Transmittals

New State Codes for California

Update to Publication 100-04, Chapter 18 and Publication 100-02, Chapter 15, Section to Add Data Regarding Novel Coronavirus (COVID-19) and its Administration to Current Claims Processing Requirements and Other General Updates

Update to Publication 100-04, Chapter 18 and Publication 100-02, Chapter 15, Section to Add Data Regarding Novel Coronavirus (COVID-19) and its Administration to Current Claims Processing Requirements and Other General Updates

Notice of New Interest Rate for Medicare Overpayments and Underpayments -3rd Qtr Notification for FY 2022

Revisions to Chapters 3, “Inpatient Hospital Billing” of the Medicare Claims Processing Manual (Pub 100-04), 18, “Preventive and Screening Services” of the Medicare Claims Processing Manual (Pub 100-04), and 32 “Billing Requirements for Special Services” of the Medicare Claims Processing Manual (Pub 100-04) to Update Coding

Updates to Current Inpatient Claim Edits

The purpose of this Change Request (CR) is to implement the following updates to the list of DRGs subject to the IPPS payment policy for the reimbursement of replaced devices offered without cost or with a credit, effective for discharges on or after 10/01/2020

System Limitation Update for Centralized Flu Billers (CFB), Pneumococcal and Covid-19 Vaccinations

International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) -- July 2022

Quarterly Update for the Durable Medical Equipment (DME), Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) - July 2022

Claims Processing Instructions for the New Hepatitis B Vaccine Code 90759

July 2022 Quarterly Average Sales Price [ASP] Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files

Claims Processing Instructions for the New Pneumococcal 15-valent Conjugate Vaccine Code 90671 and Pneumococcal 20- valent Conjugate Vaccine Code 90677

Quarterly Update to the National Correct Coding Initiative [NCCI] Procedure-to-Procedure [PTP] Edits, Version 28.2, Effective July 1, 2022

Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement

April 2022 Update of the Ambulatory Surgical Center (ASC) Payment System

April 2022 Update of the Hospital Outpatient Prospective Payment System (OPPS)

April 2022 Integrated Outpatient Code Editor (I/OCE) Specifications Version 23.1

Quarterly Update to the End-Stage Renal Disease Prospective Payment System (ESRD PPS)

Addition of new provider State Codes