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Medicare Compliance & Reimbursement

CMS MANUAL UPDATE

Published on Mon Nov 17, 2003

Physicians billing for lung volume reduction surgery - which will be covered by Medicare starting Jan. 1, 2004 - should use CPT code 32491, the Centers for Medicare & Medicaid Services says in a Nov. 4 "one-time notification" update to the CMS Manual System (change request 2688). Physicians should add modifier KZ on claims for LVRS performed on Medicare beneficiaries who are enrolled in a Medicare+ Choice plan.

In other recent updates to the Manual System, CMS:

    

  • lays out six new portable x-ray Level II HCPCS modifiers reportable with HCPCS R0075 (CR 2928);

        

  • outlines Clinical Laboratory Improvement Amendments-related policies for fecal leukocyte examination (CR 2856);

        

  • clarifies the use of the GY modifier to identify clinical diagnostic laboratory services that aren't covered by Medicare (CR 2924);

        

  • updates the list of waived tests under CLIA (CR 2933);

        

  • lays out changes to the laboratory national coverage determination edit software (CR 2935);

        

  • updates policies relating to the Comprehensive Error Rate Testing program (CR 2824);

        

  • updates the list of HCPCS codes used for skilled nursing facility consolidated billing enforcement (CR 2926);

        

  • lists 2004 Medicare deductible, coinsurance and premium rates (CR 2969); 

       
  • announces the release date of the next quarterly update to the Correct Coding Initiative edits (CR 2938);

        

  • implements recent corrections to the hospital inpatient prospective payment system rule (CR 2971);

        

  • updates the durable medical equipment, prosthetics, orthotics and supplies fee schedule for 2004 (CR 2957);

        

  • updates payment rules under the outpatient PPS (CR 2908);

        

  • schedules release dates for Medicare contractor software updates (CR 2972); and

        

  • updates the Provider Statistical and Reimbursement system (CR 2953).

        To see the updates, go to http://cms.hhs.gov/manuals/transmittals/comm_date_dsc.asp.

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