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Transmittals

  • Manual Clarifications for Skilled Nursing Facility (SNF) Part A Billing
  • April 2011 Update of the Ambulatory Surgical Center (ASC) Payment System
  • July 2011 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
  • July Quarterly Update to 2011 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
  • New Waived Tests
  • Waiver of Coinsurance and Deductible for Preventive Services in Rural Health Clinics (RHCs), Section 4104 of Affordable Care Act (ACA).
  • Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process Stemming Principally From the Affordable Care Act (ACA)
  • Advanced Diagnostic Imaging Accreditation Enrollment Procedures
  • Implementation of New Reasonable Useful Lifetime (RUL) Policy for Stationary and Portable Oxygen Equipment
  • Notice of New Interest Rate for Medicare Overpayments and Underpayments-3rd Notification for FY 2011.
  • New Specialty Code for Advanced Diagnostic Imaging Accreditation
  • Flat File Update for Institutional Claim Transaction 837I, Professional Claim Transaction 837P, and Claim Payment/Advice Transaction 835
  • Home Health Therapy Services
  • Implementation of the PWK (paperwork) segment for X12N Version 5010
  • ViPS Medicare System (VMS) ICD-10 Remove any Obsolete Quarterly Medical Review(QMR) Processes and Reports that Include ICD-9 codes
  • Upgrade of Optical Character Recognition (OCR) and Intelligent Character Recognition (ICR) Systems in Preparation for HIPAA Version 5010 (Analysis Only)
  • Modify the Common Working File (CWF) Application to Allow the Medicare Secondary Payer (MSP) Effective and Termination dates for all MSP Occurrences to be Equal
  • HITECH Overpayment Data Collection Coordination between FISS, MCS and the NLR
  • Physician Certification and Recertification of Services Manual Changes
  • System Changes to VMS to Allow DME MACs to Adjust Claims Denied as a Result of ZPIC Auto-Denial Edits to Pay After an Appeals Decision
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