2004 MLN Matters Articles
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Transmittal # | Subject | Implementation Date | CR # | MM Article # | MM Article Release Date |
---|---|---|---|---|---|
R56MCM | Chapter 11 | N/A | N/A | N/A | N/A |
R79PI | Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision | 08/09/2004 | 3222 | N/A | N/A |
R48FM | This transmittal is rescinded and replaced with Transmittal 50, dated July 30, 2004. | N/A | 3274 | N/A | N/A |
R421CP | Correction to January 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement | 01/03/2005 | 3613 | MM3613 | 01/06/2005 |
R422CP | Update to FY 2005 Wage Index for Inpatient Prospective Payment System (IPPS) and Outpatient Prospective Payment System (OPPS) Hospitals | 01/31/2005 | 3672 | MM3672 | 01/26/2005 |
R419CP | January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes | 01/03/2005 | 3632 | N/A | N/A |
R423CP | January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes | 01/14/2005 | 3632 | MM3632 | 01/12/2005 |
R211CP | Elimination of Regulations for Written Statement of Intent (SOI) | 07/19/2004 | 3310 | MM3310 | 06/24/2004 |
R84OTN | Reporting Medicare Secondary Payer (MSP) Information on the Health Insurance Portability and Accountability Act of 1996 (HIPAA) X12N 837 Created Via Free Billing Software | 10/04/2004 | 3284 | MM3284 | 06/07/2004 |
R417CP | Initial Preventive Physical Examination (IPPE)-(Note: This is a full replacement of CR 3413, transmittal 294, dated September 3, 2004. CR 3413 is rescinded.) | 01/03/2005 | 3638 | MM3638 | 12/27/2004 |
R416CP | Interest Payment on Clean Non-PIP Claims Not Paid Timely | 01/25/2005 | 3557 | N/A | N/A |
R14DEMO | Chemotherapy Demonstration Project | 01/17/2005 | 3670 | MM3670 | 01/06/2005 |
R415CP | Temporary Change in Carrier Jurisdictional Pricing Rules for Purchased Diagnostic Services | 01/25/2005 | 3630 | MM3630 | 04/01/2005 |
R5SSS | Business Partners Systems Security Manual | 02/28/2005 | 3605 | N/A | N/A |
R402CP | January Update to the Medicare Outpatient Code Editor (OCE) Version 20.1 for Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System (Non-OPPS) | 01/03/2005 | 3621 | MM3621 | 01/06/2005 |
R404CP | January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS):Changes to Coding and Payment for Drug Administration | 01/03/2005 | 3610 | MM3610 | 12/21/2004 |
R403CP | January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Billing for Devices that do not have Transitional Pass-Through Status, and that are not Classified as New Technology Ambulatory Payment Classification (APC) Groups | 01/03/2005 | 3606 | MM3606 | 12/23/2004 |
R396CP | New Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Ant-Emetic, Immunosuppressive, and Inhalation Drugs | 01/17/2005 | 3620 | MM3620 | 12/29/2004 |
R397CP | DMERC/Local Carriers/SADMERC - Drug Pricing Limits as of January 1, 2005 | 01/03/2005 | 3232 | MM3232 | 12/21/2004 |
R409CP | Diabetes Screening Tests | 01/03/2005 | 3637 | N/A | N/A |
R406CP | Update to Health Care Claims Status Category Codes and Health Care Claim Status Codes for Use with the Health Care Claim Status Request and Response ASC X12N 276/277 | 04/04/2005 | 3566 | MM3566 | 12/23/2004 |
R133OTN | Shared System Maintainer Hours for Resolution of Problems Detected as a Result of Implementation of Change Request 2525 and Change Request 2527 | 04/04/2005 | 3603 | N/A | N/A |
R11DEMO | Medicare Coordinated Care Demonstration (MCCD)-Override of Certain Medicare Secondary Payer Edit Codes | 04/04/2005 | 3594 | N/A | N/A |
R427PR1 | Section 2231, Regional Medicare Swing-Bed Rates | N/A | N/A | N/A | N/A |
R130OTN | Development of a Coordination of Benefits Agreement (COBA) Auxiliary File and Modification of the Health Insurance Portability and Accountability Act (HIPAA) 837 Coordination of Benefits (COB) Flat File and National Council for Prescription Drug Programs (NCPDP) File | 04/04/2005 | 3614 | N/A | N/A |
R408CP | Cardiovascular Disease Screening | 01/03/2005 | 3411 | MM3411 | 12/21/2004 |
R405CP | Emergency Change to Carrier Instructions for the End Stage Renal Disease (ESRD) 50/50 Rule Implementation | 01/03/2005 | 3609 | MM3609 | 12/21/2004 |
R61FM | New Location Code ICC, Status Code AR and Modified Intent Letter for Unfiled Cost Reports Only | 01/10/2005 | 3563 | N/A | N/A |
R22MSP | Medicare Secondary Payer (MSP) Debt Referral Instructions and Debt Collection Improvement Act of 1996 (DCIA) Activities | 01/10/2005 | 3293 | N/A | N/A |
R386CP | Hospice Pre-Election Evaluation and Counseling Services | 01/03/2005 | 3585 | MM3585 | 03/28/2005 |
R64MCM | Surveys, Contracting Strategy, Grievances and Appeals | N/A | N/A | N/A | N/A |
R385CP | January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of OPPS Outpatient Code Editor (OCE) Data Changes and OPPS PRICER Logic Changes; Changes to Payment for Diagnostic Mammography | 01/03/2005 | 3586 | MM3586 | 01/04/2005 |
R387CP | This instruction is to inform the fiscal intermediaries that the January 2005 Outpatient Prospective Payment System Outpatient Code Editor (OPPS OCE) Specifications have been updated with new additions, changes, and deletions | 01/03/2005 | 3583 | MM3583 | 12/07/2004 |
R401CP | 2005 Part B Deductible Update to the Back Page of Medicare Summary Notices | 01/24/2005 | 3600 | N/A | N/A |
R399CP | Expansion of the Existing Interrupted Stay Policy Under Long Term Care Hospital (LTCH) Prospective Payment System | 01/03/2005 | 3279 | MM3279 | 12/29/2004 |
R395CP | Ambulance Fee Schedule - Medical Conditions List | 01/03/2005 | 3619 | MM3619 | 01/10/2005 |
R394CP | New Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Ant-Emetic, Immunosuppressive, and Inhalation Drugs | 01/17/2005 | 3620 | N/A | N/A |
R393CP | 2005 Part B Deductible Update to the Back Page of Medicare Summary Notices | 01/24/2005 | 3600 | N/A | N/A |
R12DEMO | Chemotherapy Demonstration Project | 01/17/2005 | 3634 | N/A | N/A |
R91PI | Revision of Program Integrity Manual (PIM), Section 3.11.1.4 | 01/03/2005 | 3560 | N/A | N/A |
R90PI | Prepayment Review of Claims for MR Purposes | 01/10/2005 | 3569 | N/A | N/A |
R384CP | Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) | 04/04/2005 | 3541 | MM3541 | 12/07/2004 |
R127OTN | Instructions Applicable to the Audit of Hospitals that are Part of an Affiliated Group in Relation to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments | 12/06/2004 | 3558 | N/A | N/A |
R360CP | Annual Update of HCPCS Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) | 01/03/2005 | 3542 | MM3542 | 11/29/2004 |
R28BP | Hospice Pre-Election Evaluation and Counseling Services | 01/03/2005 | 3585 | MM3585 | 03/28/2005 |
R363CP | 2005 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment | 01/03/2005 | 3526 | MM3526 | 11/16/2004 |
R129OTN | 2005 Drug Administration Coding Revisions | 01/17/2005 | 3631 | MM3631 | 01/06/2005 |
R128OTN | Promoting Medicare's Preventive Benefits and Services on an Annual Basis | 01/03/2005 | 3527 | N/A | N/A |
R362CP | Update to the Prospective Payment System (PPS) for Home Health Agencies for Calendar Year (CY) 2005 | 01/03/2005 | 3556 | MM3556 | 11/19/2004 |
R372CP | Payment for Referred Laboratory Automated Multi-Channel Chemistry (AMCC) Tests | 04/04/2005 | 3483 | MM3483 | 01/10/2005 |
R369CP | Fee Schedule Update for 2005 for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) | 01/03/2004 | 3574 | N/A | N/A |
R371CP | Updated Billing Instructions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) | 04/04/2005 | 3487 | MM3487 | 12/10/2004 |
R374CP | Clarification to IOM Chapter 17, Section 80.4 regarding claims for Blood Clotting Factors | 11/22/2004 | 3370 | N/A | N/A |
R27BP | New ESRD Composite Payment Rates Effective January 1, 2005 | 01/03/2005 | 3554 | MM3554 | 12/07/2004 |
R89PI | Updating Financial Reporting Requirements for Medical Review and Local Provider Education and Training | 12/27/2004 | 3446 | N/A | N/A |
R60FM | Revised instructions on contractor procedures for provider audit and the Provider Statistical & Reimbursement Report (PSRR) | 01/24/2005 | 3492 | N/A | N/A |
R88PI | Timeframes for Processing 855 Enrollment Applications | 12/27/2004 | 3528 | N/A | N/A |
R382CP | Independent Laboratory Billing for the Technical Component (TC) of Physician Pathology Services to Hospital Patients | 01/03/2005 | 3467 | MM3467 | 01/04/2005 |
R361CP | MMA Drug Pricing Update - Payment Limit for J0207 (Amifostine) | 12/06/2004 | 3552 | MM3552 | 11/16/2004 |
R357CP | Implementation of Coverage of Religious Nonmedical Health Care Institution Items and Services Furnished in the Home, MMA section 706. | 04/04/2005 | 3529 | MM3529 | 11/23/2004 |
R25BP | Implementation of Coverage of Religious Nonmedical Health Care Institution (RNHCI) Items and Services Furnished in the Home, MMA section 706. | 04/04/2005 | 3529 | MM3529 | 11/23/2004 |
R63MCM | Chapter 5 and Chapter 17B | N/A | N/A | N/A | N/A |
R368CP | Instructions for Completion of Form CMS-1450 | 04/04/2005 | 3543 | MM3543 | 11/29/2004 |
R4SOM | Guidance to Surveyors for Long Term Care Facilities | 11/12/2004 | N/A | N/A | N/A |
R367CP | Section 630 of the Medicare Modernization Act (MMA) allows for the reimbursement for ambulance services provided by IHS/Tribal Hospitals, including CAHs, which manage and operate hospital-based ambulances. | 04/04/2005 | 3521 | N/A | N/A |
R5SOM | Revisions to Appendix P (Survey Protocols for Long Term Care Facilities) and Appendix PP (Guidance to Surveyors for Long Term Care Facilities) | N/A | N/A | N/A | N/A |
R370CP | New Case-Mix Adjusted End Stage Renal Disease (ESRD) Composite Payment Rates and New Composite Rates and New Composite Rate Exceptions Window for Pediatric ESRD Facilities | 04/04/2005 | 3572 | MM3572 | 01/06/2005 |
R373CP | New ESRD Composite Payment Rates Effective January 1, 2005 | 01/03/2005 | 3554 | N/A | N/A |
R377CP | Long Act Implant, Bcg Live Intravesical Vac, and Gallium ga 67; Adjustments Due to Misclassification | 12/28/2004 | 3540 | MM3540 | 12/06/2004 |
R380CP | Changes to the Laboratory National Coverage Determination (NCD) edit Software for January 2005 | 01/03/2005 | 3429 | MM3429 | 12/06/2004 |
R379CP | Low Osmolar Contrast Material/Laboratory Tests/Payment for Inpatient Services Furnished by a Critical Access Hospital (CAH) | 04/04/2005 | 3439 | MM3439 | 12/02/2004 |
R381CP | Revisions and Corrections, Chapter 29 of the IOM, Claims Processing Manual - Appeals | 01/10/2005 | 3127 | N/A | N/A |
R86PI | Payment for Emergency Medical Treatment and Labor Act (EMTALA) - Mandated Screening and Stabilization Services | 11/22/2004 | 3437 | N/A | N/A |
R353CP | DMERC - Revision to CR 2631 Requirements for DMERC claims | 04/04/2005 | 3261 | N/A | N/A |
R352CP | Three Places after the Decimal Point for ASP drug file | 04/04/2005 | 3436 | N/A | N/A |
R59FM | Notice of New Interest Rate for Medicare Overpayments and Underpayments. | 11/12/2004 | 3453 | N/A | N/A |
R358CP | Inclusion of Forteo as a Covered Osteoporosis Drug and Clarification of Manual Instructions Regarding Osteoporosis Drugs | 04/04/2005 | 3524 | MM3524 | 12/08/2004 |
R349CP | Annual Type of Service (TOS) | 01/03/2005 | 3519 | N/A | N/A |
R346CP | Three Places after the Decimal Point for ASP drug file | 04/04/2005 | 3436 | N/A | N/A |
R26BP | Inclusion of Forteo as a Covered Osteoporosis Drug and Clarification of Manual Instructions Regarding Osteoporosis Drugs | 04/04/2004 | 3524 | MM3524 | 12/08/2004 |
R125OTN | Instructions Applicable to the Audit of Hospitals that are Part of an Affiliated Group in Relation to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments | 12/06/2004 | 3558 | N/A | N/A |
R341CP | Implementation of the Medicare Physician Fee Schedule (MPFS) National Abstract File for Purchased Diagnostic Tests and Interpretations | 04/04/2005 | 3481 | MM3481 | 03/21/2005 |
R11NCD | Manualization NCD: Acupuncture for Fibromyalgia/Osteoarthritis | 04/06/2004 | 3250 | MM3250 | 04/28/2004 |
R340CP | Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement | 01/03/2005 | 3525 | MM3525 | 11/04/2004 |
R338CP | Remonal of the Skilled Nursing Facility (SNF) No Pay File | 01/03/2005 | 3534 | N/A | N/A |
R337CP | Change in Hospital Type of Bill for Billing Diagnostic and Screening Mammographics | 04/04/2005 | 3469 | MM3469 | 11/15/2004 |
R345CP | DMERC - Revision to CR 2631 Requirements for DMERC claims | 01/04/2005 | 3261 | N/A | N/A |
R336CP | Indian Health Service (IHS) or Tribal Hospitals including Critical Access Hospitals (CAH) Payment Methodology for Inpatient Social Admissions and Outpatient Services Occurring During Concurrent Stays | 04/04/2005 | 3452 | N/A | N/A |
R335CP | Incorrect Reporting of Miles, Times, Units, Services (MTUS) Indicator When a Drug is Billed in the NCPDP Format Using an NDC Code | 04/04/2005 | 3435 | N/A | N/A |
R342CP | Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site | 04/04/2005 | 3427 | MM3427 | 11/29/2004 |
R351CP | Editing of Hospitals and Skilled Nursing Facilities Part B Inpatient Services (Full Replacement of Change Request 3366) | 01/03/2005 | 3531 | MM3531 | 11/16/2004 |
R347CP | Inpatient Rehabilitation Facility (IRF) Classification Requirements | 11/29/2004 | 3503 | MM3503 | 11/08/2004 |
R348CP | January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective January 1, 2005 | 01/03/2005 | 3539 | MM3539 | 11/08/2004 |
R350CP | Editing for Part B Carriers and Durable Medical Equipment Regional Carriers (DMERCs) for Duplicate Claims in Process at the Same Time | 04/04/2005 | 3347 | N/A | N/A |
R343CP | Clarification: Modifiers for Transportation of Portable X-rays (R0075) | 04/04/2005 | 3280 | MM3280 | 11/19/2004 |
R24BP | Revision of Section 300.5.1, Chapter 15 of the Medicare Benefit Policy Manual to include 22x TOB as an applicable TOB for Diabetes Self-Management Training. | 01/03/2005 | 3531 | N/A | N/A |
R13GI | Medicare Termination of Beneficiaries With End Stage Renal Disease (ESRD) | 04/04/2005 | 2923 | MM2923 | 11/04/2004 |
R21MSP | Medicare Secondary Payer (MSP) Savings Report Redesign | 04/04/2005 | 3407 | N/A | N/A |
R20MSP | Medicare Secondary Payer (MSP) Savings Report Redesign | 04/06/2005 | 3181 | N/A | N/A |
R71PI2 | Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 5 and 6 | 05/10/2004 | 3030 | N/A | N/A |
R70PI | New Requirements for Self-Administered Drug (SAD) Exclusion List Articles in the Medicare Coverage Database (MCD) | 05/10/2004 | 3136 | N/A | N/A |
R71PI | Rewrite of the Program Integrity Manual (except Chapter 10), Transmittal Page, Business Requirements, Table of Contents, Chapters 1 and 2. | 05/10/2004 | 3030 | N/A | N/A |
R7NCD | Electrical Stimulation and Electromagnetic Therapy for the Treatment of Woundsq | 07/06/2004 | 3149 | MM3149 | 04/28/2004 |
R110CP | New Requirements for payment of drugs furnished in independent dialysis facilities and paid outside of the composite rate for dates of service (DOS) starting on January 1, 2004. Drugs furnished in this setting will be paid at the lower of billed charges or 95 percent Average Wholesale Price (AWP) for the calendar year 2004. These changes have been established with the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, PL 108-173. | 03/29/2004 | 3078 | MM3078 | 03/05/2004 |
R108CP | Type of Service (TOS) Corrections | 03/29/2004 | 3018 | N/A | N/A |
R4SSM | Medicare Business Partners Systems Security (a.k.a. CMS Business Partners Systems Security Manual) | 04/05/2004 | 3106 | N/A | N/A |
R4COM | Provider/Supplier Communications - Revisions and Additions to Existing Contractor Requirements | 04/05/2004 | 3118 | N/A | N/A |
R65OTN | Implementation of Section 508(f) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173) | 04/26/2004 | 3084 | N/A | N/A |
R64OTN | Implementation of Sections 401, 402, 504 and 508(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173 | 04/05/2004 | 3158 | MM3158 | 04/05/2004 |
R12MSP | Interim Non-Systems Solution: Converting Health Insurance Portability and Accountability Act (HIPAA) Individual Relationship Codes to Common Working File (CWF) Patient Relationship Codes | 03/19/2004 | 3117 | N/A | N/A |
R63OTN | Durable Medical Equipment Regional Carriers (DMERCs) - DeWall Posture Protector Orthotic Body Jacket (L0430): Continuation of CMS' Policy Stated in CR 2711 (B-03-025) dated April 11, 2003. | N/A | 3224 | N/A | N/A |
R69PI | Streamlining Enrollment Requirements | 04/26/2004 | 3159 | N/A | N/A |
R131CP | New Payment Allowance Percentages for DMERC Drugs | 03/26/2004 | 3153 | MM3153 | 04/05/2004 |
R118CP | Frequency Limitations for Darbepoetin Alfa (trade name Aranesp) For Treatment Of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis. | 04/05/2004 | 2984 | N/A | N/A |
R130CP | Chapter 32, Billing Instructions for Special Services | N/A | 2323 | N/A | N/A |
R117CP | Instructions for downloading the Medicare zip code file. | 04/05/2004 | 3160 | N/A | N/A |
R129CP | Additional Information and Corrections to Previous Transmittals Regarding Healthcare Common Procedure Coding System (HCPCS) Codes and Modifiers for Low Osmolar Contrast Material, Orthotics, and Durable Medical Equipment | 04/26/2004 | 3143 | N/A | N/A |
R128CP | Manualization of Deep Brain Stimulation | N/A | 2553 | N/A | N/A |
R127CP | 2004 Jurisdiction List | 05/26/2004 | 3139 | MM3139 | 03/31/2004 |
R126CP | Manualization Clarification of ICD-9 Coding | N/A | 2857 | N/A | N/A |
R125CP | Manualization of the Sacral Nerve Stimulation | N/A | 2532 | N/A | N/A |
R116CP | ESRD- Miscellaneous Code Processing Clarification | 04/05/2004 | 3019 | N/A | N/A |
R11GI | Manual Revision Regarding Waiver of Annual Deductible and Coinsurance for Both ASC Facility, and ASC/Hospital Outpatient Department Physician Services | 11/22/2004 | 3471 | MM3471 | 10/27/2004 |
R115CP | DMERCs and VIPS, Processing NDC Numbers - Clarification to CR 3141 | 07/06/2004 | 3148 | N/A | N/A |
R8BP | Policy Changes to Reflect Billing for Darbepoetin Alfa and Epoetin | 04/05/2004 | 2984 | MM2984 | 03/25/2004 |
R61OTN | Changes to the FY 2004 Graduate Medical Education (GME) Payments as Required by the Medicare Modernization Act of 2003 (MMA), P.L. 108-173 | 04/05/2004 | 3071 | MM3071 | 03/19/2004 |
R334CP | Payment of Beneficiary Submitted Flu Claims and Flu Claims Submitted by Non-Enrolled Providers | 11/26/2004 | 3555 | N/A | N/A |
R7ESRD | Chapter 7, Sanctions and ESRD Complaints and Grievances | 04/26/2004 | N/A | N/A | N/A |
R6ESRD | Chapter 6, Community Information and Resources | 04/26/2004 | N/A | N/A | N/A |
R339CP | Calendar Year (CY) 2005 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures | 11/10/2004 | 3442 | N/A | N/A |
R5ESRD | Chapter 4, Information Management | 04/26/2004 | N/A | N/A | N/A |
R124OTN | Common Working File (CWF) Duplicate Claim Edit for Referred Clinical Diagnostic and Purchased Diagnostic Services | 04/04/2005 | 3551 | MM3551 | 12/10/2004 |
R36FM | Contractor Reporting of Operations and Workload Data (CROWD) for EDI | N/A | 2249 | N/A | N/A |
R3GI | New Part B Annual Deductible | 01/03/2005 | 3121 | MM3121 | 03/16/2004 |
R119CP | MMA Drug Pricing Update-Drug Exceptions | 04/05/2004 | 3161 | MM3161 | 03/24/2004 |
R5P238 | Electronic Reporting Specifications for Form CMS-1984-99 | N/A | N/A | N/A | N/A |
R123OTN | Instructions For Pricing Trepostinil (Q4077) | 11/29/2004 | 3533 | MM3533 | 11/04/2004 |
R12P232 | Home Health Agency Cost Report | N/A | N/A | N/A | N/A |
R122OTN | Shared System and CWF Renovation of Override Code Process and Recognition of Four 2-byte Modifier Fields on the Part B Query Record - For MCS Phased Implementation Approach Only | 04/04/2005 | 3494 | N/A | N/A |
R37FM | Installation of Version 33 of the Provider Statistical and Reimbursement (PS&R) Reporting System. | 07/05/2004 | 3131 | N/A | N/A |
R62OTN | Physician Self-Referral Prohibition; 18-Month Moratorium on Physician Investment in Specialty Hospitals | 04/02/2004 | 3036 | MM3036 | 04/07/2004 |
R121OTN | Modification to Fiscal Intermediary Standard System (FISS) Regarding Common Working File Initiated Adjustments | 04/04/2005 | 3330 | N/A | N/A |
R13MSP | Updates to the Electronic Correspondence Referral System (ECRS) User Guide v7.0 and Quick Reference Card v7.0 | 04/19/2004 | 3174 | N/A | N/A |
R124CP | Electrical Stimulation and Electromagnetic Therapy for the Treatment of Wounds | 07/06/2004 | 3149 | N/A | N/A |
R123CP | April Outpatient Code Editor (OCE) Specifications Version 5.1 | 04/05/2004 | 3170 | MM3170 | 03/30/2004 |
R122CP | Revision to Required Messages in Change Request (CR) 2944, Implementation of Skilled Nursing Facility (SNF) Consolidated Billing Edit for Therapy Codes Considered Separately Payable Physician Services | 07/06/2004 | 3156 | N/A | N/A |
R8NCD | Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT) | 04/01/2004 | 2988 | MM2988 | 08/31/2004 |
R103CP | Optional Method for Outpatient Services: Cost-Based Facility Services Plus 115 percent Fee Schedule Payment for Professional Services | 07/01/2004 | 3114 | MM3114 | 02/26/2004 |
R102P | New Waived Tests--April 1, 2004 | 04/05/2004 | 3061 | MM3571 | 02/03/2005 |
R101CP | Restoring Composite Rate Exceptions for Pediatric Facilities Under the ESRD Composite Rate System | 04/01/2004 | 3119 | MM3119 | 03/05/2004 |
R7BP | Restoring Composite Rate Exceptions for Pediatric Facilities Under the ESRD Composite Rate System | 04/01/2004 | 3119 | MM3119 | 03/04/2004 |
R107CP | Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction | 07/06/2004 | 3031 | MM3031 | 08/31/2004 |
R112CP | April 2004 Changes to the Hospital Outpatient Prospective Payment System (OPPS): Payment for Drugs, Biologicals and Radiopharmaceuticals, Generic Versus Brand Name | 04/05/2004 | 3144 | MM3144 | 03/19/2004 |
R67PI | The Medicare Coverage Database | 03/12/2004 | 2976 | MM2976 | 06/23/2004 |
R11MSP | General Policy | 03/29/2004 | 3064 | MM3064 | 03/05/2004 |
R114CP | Modification of CMS' Medicare Contingency Plan for HIPPA Implementation | 07/06/2004 | 2981 | MM2981 | 03/01/2004 |
R113CP | Claims Requiring Adjustment As a Result of April 2004 Changes to the Outpatient Prospective Payment System (OPPS) | 04/05/2004 | 3145 | MM3145 | 03/31/2004 |
R132CP | April 2004 Update of the Hospital Outpatient Prospective Payment System | 04/05/2004 | 3154 | MM3154 | 04/05/2004 |
R111CP | Payment For Services Provided Under a Contractual Agreement | 03/12/2004 | 3083 | MM3083 | 03/17/2004 |
R9NCD | NCD - Ocular Photodynamic Therapy (OPT) With Verteporfin for Age-Related Macular Degeneration (AMD) | 04/01/2004 | 3191 | MM3191 | 12/16/2004 |
R68OTN | Transmittal 49 Implementation Date Extension | 07/06/2004 | 3197 | MM3197 | 04/12/2004 |
R67OTN | Requirement for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), Fiscal Intermediaries (FIs), and Full Program Safeguard Contractors (PSCs) to Encourage Providers to Submit Medical Records to the Comprehensive Error Rate Testing (CERT) Contractor for Use in the November 2004 Improper Medicare Fee-For-Service (FFS) Payments Report | 04/30/2004 | 3157 | N/A | N/A |
R48MCM | Grievances, Organization Determinations, and Appeals | N/A | N/A | N/A | N/A |
R135CP | Purchased Diagnostic Test - Carriers | N/A | 1658 | N/A | N/A |
R133CP | Billing NonCovered Charges to Fiscal Intermediaries - Summary and New Instructions - Clarification | 04/16/2004 | 3115 | N/A | N/A |
R134CP | Instructions for Downloading the Medicare Zip Code File. | 07/06/2004 | 3198 | N/A | N/A |
R70OTN | How Fiscal Intermediary's are to Record Coinsurance Amounts from The Provider Statistical and Reimbursement (PS&R) Report for Providers Who Elected to Accept Reduced Coinsurance for Outpatient Prospective Payment System (OPPS) Services | 05/10/2004 | 3166 | N/A | N/A |
R10NCD | NCD is being released | N/A | N/A | N/A | N/A |
R69OTN | Carrier Only* Shared System Maintainer Hours for Resolution of Problems Detected As A Result of Implementation of CR 2525 and CR 2527 | N/A | 3146 | N/A | N/A |
R50MCM | Chapter 20, Managed Care and M+C Systems Business Requirements | N/A | N/A | N/A | N/A |
R71PI4 | Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 13 and 11 | 05/10/2004 | 3030 | N/A | N/A |
R71PI5 | Rewrite of the Program Integrity Manual (except Chapter 10), Exhibits | 05/10/2004 | 3030 | N/A | N/A |
R71PI3 | Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 7, 8, 9 and 12 | 05/10/2004 | 3030 | N/A | N/A |
R71PI1 | Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 3 and 4 | 05/10/2004 | 3030 | N/A | N/A |
R121CP | Manualization of Place of Service (POS) Code Set Program Memorandum; Revision to Group Home Code Description | 04/01/2004 | 3087 | MM3087 | 04/13/2004 |
R120CP | April Update to the January Medicare Outpatient Code Editor (OCE) Specifications Version 19.1 R1 For Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System | 04/05/2004 | 3155 | MM3155 | 08/31/2004 |
R85P | Processing of Claims for Referred Services for a Independent Clinical Diagnostic Laboratory | 07/06/2004 | 3090 | MM3090 | 04/05/2004 |
R87CP | Expansion of Transfer Policy Under Inpatient Payment Prospective System | 07/06/2004 | 2934 | MM2934 | 03/01/2004 |
R84CP | Additional Guidelines for Implementing the National Council for Prescription Drug Program | 07/06/2004 | 3095 | MM3095 | 02/13/2004 |
R86CP | X12N 837 Professional Implementation Guide (IG) Edits | 07/06/2004 | 3050 | MM3050 | 02/10/2004 |
R35FM | Unsolicited/Voluntary Refunds | 10/04/2004 | 1444 | N/A | N/A |
R2GI | Scheduled Release for April Updates to Software Programs and Pricing/Coding Files | 03/08/2004 | 3123 | N/A | N/A |
R99CP | Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Coordination of Benefits (COB) Gap Fill Additional Instruction | 07/06/2004 | 3100 | N/A | N/A |
R330CP | DMERC-Beneficiary Submitted Claims, Process First Claim | 04/04/2005 | 3233 | N/A | N/A |
R332CP | New Policy and Refinements on Billing Noncovered Charges to Fiscal Intermediaries (FIs) | 04/04/2005 | 3416 | N/A | N/A |
R329CP | DMERC Only - Payment to Providers/Suppliers Qualified to Bill Medicare for Prosthetics and Certain Custom-Fabricated Orthotics | 07/05/2005 | 3373 | N/A | N/A |
R328CP | 2005 Annual Update for Skilled Nursing Facility (SNF) Consolidated Billing for the Common Working File (CWF) and Medicare Carriers | 01/03/2005 | 3535 | MM3535 | 12/29/2004 |
R325CP | New Waived Tests-January 1, 2005 | 01/03/2005 | 3484 | N/A | N/A |
R327CP | This transmittal rescinded and replaced by R374CP | 11/22/2005 | 3370 | N/A | N/A |
R321CP | Instructions for Downloading the Medicare Zip Code File | 04/04/2005 | 3482 | N/A | N/A |
R320CP | Reminder Notice of the Implementation of the Ambulance Transition Schedule | 01/03/2005 | 3473 | N/A | N/A |
R319CP | CORF/OPT Edit for Billing Inappropriate Supplies | 04/04/2005 | 3468 | MM3468 | 10/28/2004 |
R316CP | Clarification of Messgaes in Chapter 1, Section 10.1.1.1 to Match Official Listing on the WPC-EDI Web Site | N/A | 3462 | N/A | N/A |
R318CP | Clarification of CR 3176 - Payment amounts for ESRD drug administration supplies: HCPCS A4657 and A4913 | 11/22/2004 | 3451 | N/A | N/A |
R317CP | Clarification to Chapter 26 of the Internet Only Manual (IOM) | N/A | 3431 | N/A | N/A |
R315CP | Temporary Change in Carrier Jurisdictional Pricing Rules for Purchased Diagnostic Services | 11/22/2004 | 3464 | N/A | N/A |
R12GI | New Policy and Refinements on Billing Noncovered Charges to Fiscal Intermediaries (FIs) | 04/04/2005 | 3416 | MM3416 | 10/28/2004 |
R326CP | Invalid Diagnosis Code Editing - Second Phase | 04/04/2005 | 3260 | MM3260 | 10/28/2004 |
R323CP | Update Regarding the Use of American Dental Association's (ADA) Current Dental Terminology (CDT) Codes on Medicare Contractors' Web Sites and Other Electronic Media | 11/22/2004 | 3499 | N/A | N/A |
R324CP | Quarterly Update to Correct Coding Initiative (CCI) edits, Version 11.0, Effective January 1, 2005 | 01/03/2005 | 3491 | MM3491 | 10/28/2004 |
R322CP | Release Medlearn Article for Change Request (CR) 2813 (End Stage Renal Disease Reimbursement for Automated Multi-channel Chemistry Test(s)). | 10/29/2005 | 3501 | N/A | N/A |
R57FM | Revised Reporting Requirements for Contractor Reporting of Operational Workload Data (CROWD) Health Professional Shortage Area (HPSA) Quarterly Report (CMS Form 1565E, CROWD Form S) | 04/04/2005 | 3472 | N/A | N/A |
R85PI | Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial | 04/04/2005 | 3363 | N/A | N/A |
R56FM | Revision to Balancing Requirement on Form 5, Line 10, of the Contractor Reporting of Operational and Workload Data (Crowd) | 11/22/2005 | 3486 | N/A | N/A |
R308CP | Two New Medicare Summary Notice (MSN) Messages for Parental Pumps - DMERC only | 10/04/2004 | 3506 | N/A | N/A |
R305CP | Disabling the CWF 57x3 Consistency Error Code | 01/03/2005 | 3470 | N/A | N/A |
R114OTN | Payment Allowances for the Influenza Virus Vaccine (CPT 90658) and the Pneumoccocal Vaccine (CPT 90732) | 10/04/2004 | 3490 | MM3490 | 11/19/2004 |
R304CP | Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit | 06/28/2004 | 3226 | MM3226 | 10/15/2004 |
R22BP | Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit | 06/28/2004 | 3226 | N/A | N/A |
R21BP | Medicare Comprehensive Outpatient Rehabilitation Facility Coverage | 10/25/2004 | 3315 | MM3315 | 10/15/2004 |
R117OTN | New Remark Code Message for Use with Claims for Parenteral Pumps - (DMERC) Only | 10/04/2004 | 3405 | N/A | N/A |
R310CP | Billing Requirements for Positron Emission Tomography (PET) Scans for Dementia and Neurodegenerative Diseases | 10/04/2004 | 3426 | N/A | N/A |
R426PR1 | For Assets Acquired On or After May 1, 2004 | N/A | N/A | N/A | N/A |
R55FM | Reporting Appeals Redetermination Information On Forms CMS-2591 and 2590 | 11/15/2004 | 3448 | N/A | N/A |
R311CP | Instructions for Completion of Form CMS-1450 | 01/05/2005 | 3417 | MM3417 | 10/15/2004 |
R118OTN | Shared Systems Maintainers Hours for Resolution of Problems Detected as a Result of Implementation of Change Request 2525 and Change Request 2527 | 01/03/2005 | 3536 | N/A | N/A |
R314CP | Percutaneous Transluminal Angioplasty (PTA) | 10/12/2004 | 3489 | MM3489 | 10/20/2004 |
R25NCD | Percutaneous Transluminal Angioplasty (PTA) | 10/12/2004 | 3489 | MM3489 | 10/20/2004 |
R120OTN | Override of Common Working File (CWF) Edit for Observation Services Exceeding 48 Hours | 04/04/2005 | 3311 | MM3311 | 10/13/2005 |
R302CP | Nursing Facility Visits (Codes 99301 -99313) | 10/25/2004 | 3096 | N/A | N/A |
R303CP | Instructions for Completion of Form CMS-1450 | 01/05/2004 | 3417 | N/A | N/A |
R309CP | Fiscal Year (FY) 2005 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) and Other Bill Processing Changes Related to the IPPS Final Rule | 10/04/2004 | 3459 | MM3459 | 04/29/2005 |
R306CP | Full Replacement of CR 3415, 3rd Update to the 2004 Medicare Physician Fee Schedule Database. | 10/04/2004 | 3505 | MM3505 | 10/05/2004 |
R62MCM | Revisions to Chapter 13 - Medicare+Choice Beneficiary Grievances, Organization Determinations and Appeals | N/A | N/A | N/A | N/A |
R299CP | Use of Condition Code 44, "Inpatient Admission Changed to Outpatient" | 10/12/2004 | 3444 | N/A | N/A |
R297CP | Reasonable Charge Update for 2005 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, Therapeutic Shoes, and Certain Intraocular Lenses | 01/03/2005 | 3430 | MM3430 | 09/30/2004 |
R298CP | MSN and ANSI Messages for Mammography Claims | 09/25/2004 | 2617 | MM2617 | 06/25/2004 |
R21NCD | Magnetic Resonance Spectroscopy for Diagnosing Brain Tumors | 09/10/2004 | 3425 | MM3425 | 09/27/2004 |
R19BP | Hospital Services Covered Under Part B | 10/12/2004 | 3444 | N/A | N/A |
R10GI | Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year 2005 | 01/03/2005 | 3463 | MM3463 | 09/21/2004 |
R267CP | Crossover Patients in New Long Term Care Hospitals (LTCH) | 01/03/2005 | 3391 | MM3391 | 09/27/2004 |
R301CP | Editing Of Hospital And Skilled Nursing Facility Part B Inpatient Services | 01/03/2005 | 3366 | MM3366 | 09/27/2004 |
R116OTN | Notification of Medlearn Matters (MM) Article for Confidential Change Request (CR) 3301 | N/A | 3465 | N/A | N/A |
R54FM | Notification to Providers of Intent to Complete a Post-Payment Audit | 10/25/2004 | 3441 | N/A | N/A |
R19MSP | Clarification of MSP Rules in Relation to a Temporary Leave of Absence | 10/25/2004 | 3447 | MM3447 | 09/29/2004 |
R288CP | Fiscal Year (FY) 2005 Payment for Services Furnished in Ambulatory Surgical Centers (ASCs) | 10/01/2004 | 3394 | MM3394 | 09/02/2004 |
R283CP | 2005 Healthcare Common Procedure Coding System (HCPCS) Annual Update reminder | 01/03/2005 | 3422 | MM3422 | 09/02/2004 |
R285CP | Addition of Physician Assistants, Nurse Practitioners and Clinical Nurse Specialists as Emergency On-Call Providers for Critical Access Hospitals (CAHs) | 01/03/2005 | 3228 | MM3228 | 09/02/2004 |
R6P229 | For Cost Reporting Periods End On or After March 31, 2002 | N/A | N/A | N/A | N/A |
R61MCM | Emergency and Urgently Needed Services | N/A | N/A | N/A | N/A |
R296CP | Payment Denial for Medicare Services Furnished to Alien Beneficiaries Who Are Not Lawfully Present in the United States | N/A | 2825 | N/A | N/A |
R295CP | MSN Messages and Reason Codes for Mammography | 09/25/2004 | 2617 | MM2617 | 06/25/2004 |
R112OTN | Billing Instructions for ADVATE rAHF-PFM on Medicare Claims | 09/27/2004 | 3331 | MM3331 | 10/04/2004 |
R113OTN | Implementation of Section 921 of the Medicare Modernization Act (MMA) - Provider Customer Service Program | 01/05/2005 | 3376 | MM3376 | 12/23/2004 |
R286CP | Medicare Physician Fee Schedule Database (MPFSDB) 2005 File Layout | 01/03/2005 | 3421 | N/A | N/A |
R287CP | Schedule for Completing the Calendar Year (CY) 2005 Fee Schedule Updates and the Participating Physician Enrollment Procedures | 08/27/2004 | 3409 | N/A | N/A |
R284CP | DMERCs Only-Appeals of Duplicate claims | 09/27/2004 | 3371 | N/A | N/A |
R58OTN | Program Integrity Management Reporting (PIMR) System Program Integrity Management Reporting System (PIMR) FY 2004 F and T Codes | 04/01/2004 | 3110 | N/A | N/A |
R46MCM | Chapter 19, Managed Care and M+C Systems Requirements | N/A | N/A | N/A | N/A |
R45MCM | Chapter 13, Grievances Organization Determinations and Appeals | N/A | N/A | N/A | N/A |
R10MSP | Update the Part B Shared Systems to Send the Appropriate Medicare Fee Schedule Amounts to the Medicare Secondary Payer Payment (MSPPAY) Software for Psychiatric MSP Claims | 07/06/2004 | 2955 | N/A | N/A |
R100CP | Outpatient Clinical Laboratory Tests Furnished by Hospitals With Fewer Than 50 beds in Qualified Rural Areas | 07/06/2004 | 3130 | MM3130 | 03/31/2004 |
R32SOM | Appendix C-Survey Procedures and Interpretive Guidelines for Laboratories and Laboratory Services | 04/01/2004 | N/A | N/A | N/A |
R59OTN | Temporary 5 Percent Payment Increase for Home Health Services Furnished in a Rural Area for One Year Under the Home Health Prospective Payment System (HH PPS), Change of HH PPS Annual Update from a Fiscal Year Update to a Calendar Year Update, and Adjustment of HH PPS Annual Update to the Home Health Market Basket Percentage Increase Minus 0.8 Percent | 04/05/2004 | 3085 | MM3085 | 03/16/2004 |
R425PR1 | Regional Medicare Swing-Bed Rates | N/A | N/A | N/A | N/A |
R47MCM | Chapter 7--Medicare+Choice-Enrollment and Disenrollment | N/A | N/A | N/A | N/A |
R66PI | Progressive Corrective Action Program Memorandum and Providing Updated Instructions on How Contractors Must Identify, Verify, and Correct Billing Errors. | 04/02/2004 | 3124 | N/A | N/A |
R105CP | 1st Update to the 2004 Medicare Physician Fee Schedule Database | 04/05/2004 | 3128 | N/A | N/A |
R104CP | DMERCs and VIPS, Processing NDC Numbers | 04/05/2004 | 3141 | MM3141 | 05/06/2004 |
R77CP | Change in Methodolgy for Determining Payment for Outliers | 03/08/2004 | 2998 | N/A | N/A |
R83CP | New "K" Codes for Wheelchair Cushions | 07/06/2004 | 3069 | MM3069 | 02/28/2004 |
R76CP | SNF Inpatient Part A Billing | N/A | 3133 | N/A | N/A |
R82CP | ESRD Data for Use in Adjusting Claims | 07/06/2004 | 3066 | N/A | N/A |
R81CP | Update of UB-92 Codes | 07/06/2004 | 3012 | N/A | N/A |
R80CP | Extend Medicare Coverage for Certain Colorectal Cancer Screenings at SNFs | 07/06/2004 | 2874 | MM2874 | 02/27/2004 |
R88CP | Implementation of Changes to Payment for Ambulance Services Required by Section 414 of MMA | 07/05/2004 | 3099 | MM3099 | 07/14/2004 |
R89CP | The Elimination of the 90-Day Grace Period for HCPCS Codes | 07/06/2004 | 3093 | MM3093 | 02/12/2004 |
R8MSP | Common Working File MSP Modifications | 07/06/2004 | 2775 | N/A | N/A |
R7MSP | Sending the Primary Payer Covered Charge Amount to the Medicare Secondary Payment (MSPPAY) Module for MSP Home Health Prospective Payment System (HH PPS) Claims | 07/06/2004 | 2954 | N/A | N/A |
R96CP | Claims Status Codes in ASC X12N 276/277 Claims Status Health Insurance Portability and Accountability Act (HIPAA) Transactions | N/A | 3017 | N/A | N/A |
R95CP | Elimination of the 90-Day Grace Period for ICD-9-CM Codes | 10/01/2004 | 3094 | MM3094 | 02/10/2004 |
R97CP | Implementation of New Medicare Redetermination Notice (MRN) | 07/06/2004 | 2620 | MM2620 | 10/04/2004 |
R98CP | Consolidation of the Claims Crossover Process: Additional Common Working File (CWF) Functionality | 07/06/2004 | 3109 | MM3109 | 03/05/2004 |
R94CP | Additional Information in Medicare Summary Notices (MSNs) to Beneficiaries about Skilled Nursing Facility (SNF) Benefits | 07/06/2004 | 3098 | MM3098 | 02/25/2004 |
R93CP | Remittance Advice Remark Code and Claim Adjustment Reason Code Update | 04/05/2004 | 3122 | N/A | N/A |
R92CP | Updates to the January 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement | 04/05/2004 | 3070 | N/A | N/A |
R91CP | Revisions to Processing of Non-covered Charges on Certain Home Health Prospective Payment System Claims | 07/06/2004 | 3077 | N/A | N/A |
R90CP | Implementation of Skilled Nursing Facility Consolidated Billing CWF Edit for Therapy Codes Considered Separately Payable Physician Services | 07/06/2004 | 2944 | N/A | N/A |
R79CP | ESRD Reimbursement for AMCC Tests | 07/06/2004 | 2813 | N/A | N/A |
R58CP | April Quarterly DMEPOS Fee Schedule Update | 04/05/2004 | 3014 | N/A | N/A |
R78CP | Medicare Incentive Payments for Physician Care | 07/06/2004 | 3108 | MM3108 | 02/26/2004 |
R57CP | Implementation Guide (IG) Edits | 04/05/2004 | 3001 | N/A | N/A |
R49OTN | Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases | 03/02/2004 | 3075 | N/A | N/A |
R63CP | Special Rules for Critical Access Hospital (CAH) Outpatient Billing | 04/05/2004 | 3051 | MM3051 | 12/06/2004 |
R48OTN | Transfer of "WW" Codes for Oral Anti-Cancer Drugs Billed Using National Drug Codes (NDCs) on Durable Medical Equipment Regional Carrier (DMERC) Claims | 04/01/2004 | 2863 | N/A | N/A |
R65PI | Fiscal Intermediaries to Perform Medical Review on Long Term Care Hospitals | 03/02/2004 | 2905 | N/A | N/A |
R64PI | Role Conditions of Participation (COPs) Requirements When Making a Payment Decision | 03/02/2004 | 3042 | N/A | N/A |
R31FM | Installation of Version 31 of the Provider Statistical and Reimbursement (PS&R) Reporting System | 02/16/2004 | 3073 | N/A | N/A |
R75CP | MMA Pricing File Clarifications | 01/03/2004 | 3105 | MM3105 | 03/10/2004 |
R56OTN | Program Integrity Management Reporting (PIMR) System for Part A - Phase 4 | 07/06/2004 | 3113 | N/A | N/A |
R55OTN | Shared System Maintainer Hours for Resolution of Problems Detected During HIPAA Transaction Release Testing | 07/06/2004 | 3067 | N/A | N/A |
R53OTN | Surgical Lines with No Charges | 07/06/2004 | 3104 | N/A | N/A |
R38OTN | Provider Education Article: 2004 Medicare Physician Fee Schedule Increase and Extension of the Annual Participation Enrollment Period | 01/05/2004 | 3040 | N/A | N/A |
R37OTN | Home Health Cost Reporting Processes | 02/02/2004 | 2993 | MM2993 | 02/03/2004 |
R61PI | Clarification of Proof of Delivery Requirements | 02/02/2004 | 2903 | N/A | N/A |
R29FM | Revisions to Chapter 3 & 4 | 02/06/2004 | 2911 | N/A | N/A |
R59CP | New HCPCS Code for Ambulance Night Differential Charges | 01/05/2004 | 3035 | N/A | N/A |
R40OTN | Provider Education Article: Renewed Moratorium on Outpatient Rehabilitation Therapy Caps | 01/20/2004 | 3045 | N/A | N/A |
R4BP | Dentists, podiatrists, and optometrists are added to the definition/list of physicians who may opt out of Medicare | 02/02/2004 | 3016 | MM3016 | 01/15/2004 |
R39OTN | Change in Coding on Medicare Claims for Darbepoetin Alfa (trade name Aranesp) and Epoetin Alfa (trade name Epogen, EPO) For Treatment Of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis | 01/05/2004 | 2963 | MM2963 | 02/13/2004 |
R41OTN | Provider Education Article: New Enrollee Rights, New Provider Responsibilities in M+C Program | 01/09/2004 | 3044 | N/A | N/A |
R44MCM | Chapter 6, Relationships With Providers | N/A | N/A | N/A | N/A |
R43MCM | Chapter 4, Benefits and Beneficiary Protection | N/A | N/A | N/A | N/A |
R42MCM | Chapter 3, Marketing | N/A | N/A | N/A | N/A |
R41MCM | Chapter 2, Enrollment and Disenrollment | N/A | N/A | N/A | N/A |
R60CP | Chapter 18, Preventive and Screening Services | N/A | 2632 | N/A | N/A |
R5BP | Chapter 15, Covered Medical and Other Health Services | N/A | 2779 | N/A | N/A |
R42OTN | Payment to Ambulatory Surgical Centers (ASCs) for G0260 and to Physicians for 27096 When 27096 is Performed in an ASC | 02/02/2004 | 2979 | MM2979 | 02/13/2004 |
R6MSP | Automatic Notice of Change to MSP Auxiliary File | 01/11/2004 | 2608 | N/A | N/A |
R67CP | Revision to CR 2912: Coding, Testing, and Implementation Phases of CR 2631 for Jurisdiction | 04/05/2004 | 3039 | N/A | N/A |
R66CP | Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.1, Effective April 1, 2004 | 04/05/2004 | 2997 | N/A | N/A |
R65CP | ANSI X12 Transaction 835 Companion Document Change for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), and Fiscal Intermediaries (Fis) | 02/16/2004 | 2948 | N/A | N/A |
R64CP | Coding Change for Ventricular Assist Devices (VADs) for Beneficiaries in an Medicare+Choice (M+C) Plan | 02/16/2004 | 3068 | MM3068 | 02/04/2004 |
R62CP | January 2004 annual update of HCPCS codes used for Home Health Consolidated Billing Enforcement | 02/16/2004 | 3024 | N/A | N/A |
R61CP | Diagnosis coding instructions for anticipated payment and claims to conform with HIPAA requirements | 02/16/2004 | 2992 | N/A | N/A |
R47OTN | Implementation of the Occupational Mix Survey | 02/23/2004 | 3043 | N/A | N/A |
R290CP | October 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS) | 10/04/2004 | 3420 | MM3420 | 09/08/2004 |
R46OTN | Railroad Medicare Carrier Collection of Data | 02/23/2004 | 3041 | N/A | N/A |
R45OTN | Emergency Correction to Healthcare Common Procedure Coding System (HCPCS) Codes for Low Osmolar Contrast Material | 04/05/2004 | 3053 | MM3053 | 03/20/2004 |
R44OTN | Correction-CWF Edits for Inserts for Therapeutic Shoes | 04/01/2004 | 3029 | N/A | N/A |
R289CP | File Descriptions and Instructions for Retrieving the 2005 Pricing Files through CMS's Mainframe Telecommunications System | 01/03/2005 | 3428 | N/A | N/A |
R43OTN | Correction To The Effective Date On 9 Code Pairs in Correct Coding Initiative (CCI) Version 9.3 (Cardiology edits) | 02/23/2004 | 3008 | N/A | N/A |
R63PI | Benefit Improvement Protection Act (BIPA) | 02/23/2004 | 3010 | N/A | N/A |
R240CP | Expansion of the Existing Interrupted Stay Policy Under Long Term Care Hospital (LTCH) Prospective Payment System | 01/03/2005 | 3279 | N/A | N/A |
R62PI | The Focused Medical Review Report | 04/05/2004 | 3062 | N/A | N/A |
R74CP | Intravenous Immune Globulin | 04/05/2004 | 3060 | MM3060 | 02/10/2004 |
R73CP | MCE and IPPS Transfers Between Hospitals | N/A | 2176 | N/A | N/A |
R71CP | Changes to the Laboratory National Coverage Determination (NCD) Edit Software | 04/05/2004 | 3032 | N/A | N/A |
R72CP | Update of Address for the Railroad Retirement Board (RRB) | 02/23/2004 | 3034 | N/A | N/A |
R69CP | Criteria for Using the CB Modifier | 02/23/2004 | 2906 | N/A | N/A |
R6NCD | Cardiac Output Monitoring by Thoracic Electrical Bioimpedance | 02/23/2004 | 2689 | N/A | N/A |
R6BP | Intravenous Immune Globulin | 04/05/2004 | 3059 | MM3060 | 02/10/2004 |
R30FM | Notice of New Interest Rates for Medicare Overpayments and Underpayments | 02/04/2004 | 2829 | N/A | N/A |
R68CP | New Requirements for Critical Access Hospitals. These changes have been established with the "Medicare Prescription Drug, Improvement, and Modernization Act" (MPDIMA) of 2003, Pub.L. 108-173 | 04/05/2004 | 3052 | MM3052 | 02/06/2004 |
R52OTN | Provider Data on Outbound Coordination of Benefit (COB) Files | 07/06/2004 | 3101 | N/A | N/A |
R50OTN | ANSI X12 Transaction 270/271 Changes | 04/05/2004 | 3065 | N/A | N/A |
R51OTN | Changes in Payment for Services Furnished in Ambulatory Surgical Centers for Fiscal Year 2004 | 04/05/2004 | 3082 | MM3082 | 05/06/2004 |
R33FM | Coordination of Medicare and Complementary Insurance Programs | 07/06/2004 | 3109 | MM3109 | 02/29/2004 |
R32FM | Expanded Identification and Workload Reporting for CMS Medicare Systems | 07/06/2004 | 3023 | N/A | N/A |
R34FM | Chapter 7 - Internal Control Requirements Update | 03/08/2004 | 3006 | N/A | N/A |
R51FM | Notice of New Interest Rate for Medicare Overpatments and Underpatyments | 08/09/2004 | 2831 | N/A | N/A |
R52FM | Notice of New Insterest Rate for Medicare Overpayments and Underpayments | 08/09/2004 | 2831 | N/A | N/A |
R9MSP | Converting Health Insurance Portability and Accountability ct (HIPAA) Individual Relationship Codes to Common Working File (CWF) Patient Relationship Codes | 07/06/2004 | 3116 | N/A | N/A |
R270CP | Update to the Frequency of Billing | 01/03/2005 | 3382 | N/A | N/A |
R269CP | Number of Drug Pricing Files That Must Be Maintained Online for Medicare | 01/03/2005 | 3231 | MM3231 | 12/16/2004 |
R271CP | Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2005 | 10/04/2004 | 3386 | N/A | N/A |
R272CP | October Quarterly Update For 2004 | 10/04/2004 | 3377 | MM3377 | 08/18/2004 |
R5DEMO | Use of Group Health Plan Payment System to Pay Capitated Payments to Non-Health Plan Demonstration/Program Sites Serving Medicare Fee For Service Beneficiaries- Updated List of Plan Numbers | 01/03/2005 | 3423 | N/A | N/A |
R58MCM | Chapter 5 Revisions | N/A | N/A | N/A | N/A |
R57MCM | Chapter 7 Revisions | N/A | N/A | N/A | N/A |
R278CP | 3rd Update to the 2004 Medicare Physician Fee Schedule Database | 10/04/2004 | 3415 | MM3415 | 08/21/2004 |
R276CP | Further Information Related to CR 3175, Distinct Part Units of Critical Access Hospitals (CAHs) | 01/03/2005 | 3399 | MM3399 | 08/23/2004 |
R275CP | The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2003 for Inpatient Prospective Payment System (IPPS) Hospitals | 10/04/2004 | 3403 | N/A | N/A |
R274CP | Good Cause Waiver of Late Claim Filing Payment Reduction Penalty | 09/14/2004 | 3042 | N/A | N/A |
R282CP | Good Cause Waiver of Late Claim Filing Payment Reduction Penalty | 09/14/2004 | 3402 | N/A | N/A |
R106OTN | MMA Drug Pricing Update-Payment Limits for J9045 (Carboplatin injection) and J9310 (Rituximab cancer treatment) | 09/24/2004 | 3419 | MM3419 | 09/02/2004 |
R111OTN | Creation of CWF Auxilliary Files and Associated Logic to Properly Calculate Medicare-Equivalent Deductibles for VA Claims | 01/03/2005 | 3450 | N/A | N/A |
R110OTN | MMA Drug Pricing Update-Payment Limits for J1000 (Depo-estradiol cypionate inj) | 09/27/2004 | 3418 | MM3418 | 09/02/2004 |
R109OTN | CWF Analysis to Process Claims Per the Renovated Override Code Billing Instructions for ADVATE rAHF-PFM on Medicare Claims | 09/27/2004 | 3331 | N/A | N/A |
R108OTN | New Remark Code Message for Use with Claims for Parenteral Pumps - Durable Medical Equipment Regional Carrier (DMERC) Only | 09/27/2004 | 3405 | N/A | N/A |
R107OTN | CWF Analysis to Process Claims Per the Renovated Override Code Processing (re: CR3190) and CWF Analysis to Review System Edits for Additional 2-byte Modifiers Added in CR3190. (Phase 2) | 01/03/2005 | 3320 | N/A | N/A |
R6DEMO | Revision of CR 3269 for the Demonstration Project to Clarify the Definition of Homebound (Homebound Demonstration) | 01/03/2005 | 3432 | N/A | N/A |
R83PI | PIM Revisions for Chapter 4 | 09/27/2004 | 3379 | N/A | N/A |
R53FM | Change Request 3367, Debt Collection System (DCS), replaces Change Request 2952, Debt Collection System (DCS) | 09/27/2004 | 3367 | N/A | N/A |
R18MSP | Application of the Medicare Secondary Payer for the Working Aged Provision and the Medicare Secondary for the Disabled Provision to Former Spouses and Certain Family Members with Coverage Under the Federal Employees Health Benefits (FEHB) Program | 11/29/2004 | 3120 | MM3120 | 09/02/2004 |
R229CP | Additional Clarification of Bill Types 22x and 23x Submitted by Skilled Nursing Facilities (SNFs) With Instructions for Involuntarily Moving a Beneficiary Out of the SNF and Ending a Benefit Period | 08/19/2004 | 3323 | MM3323 | 08/02/2004 |
R291CP | Use of Transmission Date in the Service Date/Assessment Date Field for Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) Claims | 01/03/2005 | 3433 | N/A | N/A |
R100OTN | This transmittal is rescinded and replaced with Transmittal 103, dated July 30, 2004 | N/A | 3236 | N/A | N/A |
R99OTN | This One-Time Notification is a Full Replacement for Transmittal 86 (CR 3142) Interface File from Recovery Management and Accounting System (ReMAS | 01/03/2005 | 3383 | N/A | N/A |
R98OTN | Change to Previous Transmittal Regarding the Discontinued Use of Revenue Code 0910 | 10/04/2004 | 3343 | MM3343 | 08/03/2004 |
R96OTN | Annual Changes to the Amount in Controversy (AIC) Thresholds for the Administrative Law Judge (ALJ) and Judicial Review Levels of the Claim Appeals Process as Required by Section 940 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 | 10/01/2004 | 3354 | N/A | N/A |
R94OTN | Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing | 01/03/2005 | 3316 | N/A | N/A |
R97OTN | Implementation of the Business Segment Identifier (BSI) in the Healthcare Integrated General Ledger Accounting System (HIGLAS) | 01/03/2005 | 3362 | N/A | N/A |
R17MSP | Clarification of CR 3064 | 08/16/2004 | 3267 | MM3267 | 07/28/2004 |
R49FM | Procedures For Re-Issuance and Stale Dating of Medicare Checks | 08/16/2004 | 2951 | MM2951 | 07/21/2004 |
R2SOM | Provider Identification Numbers | N/A | 3245 | N/A | N/A |
R59MCM | Chapter 2 | N/A | N/A | N/A | N/A |
R60MCM | Chapter 3 | N/A | N/A | N/A | N/A |
R273CP | Modification of CMS's Medicare Contingency Plan for HIPAA Implementation | 07/06/2004 | 2981 | N/A | N/A |
R230CP | Update to the Claims Status Codes | 01/03/2005 | 3361 | MM3361 | 07/28/2004 |
SE0431 | Skilled Nursing Facility Consolidated Billing | N/A | N/A | SE0431 | 02/18/2005 |
R313CP | Remittance Advice Remark Code and Claim Adjustment Reason Code Update | 01/03/2005 | 3466 | MM3466 | 10/20/2004 |
R24NCD | Update to Chapter 1, Section 220.6 - Dementia and Neurodegenerative Diseases | 10/04/2004 | 3426 | MM3426 | 04/22/2005 |
R84PI | Payment for Emergency Medical Treatment and Labor Act (EMTALA) - Mandated Screening and Stabilization Services | 11/22/2004 | 3437 | MM3437 | 10/28/2004 |
R131OTN | Coverage of Routine Costs of Clinical Trials Involving Investigational Device Exemption (IDE) Category A Devices | 04/04/2005 | 3548 | MM3548 | 12/21/2004 |
R378CP | Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills | 01/03/2005 | 3568 | MM3568 | 01/04/2005 |
SE0436 | Skilled Nursing Facility Consolidated Billing and Preventive/Screening Services | N/A | N/A | SE0436 | 02/18/2004 |
R23NCD | Treatment of Obesity | 10/01/2004 | 3502 | MM3502 | 10/12/2004 |
R300CP | Payment For Outpatient End Stage Renal Disease (ESRD)-Related Services | 10/18/2004 | 3414 | MM3414 | 09/27/2004 |
SE0433 | Skilled Nursing Facility Consolidated Billing as It Relates to Ambulance Services | N/A | N/A | SE0433 | 02/18/2005 |
R407CP | Hospital Billing for Repetitive Services | 01/03/2005 | 3633 | MM3633 | 12/27/2004 |
R23BP | Revised Requirements for Chiropractic Billing of Active/Corrective Treatment and Maintenance Therapy. Full Replacement of CR 3063 | 10/04/2004 | 3449 | MM3449 | 11/19/2004 |
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