July

The following program transmittals were issued by the Centers for Medicare and Medicaid Services between July 1 and August 12. CMS uses transmittals to communicate new or changed policies or procedures that will be incorporated into the CMS Online Manual System. The cover or transmittal page summarizes and specifies the changes.

|Transmittal # [pic] |Subject |Impl Date |

|R1000CP |Common Working File (CWF) to the Medicare Beneficiary Database (MBD) Data Exchange |10/02/2006 |

| |Changes | |

|R1001CP |Modifications to the Common Working File (CWF) Interrupted Stay Edits for Long Term |01/02/2007 |

| |Care Hospital (LTCH) Claims for Discharges to an Acute Care Hospital | |

|R1004CP |Non-Application of Deductible for Colorectal Cancer Screening Tests |01/02/2007 |

|R1005CP |Medicare Physician Fee Schedule Database (MPFSDB) 2007 File Layout |01/02/2007 |

|R1006CP |Modification to the Coordination of Benefits Agreement (COBA) Claims Selection |10/02/2006 |

| |Criteria and File Transfer Protocols | |

|R1007CP |Change in Healthcare Common Procedure Coding System (HCPCS) for Renal Dialysis |01/02/2007 |

| |Facilities and Hospitals Billing for End Stage Renal Disease (ESRD) Related Epoetin | |

| |Alfa (EPO) Effective January 1, 2007 | |

|R1008CP |Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) |10/02/2006 |

| |Pricer Update for FY 2007 | |

|R1009CP |Correction to Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement |01/02/2007 |

| |if SNF Inpatient Claims are Partially Non-Covered | |

|R100FM |Collection of Fee-for-Service Payments Made During Periods of Managed Care |06/26/2006 |

| |Enrollment | |

|R1010CP |Additional Requirements Necessary to Implement the Revised Health Insurance Claim |01/02/2007 |

| |Form CMS-1500 (08/05) | |

|R1011CP |Instructions for Reporting Hospice Services in Greater Line Item Detail |01/02/2007 |

|R1016CP |Outpatient Therapy - Additional DRA Mandated Service Edit |01/02/2007 |

|R1018CP |Uniform Billing (UB-04) Implementation |03/01/2007 |

|R1019CP |Outpatient Therapy - Additional DRA Mandated Service Edits |01/02/2007 |

|R101FM |Notice of New Interest Rate for Medicare Overpayments and Underpayments |07/19/2006 |

|R1021CP |2007 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payment |01/02/2007 |

|R1023CP |Update To The Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice|10/02/2006 |

| |Pricer For FY 2007 | |

|R1024CP |Reporting of Taxonomy Codes to Identify Provider Subparts on Institutional Claims |01/02/2007 |

|R1025CP |Revised Home Health Advance Beneficiary Notice |09/01/2006 |

|R1026CP |Medicare Telehealth Services |01/02/2007 |

|R1027CP |Clarifications and Additions to Chapter 19, Indian Health Services (IHS) |09/11/2006 |

|R1028CP |Downloading the Medicare Zip Code File |01/02/2007 |

|R1029CP |Schedule for Completing the Calendar Year 2007 Fee Schedule Updates and the |08/25/2006 |

| |Participating Physician Enrollment Procedures | |

|R102FM |Notice of New Interest Rate for Medicare Overpayments and Underpayments. |07/19/2006 |

|R103FM |Internal Control Requirement Update |07/24/2006 |

|R104FM |Updated Procedures for AC Communication with RAC |09/11/2006 |

|R149PI |Notification to Provider(s) or Supplier(s) Regarding Postpayment Review Results |07/31/2006 |

|R150PI |Re-issuance of Chapter 10, Introduction of Provider Enrollment |07/03/2006 |

|R151PI |Provider Enrollment Appeals Process |08/14/2006 |

|R152PI |Correction of Common Working File (CWF) Edit D903 for Wheelchair and Power Operated |01/02/2007 |

| |Vehicle (POV) Codes | |

|R153PI |The Medicare Claims System (MCS) and The Provider Enrollment System (PES) Changes |01/02/2007 |

| |for the National Provider Identifier (NPI) | |

|R154PI |Coding Change to MCS to Accept NPI From PECOS Extract File |01/02/2007 |

|R155PI |Medically Unlikely Edits (MUE) |01/02/2007 |

|R15QIO |Revisions to Chapter 10, "Confidentiality and Disclosure" |06/30/2006 |

|R16COM |Disclosure Desk Reference for Provider Contact Centers |10/02/2006 |

|R16P236 |Provider Cost Reporting Forms and Instructions, Chapter 36, Form CMS-2552-96 |N/A |

|R16QIO |Revisions to Chapter 1, "Background and Responsibilities" |06/30/2006 |

|R230OTN |New Remittance Advice Remark Code Message Used for the Physician's Voluntary |07/17/2006 |

| |Reporting Program (PVRP) | |

|R232OTN |Allowing Veterans Administration (VA) Claims with Various OSCAR Numbers |01/02/2007 |

|R233OTN |Enhance the Multi Carrier System (MCS) to avoid duplicate payments when a full claim|N/A |

| |adjustment is performed: Analysis and Design Phase | |

|R48DEMO |Laboratory Competitive Bidding Demonstration |01/02/2007 |

|R49DEMO |Laboratory Competitive Bidding Demonstration |01/02/2007 |

|R51BP |Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic |09/21/2006 |

| |Tests; Clinical Psychologist Services | |

|R52BP |Therapy Caps Exception Process |03/13/2006 |

|R53BP |Medicare Telehealth Services Update |08/07/2006 |

|R54MSP |Revision to the contents of the Intent to Refer Demand Packages |10/02/2006 |

|R55MSP |Update the Fiscal Intermediary Shared System (FISS) on Processing Medicare Secondary|10/02/2006 |

| |Payer (MSP) Fully Paid Claims When Condition Code 77 is Not Present on Outpatient | |

| |and Home Health Claims | |

|R60NCD |Lumbar Artificial Disc Replacement (LADR) |N/A |

|R982CP |New Use of Hospital Issued Notices of Noncoverage (HINNs) |09/18/2006 |

|R983CP |Healthcare Provider Taxonomy Codes (HPTC) Update |10/02/2006 |

|R984CP |Healthcare Common Procedure Coding System (HCPCS) Correction for the Caffeine |10/02/2006 |

| |Halothane Contracture Test for Malignant Hyperthermia Susceptibility | |

|R985CP |Appeals Updates |06/01/2006 |

|R986CP |Payment for Islet Cell Transplantation in NIH-Sponsored Clinical Trials |07/31/2006 |

|R987CP |Claim Status Category Code and Claim Status Code Update |10/02/2006 |

|R988CP |Correction to CR 4136: New Waived Tests |07/24/2006 |

|R989CP |Correction to CR 4122: Correction of Typographical Error in the Do Not Forward (DNF)|10/02/2006 |

| |Reports | |

|R98FM |Correction of CROWD Form 5 Reporting for Internet Pilot Carriers |07/17/2006 |

|R990CP |Medicare Contractor Annual Update of the International Classification of Diseases, |10/02/2006 |

| |Ninth Revision, Clinical Modification (ICD-9-CM) | |

|R991CP |Eligibility Rules of Behavior |07/24/2006 |

|R992CP |Lumbar Artificial Disc Replacement (LADR) |N/A |

|R993CP |Non-Physician Practitioner (NPP) Payment for Care Plan Oversight |10/02/2006 |

|R994CP |Special Issues Associated with the Advance Beneficiary Notice (ABN) for Hospice |09/29/2006 |

| |Providers and Comprehensive Outpatient Rehabilitation Facilities (CORFs) | |

|R995CP |Common Working File (CWF) Part C Data Exchange and Data Display Changes |10/02/2006 |

|R996CP |Stage 2 NPI Changes for Transaction 835, and Standard Paper Remittance Advice, and |10/02/2006 |

| |Changes in Medicare Claims Processing Manual, Chapter 22 - Remittance Advice | |

|R997CP |Medicare Telehealth Services Update |08/07/2006 |

|R999CP |Non-Physician Practitioner (NPP) Payment for Care Plan Oversight |10/02/2006 |

|R99FM |Instructions for Medicare Credit Balance Reporting Activities. |10/02/2006 |

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