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Medicare Compliance & Reimbursement

COVERAGE:

Get Set For New HCPCS Updating Process

Published on Sat Oct 23, 2004

What you need to know about Medicare's effort to 'speed the use of technology.'

Dramatic increases in the number of coding applications has spurred the Centers for Medicare & Medicaid Services to change the way it updates the Healthcare Common Procedure Coding System, the agency said Oct.6.

The revisions, which will be instituted over the next 18 months, are aimed at making new treatments available more quickly. Herb Kuhn, director at the Center for Medicare Management says he hopes the changes promote "greater acceptance and transparency" of the coding process. 

Here's what to expect:
     

  • New Coding Application Deadline: Mark your calendars for Jan. 3, 2005. 

  • Public Meetings. Durable medical equipment, orthotics and supplies meetings will be expanded to include all public requests for HCPCS products, supplies and services, with agenda items published in advance.

  • Appeals Process. In 2007, denied applicants who appeal the decision can have their application reconsidered during the same coding cycle.

  • Public Notice of Decisions. All will be published on the CMS Web site prior to public meetings.

  • Revision of the HCPCS Code Application Form. CMS says the format will be more "streamlined and user-friendly," and will incorporate suggestions.

  • Elimination/Reduction of Requirement for Six Months of Marketing Data. This will be waived for drug applications, and reduced to three months for DMEPOS.

    Got questions? CMS plans to hold an Open Door forum on the changes on Oct. 27. More information will be available soon at www.cms.hhs.gov/opendoor.

    Lesson Learned: Providers need to brace for new phase of HCPCS coding process revisions.

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