- August 28, 2008
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The Centers for Medicare & Medicaid Services (CMS) reported today that Medicare health care providers continue to be satisfied with services provided by Medicare fee-for-service contractors showing a relatively smooth transition to the new Medicare Administrative Contractors (MACs)
The summary report of the survey findings is available on the CMS Web site in the MCPSS section - click here.
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- August 27, 2008
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Webinars are web-based interactive training sessions for Medicare Part B providers and their office staff. Web-based training allows participants to engage in interactive training sessions via Internet. Both an open telephone line and a personal computer with a high speed internet connection are required to attend. Click the link above for new topics and dates.
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Join us for lunch and get the education you need. These power packed sessions are uniquely tailored to fit your busy schedule. Click the link above for the latest topics and dates.
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Due to popular demand we added an additional session in Baltimore, MD for our Office and Outpatient Services Workshops. Click the link above to register.
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- August 26, 2008
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The Part B Medicare Report is available.
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The purpose of this article is to provide all J-12 contract areas with the appropriate instructions for reporting radiopharmaceuticals used in conjunction with diagnostic or therapeutic services such as SPECT studies or cardiovascular stress testing procedures.
Labor Day Holiday EDI Availability
Highmark Medicare Services will be observing the Labor Day holiday on September 1, 2008. Our business doors will be closed and the EDI Services Help Desk will not be available. However, you may continue utilizing EDI services.
On September 1, 2008, EDI platforms are available for claim submission, report retrieval, ERA, and beneficiary eligibility transactions. However, there will be no batch claim processing cycle executed for this date. Medicare checks and ERA will not be generated on this day. The MCS Edit Report for EDI claims received after 4 PM on August 29, 2008, will be available for retrieval on September 3, 2008.
MLN Matters Articles from CMS
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- August 25, 2008
Information for Eligible Professionals Who Participated in the 2007 Physician Quality Reporting Initiative (PQRI)
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that 2007 PQRI Final Feedback Reports are available on a secure website.
Two MLN Matters articles on accessing the reports are now available that can assist individual eligible professionals and group practices that reported valid 2007 PQRI quality measures data to Medicare. The reports are organized by Tax Identification Number (TIN). For eligible professionals reporting measures for 2007 PQRI under a group practice TIN, the group practice determines who can access the Feedback Report for the group practice or organization.
The first article, "Steps for Individual Eligible Professionals to Access Their 2007 PQRI Feedback Reports Personally",MM SE0830. The second article, "Steps for Organizations to Access Their 2007 PQRI Feedback Reports", MM SE0831.
Once you are registered in the Individuals Authorized Access to CMS Computer Services (IACS) system and have access to the PQRI feedback report application, any questions about the Feedback Report should be directed to the Report Delivery System Help Desk referenced at the end of the MLN Matters articles. Additional educational resources and information about the PQRI program is available here.
Your Medicare Payments Could Be Reduced If The Internal Revenue Service (IRS) Needs To Collect Overdue Taxes That You Owe
The Taxpayer Relief Act of 1997, Section 1024, authorizes the IRS to reduce certain federal payments, including Medicare payments, to allow collection of overdue taxes. Should you owe such taxes and your payments are reduced, your remittance advice will reflect a provider level adjustment code (PLB) of "WU" in the PLB03-1 data field. For more information, please see MLN Matters Article #MM6125.
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Medicare is statutorily required to adjust payments for physician fee schedule services to account for differences in costs due to geographic location.
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Join us for our next Ask the Contractor Teleconference (ACT) on August 26th at 9:30 am. During this teleconference we will discuss the most current Medicare changes and allow you to interact directly with representatives from various departments within Highmark Medicare Services. Click here for materials.
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Join us for our next Ask the Contractor Teleconference (ACT) on August 27th at 9:30 am. During this teleconference we will discuss the most current Medicare changes and allow you to interact directly with representatives from various departments within Highmark Medicare Services. Click here for material.
- August 21, 2008
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The following Part B Local Coverage Determination (LCD) has been revised :
- Z-8M - Sleep Disorders Testing
The following Part B Local Coverage Determination (LCD) has been retired effective August 19, 2008:
- I-43M - Erythropoiesis Stimulating Agent (ESA): Darbepoetin alfa
The following Part B Billing and Coding Articles are retiring effective August 22, 2008:
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Please join us. This lunch and learn teleconference will discuss the CERT program and it's impact on providers. It will provide providers with tips to avoid common evaluation and management errors. Materials are coming soon.
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- August 20, 2008
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The following Part B Local Coverage Determinations (LCDs) are effective
August 20, 2008- I-6J - Approved Drugs and Biologicals
- I-7V - Erythropoiesis Stimulating Agents (ESAs)
- M-62F - Scanning Computerized Ophthalmic Diagnostic Imaging
- R-13 - Radiation Therapy Services
- Z-56G - Trigger Point Injections
- Z-61B - Paravertebral Facet Joint Nerve Block and Sacroiliac Joint Injection
The following Part B Local Coverage Determination (LCD) retired effective
August 19, 2008:- S-151A - Sacroiliac Joint Injection
The following Part B Billing and Coding Articles have been revised:
- I-6J - Approved Drugs and Biologicals
- I-7V - NCD Coding Article for Erythropoiesis Stimulating Agents (ESAs)
The following Part B Billing and Coding Articles retired effective August 19, 2008:
- R-4Q - Radiation Oncology: Radiation Therapy Treatment and Complementary Services
- R-10G - Intensity Modulated Radiation Therapy (IMRT)
- R-12B - Stereotactic Radiosurgery
- S-151A - Sacroiliac Joint Injection
- Z-56F - Trigger Point Injections
- Z-61A - Paravertebral Facet Joint Nerve Block
MLN Matters Articles from CMS
New:
MM6109 – Remittance Advice Remark Code and Claim Adjustment Reason Code Update
MM6158 – Part B Drug Competitive Acquisition Program (CAP) Quarterly Drug Update
MM6121 – 2008 Reminder for Roster Billing and Centralized Billing for Influenza and Pneumococcal Vaccinations
MM6124 – Revisions to the Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals
MM6125 – Reporting Withholding Due to IRS Federal Payment Levy Program (FPLP) on the Remittance Advice
Revised:
MM6139 – Implementation of New Provider Authentication Requirements for Medicare Contractor Provider Telephone and Written Inquiries
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- August 19, 2008
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The Centers for Medicare & Medicaid Services (CMS) will be hosting a series of End-Stage-Renal-Disease Stakeholder Meetings to discuss the End-Stage-Renal-Disease (ESRD) Network (NW) Program.
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The Department of Health and Human Services (HHS) announced Friday a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10 code sets, effective October 1, 2011.
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The Centers for Medicare & Medicare Services (CMS) recently announced that as Medicare’s Part D prescription drug program enters its fourth year, beneficiary satisfaction rates remain high, program costs remain lower than originally expected and Medicare prescription drug plan bids reflect nationwide drug price trends.
In addition to average premiums for 2009, CMS has announced: the 2009 national average monthly bid; the base beneficiary premium; the regional low-income subsidy premium amounts for 2009; and the 2009 Medicare Advantage regional preferred provider organization benchmarks. To view this information visit here.
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Join us for our next Ask the Contractor Teleconference (ACT) on August 27, 2008 at 9:30 am. During this teleconference we will discuss the most current Medicare changes and allow you to interact directly with representatives from various departments within Highmark Medicare Services.
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Join us for our next Ask the Contractor Teleconference (ACT) on August 26, 2008 at 9:30 am. During this teleconference we will discuss the most current Medicare changes and allow you to interact directly with representatives from various departments within Highmark Medicare Services.
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