Medicare Compliance & Reimbursement

PROGRAM MEMO ROUNDUP

The Centers for Medicare & Medicaid Services has added a trio of new "K" codes for billing for speech generating devices.

According to an Aug. 22 program memorandum (AB-03-128; http://cms.hhs.gov/manuals/pm_trans/AB03128.pdf), the new codes are: K0615 - Speech generating device, digitized speech, using pre-recorded messages, from 8 to 20 minutes recording time; K0616 - Speech generating device, digitized speech, using pre-recorded messages, 20 to 40 minutes recording time; and K0617 - Speech generating device, digitized speech, using pre-recorded messages, more than 40 minutes recording time.

In other recent program memoranda, CMS:

  • updates the code list for therapy services that won't be subject to the therapy cap when billed under a therapy plan of care (B-03-065; http://cms.hhs.gov/manuals/pm_trans/B03065.pdf);

  • announces the addition of three new ICD-9-CM diagnosis codes (AB-03-129; http://cms.hhs.gov/manuals/pm_trans/AB03129.pdf);

  • lays out guidelines for Part B laboratory testing (AB-03-132; http://cms.hhs.gov/manuals/pm_trans/AB03132.pdf);

  • addresses Clinical Laboratory Improvement Amendments issues relating to fecal leukocyte examinations (AB-03-127; http://cms.hhs.gov/manuals/pm_trans/AB03127.pdf);

  • supplies coding information for implantable automatic defibrillators provided for Medicare+Choice enrollees (AB-03-134; http://cms.hhs.gov/manuals/pm_trans/AB03134.pdf);

  • provides guidance to contractors on managing Medicare appeals in fiscal year 2004 (AB-03-133; http://cms.hhs.gov/manuals/pm_trans/AB03133.pdf);

  • corrects previous guidance on payment issues relating to the use of levocarnitine for end stage renal disease patients (AB-03-130; http://cms.hhs.gov/manuals/pm_trans/AB03130.pdf);

  • outlines bill-processing changes involving the hospital inpatient prospective payment system (A-03-073; http://cms.hhs.gov/manuals/pm_trans/A03073.pdf);

  • addresses edits for cancer diagnosis for national drug codes (B-03-066; http://cms.hhs.gov/manuals/pm_trans/B03066.pdf);

  • outlines Health Insurance Portability and Accountability Act issues as they apply to beneficiary-submitted Medicare claims (B-03-064; http://cms.hhs.gov/manuals/pm_trans/B03064.pdf);

  • clarifies that the type of service for HCPCS code L0480 should be "P," not "9" (AB-03-126; http://cms.hhs.gov/manuals/pm_trans/AB03126.pdf);

  • outlines new skilled nursing facility consolidated billing common working file edits (B-03-068; http://cms.hhs.gov/manuals/pm_trans/B03068.pdf); and

  • corrects provider statistical and reimbursement system report data relating to mammography and outpatient therapy (A-03-071; http://cms.hhs.gov/manuals/pm_trans/A03071.pdf).

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