Medicare Compliance & Reimbursement

Program Transmittal Roundup

The Centers for Medicare & Medicaid Services said in an Aug. 27 transmittal (CR 3418) that the payment limits for HCPCS drug code J1000 (Injection, Depo-estradiol cypionate, up to 5 mg) will be updated for dates of service Jan. 1, 2004 and on or before Dec. 31, 2004. The implementation date is Sept. 27, 2004.

In other recent transmittals, CMS:

  • updates the payment limit for HCPCS codes J9045 (Carboplatin 50 mg) and J9310 (Rituximab 100 mg) for dates of service April 1, 2004 to Dec. 31, 2004, implementation Sept. 24. (CR 3419);

  • creates a new ANSI Remittance Advice Remark code N218 (CR 3405);

  • reminds providers to bill the ADVATE rAHF-PFM with HCPCS code J7192 (Factor VIII antihemophilic factor, recombinant per IU) starting Sept. 27 (CR 3331);

  • creates CWF auxiliary file to calculate Medicare-equivalent deductibles for VA claims (CR 3450).

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