Due to a nation-wide installation of an upgrade to the Fiscal Intermediary Shared System (FISS) at all Medicare Part A contractors, no access will be available to the FISS on-line system starting Saturday, August 30 and running through Monday, September 1, 2008. Access to the FISS on-line system will be available at the normal time on Tuesday, September 2, 2008.
As part of this upgrade to FISS, we have communicated changes impacting claims screens. As a reminder, screens within FISS will be modified to identify HCPCS codes that will be reimbursed at the Medicare Physician Fee Schedule (MPFS) fee rate so that the correct carrier and locality can be used in the payment of those services. All MPFS HCPCS codes retrieved from the Centers for Medicare & Medicaid Services will have a one byte indicator (M) added to the record within FISS. The (M) HCPCS Identifier field is a protected field, which can not be added to or updated manually.
The (M) HCPCS identifier signifies that the HCPCS is a MPFS code. The revenue line, flagged with an (M), will be investigated during pricing to determine if reimbursement will be at the MPFS fee amount. If the (M) remains on the claim through the editing process, the HCPCS will be reimbursed at the MPFS fee amount and that revenue line is subject to the nine digit zip code (ZIP9) editing, which is outlined in MLN Matters Article MM5730. If the (M) is removed from the revenue line during the editing process, it indicates that even though the HCPCS is a MPFS code, it is not subject to the ZIP9 editing.
Due to the above process, there are screen changes necessary to the FISS. A new 'HCPC TYPE' ata field will be added to the claim screen (MAP171A). There also will be a new ‘TYP’ field added on the HCPCS screen. The indicator values for both FISS screen changes are 'M' or blank.
Additionally, below is a summary of other FISS DDE screen changes. These screen updates will allow for an expanded dollar amount of several fields. If you are using software or macros to automate your claim entry into the FISS Medicare processing system via Direct Data Entry (DDE), please contact your software vendor to ensure the appropriate updates have been completed and will be available to you in conjunction with the upcoming change.
Screen 1: Claim Summary Totals Inquiry
TOTAL CHARGES is expanding by 3 positions.
TOTAL PAYMENT is expanding by 3 positions.
Screen 2: UB92 Claim Inquiry
SERV RATE is expanding by 3 positions.
ESRD-RED/PSYCH/HBCF is expanding by 1 position.
Screen 3: INST CLAIM ENTRY
PROVIDER PAYMENT is expanding by 2 positions.
Screen 4: DRG/PPS INQUIRY
OUTLIER COST THRESHOLD is expanding by 3 positions.
OUTLIER PORTION is expanding by 2 positions.
PROV REIM is expanding by 2 positions.
Screen 5: CHECK HISTORY
AMOUNT is expanding by 4 positions.