Transmittals

Health Insurance Portability and Accountability Act (HIPAA) Electronic Data Interchange (EDI) Front End Updates for January 2025

International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) and Update to the Appropriate Use Criteria (AUC) Program--January 2025

Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index and Hospice Pricer for Fiscal Year (FY) 2025

July 2024 Update of the Hospital Outpatient Prospective Payment System (OPPS)

October 2024 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files

Internet-Only Manual Update for Billing Code G0444 for Annual Depression Screening

Fiscal Intermediary Shared System (FISS) – Implement Common Working File (CWF) Reply Generator for Contractor User Acceptance Testing

Updating Coding List Included in CRs 11914 and 11915

Revisions to the Skilled Nursing Facility (SNF) Advance Beneficiary Notice of Non-Coverage (ABN)

Modernize the Vaccine Process and Roster Billing - Full Agile Pilot CR

Updates to the Recovery Audit Contractor Data Warehouse (RACDW) Suppression Upload File Format

The purpose of this Change Request (CR) is to provide information and implementation instructions for CMS-1739-F issued June 9, 2023 which concerned the treatment of Medicare Part C days for the purposes of calculating Medicare DSH.

Clarification of Actions to Be Taken When Automated Duplicate Primary Payer (DPP) Claims Cannot Be Processed Due to Previous Secondary Payment Actions and Advanced Dates of Service on Claims

Updating IOM 100-06, Chapter 4, Section 70.16 - Debt Close-Out

Fiscal Intermediary Shared System (FISS) User Enhancement Change Request (UECR) - Expand the Home Health Payment Totals Screens to Display 6 Years of Claims Payment Information

The Fiscal Intermediary Shared System (FISS) Submission of Copybook Files to the Provider and Statistical Reimbursement (PS&R) System

Revision to the Cost Report Acceptability Checklists - This CR Rescinds and Fully Replaces CR 11644.

User Enhancement Change Request (UECR) - Update the Multi-Carrier System (MCS) Criteria File (CRIT) Maintenance/Criteria Location Movement Maintenance (CT/CM)

File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions

In this transmittal, the factor for CY 2023 has been added and the factor for CY 2013 has been deleted. The factors are applied on a calendar year basis.