Medicare Compliance & Reimbursement

Physicians should expect an influx of patients seeking colorectal screenings in coming weeks, as the Centers for Medicare & Medicaid Services and other organizations publicize March as Colorectal Cancer Awareness Month. In a Feb. 28 program memorandum (AB-03-033; http://cms.hhs.gov/manuals/pm_trans/AB03033.pdf), CMS orders fiscal intermediaries and carriers to include a CRC message on Medicare Summary Notices, place an article on CRC on their beneficiary Web sites, and advertise CRC Awareness Month in their provider newsletters and Web pages. In other recent program memoranda, CMS:

• lays out payment policies for services listed on fee schedules without a specific payment amount (A-03-017; http://cms.hhs.gov/manuals/pm_trans/A03017.pdf);

• instructs carriers how to price anesthesia add-on codes (B-03-017; http://cms.hhs.gov/manuals/pm_trans/B03017.pdf);

• confirms that electromagnetic stimulation HCPCS code E0761 (non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device) is not covered by Medicare (A-03-015; http://cms.hhs.gov/manuals/pm_trans/A03015.pdf);

• updates rules on the coverage and billing of sacral nerve stimulation (AB-03-028; http://cms.hhs.gov/manuals/pm_trans/AB03028.pdf);

• clarifies policies on continuous home care provided under the hospice benefit (A-03-016; http://cms.hhs.gov/manuals/pm_trans/A03016.pdf);

• announces April 1 changes to the laboratory national coverage determination edit software (AB-03-030; http://cms.hhs.gov/manuals/pm_trans/AB03030.pdf);

• advises carriers that changes to the correct coding edits (version 9.2) will be available May 16 (B-03-018; http://cms.hhs.gov/manuals/pm_trans/B03018.pdf);

• unveils changes to certain temporary “K” codes and code A4232 (AB-03-031; http://cms.hhs.gov/manuals/pm_trans/AB03031.pdf);

• updates the assignment of durable medical equipment, prosthetics, orthotics and supplies HCPCS codes to DME regional carrier and Part B carrier jurisdictions (B-03-020; http://cms.hhs.gov/manuals/pm_trans/B03020.pdf);

• counsels DMERCs on how to use “short descriptions” on MSNs (B-03-019; http://cms.hhs.gov/manuals/pm_trans/B03019.pdf);

• instructs contractors on how to retrieve the 2003 ambulatory surgical center HCPCS changes (AB-03-032; http://cms.hhs.gov/manuals/pm_trans/AB03032.pdf);

• issues contractor claims processing instructions on the 2003 Medicare physician fee schedule (AB-03-027; http://cms.hhs.gov/manuals/pm_trans/AB03027.pdf and AB-03-035; http://cms.hhs.gov/manuals/pm_trans/AB03035.pdf); and

• gives contractors marching orders for compliance with the Health Insurance Portability Act privacy and transaction standards (AB-03-034; h t t p ://cms .h h s .gov /manuals/pm_trans/AB03034.pdf and AB-03-029; http://cms.hhs.gov/manuals/pm_trans/AB03029.pdf).