2021-10-28-MLNC

Date
2021-10-28
Title
Make a Strong Flu Shot Recommendation — it’s Critical

Thursday, October 28, 2021

 News

Compliance

Events

MLN Matters® Articles

 

News

 

Make a Strong Flu Shot Recommendation — it’s Critical

As a health care provider, your strong recommendation makes a difference in whether your patients get a flu shot. The CDC recommends annual flu shots for everyone 6 months and older. Reducing the spread of respiratory illnesses, like flu, is important to protect people 65 years and older, vulnerable populations, and others during the COVID-19 pandemic. According to the CDC and the Advisory Committee on Immunization Practices, you may give the flu and COVID-19 vaccines at the same visit.

Medicare Part B covers 1 flu shot per flu season and additional flu shots if medically necessary. Your patients pay nothing if you accept assignment.

Every office visit is an opportunity to remind your patients that the flu shot helps protect them from serious flu illness and complications. Don’t miss this critical opportunity to keep your patients safe and healthy.

More Information:

 

Make Health Information Understandable During Health Literacy Month

During October, we encourage you to make it easier for your patients to find, understand, and use information and services to make health decisions for themselves and others:

  • For those over 65, low health literacy may lead to poor physical functioning, pain, limitations of daily activities, and poor mental health
  • Hispanic adults have the lowest level of health literacy among racial and ethnic groups, followed by Black adults and American Indian/Alaskan Native adults
  • Spanish-speaking adults have an increased likelihood of inadequate health literacy when compared to English-speaking adults

More Information:

 

Ambulance Fee Schedule: CY 2022 Ambulance Inflation Factor

According to the Social Security Act, the Ambulance Fee Schedule is updated annually by an Ambulance Inflation Factor (AIF): Consumer Price Index for All Urban Consumers (CPI-U) (June–June of the previous year) reduced by Multi-Factor Productivity (MFP). The CPI-U for 2022 is 5.4% and the MFP for Calendar Year (CY) 2022 is 0.3%. Therefore, the AIF for CY 2022 is 5.1%.

For more information, see the official instruction (PDF) issued to your MAC.

 

Compliance

 

Home Health LUPA Threshold: Bill Correctly

In a recent report, the Office of Inspector General found that Medicare improperly paid some claims for home health services with 5–7 visits in a payment episode. Review the Medicare Home Health Benefit (PDF) and Home Health Prospective Payment System (PPS) (PDF) booklets to properly bill for services slightly above the Low Utilization Payment Adjustment (LUPA) threshold.

Visit the Home Health Prospective Payment System webpage for additional resources to stay informed about the latest policy and payment updates:

 

Events

 

Medicare Ground Ambulance Data Collection System Webinar: Reporting Revenue — October 28

Thursday, October 28 from 2–3 pm ET

Register for this Zoom webinar.

Learn how to report revenue (section 13 of the Medicare Ground Ambulance Data Collection Instrument) from health insurers and from other sources.

A Q&A session will follow the presentation. You may send questions in advance to AmbulanceDataCollection@cms.hhs.gov with “October 28 Revenue Webinar” in the subject line. During the call, we’ll answer questions submitted in advance and live questions from the chat box.

More Information:

 

Medicare Ground Ambulance Data Collection System Webinar: Hospitals & Other Providers — November 4

Thursday, November 4 from 2–3 pm ET

Register for this Zoom webinar.

Target Audience: Hospitals and other ground ambulance service providers (for example, skilled nursing facilities)

Hospitals and other providers will learn how to collect and report responses to select questions related to hospital and other Medicare provider of services.

A Q&A session will follow the presentation. You may send questions in advance to AmbulanceDataCollection@cms.hhs.gov with “November 4 Provider Webinar” in the subject line. During the call, we’ll answer questions submitted in advance and live questions from the chat box.

More Information:

 

MLN Matters® Articles

 

April 2022 Update to the Java Medicare Code Editor (MCE) for New Edit 20 — Unspecified Code Edit

Learn how this new edit applies when entering an unspecified diagnosis code (PDF):

  • Complication or comorbidity
  • Major complication or comorbidity
  • Other codes for this subcategory that specify the anatomic site

 

Skilled Nursing Facility (SNF) Claims Processing Update to Fiscal Year End (FYE) Edits

Learn about updates to the Fiscal Intermediary Shared System (PDF):

  • How CMS is correcting SNF FYE claims editing
  • How the revised edit affects you

Make sure your billing staff knows about this change.

 

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