National Government Services

	Medicare Monthly Review

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	National Government Services, Inc. Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter

November 2006

MIR-2006-11AB

CPT five-digit codes, descriptions, and other data only are copyright 2007American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS clauses apply.

In This Issue:

KEY		Part A & B Contents
Part A	Part B	Title

A	A	2007 Annual Update of HCPCS Codes for SNF Consolidated Billing
A	A	Breast Cancer Awareness
A	A	CMS Announces Part D Low-Income Subsidy (LIS) Redetermination Information
A	A	Communications Infrastructure Testing
A	A	Electronic Data Interchange (EDI) Media Changes
A	A	Ending the Contingency Plan for Remittance Advice and Charging for PC Print, Medicare Remit Easy Print (MREP) and Duplicate RAs
A	A	Flu Shot Reminder
A	A	Guidelines for Teaching Physician, Interns, and Residents Fact Sheet
H	P	Holding of Pancreas Transplant Alone (PS) Claims – Amendment to MLN Matters Article MM5093
A	A	NPI: Get It, Share It, Use It – Resources for Commonly Asked Questions
A	A	NPI: Get It, Share It, Use It – Training Package: Module 5 Available Now
A	A	October Update to 2006 Medicare Physician Fee Schedule (MPFS) Database
H		“Own Your Future”: Long-Term Care (LTC) Campaign
H	P	Pancreas Transplants Alone
H, S, O	P, Q	Psychological and Neuropsychological Tests
A	A	Reminder about Medicare Preventive Services Provider Education Products
A	A	Termination of HCPCS Code G0107, Colorectal Cancer Screening, Fecal-Occult Blood Tests (FOBT), 1-3 Simultaneous Determinations



KEY	Part A ONLY Contents
Part A	Title
H	Fiscal Year (FY) 2007 Inpatient Prospective Payment System (IPPS), Long-Term Care Hospital (LTCH), and Inpatient Psychiatric Facility (IPF) PPS Changes
H	Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2007
H	Notifying Medicare Patients about Lifetime Reserve Days (LRD)
A	October 2006 Non-Outpatient Prospective Payment System Outpatient Code Editor (Non-OPPS OCE) Specifications Version 22.0
H	October 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes
A	Skilled Nursing Facility Consolidated Billing Web-Based Training Course
H, S	Understanding the Remittance Advice for Institutional Providers



KEY	Part B ONLY Contents
Part B	Title
A	Additional Requirement Necessary to Implement the Revised Health Insurance Claim Form CMS-1500
A	Clarification of Requirements for the Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals
A	Medicare Remit Easy Print (MREP) Version 1.9 Is Now Available for Download!
A	Medicare Part B Drug Competitive Acquisition Program
A	Telephone Reopenings
A	Update to the Place of Service (POS) Code Set to Add a Code for Prison/Correctional Facility

Part A Contact Information

Automated IVR Inquiries 1 (877) 567-7205
Monday - Friday 6:00 a.m. to 6:00 p.m.
Saturdays 9:00 a.m. to 2:00 p.m.

These hours represent minimum availability. System access is generally available until 10:00 p.m. on weekdays and 6:00 p.m. on weekends.

Provider Inquiries: 1 (888) 855-4356
Monday & Friday 9:00 a.m. to 4:00 p.m.
Tuesday - Thursday 8:00 a.m. to 4:00 p.m.

You will be able to transfer to a provider representative only during these hours. Please have your provider number, the HIC number and service dates available when you call.

The Provider Inquiries TTY number for the Hearing Impaired is: 1 (877) 425--2370
Monday & Friday 9:00 a.m. to 4:00 p.m.
Tuesday - Thursday 8:00 a.m. to 4:00 p.m.

Beneficiary Inquiries:
English and Spanish 1-800-MEDICARE
(1-800-633-4227)
TTY for the Hearing-Impaired: 1 (877) 486-2048

Integrated Electronic Services (IES)
Technical Help Desk: 1 (866) 889-7322
Monday - Friday from 8:30 a.m. until 4:30 p.m.

Medicare Fraud Hotline:
To report fraud and abuse in the Medicare and Medicaid programs: 1(800) HHS-TIPS/1(800) 447-8477

The Hotline TTY Number for the Hearing-Impaired is: 1(877) 623-6190
Medical Director: Dr. Ted Triana 1(315) 442-4893

Part B New Jersey Contact Information

Beneficiary TDD:	(800) 992-0165
Beneficiary Telephone Inquiries & ARU:	(800) 633-4227
DMERC:	(866) 419-9458
EMC:	(866) 488-0546
Fax-on-Demand (FOD):	(888) 281-8586
Part B Provider IVR:	(877) 567-9235
Part B Telephone Reopenings	(866) 620-1190
Part B Provider Customer Service:	(888) 855-4346
Provider Enrollment:	(866) 309-0486
Provider TDD:	(888) 897-7542

Provider Enrollment Mail claims to :

Empire Medicare Services
Provider Enrollment
P.O. Box 69218
Harrisburg, PA 17106-9218

Empire Medicare Services
Provider Claims
P.O. Box 69201
Harrisburg, PA. 17106-9201

Part B Appeals & Correspondence
Empire Medicare Services
P.O. Box 69202
Harrisburg, PA 17106-9202

Part B New York Contact Information

Part B Provider Telephone Inquiries (STAR) Claim Status and information, eligibility deductible, pricing and seminar information:	(877) 869-6504
Claim Entry (MTCE):	(631) 244-5300
Claim Entry (MTCE) Information:	(212) 476-7934
DMERC:	(866) 419-9458
EMC Technical Support Help Desk:	(866) 889-7322
Fax-on-Demand (FOD):	(866) 709-1905
General Provider Enrollment Information:	(866) 837-0241
Health Professional Shortage Area (HPSA) and EMC Audit:	(315) 442-4600
IES Technical Help Desk:	(866) 889-7322
Part B Telephone Reopenings	(888) 399-7719


Provider Enrollment Empire Medicare Services Reimbursement Dept. P.O. Box 1200 Crompond, NY 10517-1200	Mail Assigned Claims to: Empire Medicare Services P.O. Box 100 Yorktown Heights, NY 10598


Unassigned Claims to : Empire Medicare Services P.O. Box 355 Crompond, NY 10517	Health Professional Shortage Area (HPSA) & EMC Audit Empire Medicare Services P.O. Box 4716 Syracuse, NY 13221-4716

UPIN Directories (CD/ROM version)
Quality Assurance and Coordination Dept.
P.O. Box 1201
Crompond, NY 10517

Back Issue Requests
Empire Medicare Services
MNB-Back Issues
800 2nd Avenue
3rd Floor
New York, NY 10017

Part B Appeals & Correspondence
Empire Medicare Services
P.O. Box 2280
Peekskill, NY 10566

Part A Key: A-All Providers, C-Community Mental Health Centers (CMHC), E-Renal Dialysis (ESRD) Providers, H-Hospitals, M-Home Health Providers, O-Comprehensive Outpatient Rehabilitation Facilities (CORF) and Outpatient Physical Therapy Providers, P-Hospice Providers, S-Skilled Nursing Facilities (SNF), NA-Not Applicable

Part B Key: A-All Providers, B-Ambulance, C-Cardiovascular, D-DMEPOS, E-Drugs & Biologicals, F-ASC, G-Anesthesia, H-Physical & Occupational Therapy, I-Beneficiaries, J-Insurers, K-Home Health Care, L-Laboratory, M-Medicine, N-Non-Physician Practitioner, O-Nuclear Medicine, P-Physicians, R-Radiology, S-Surgery, U-Urology, V-Chiropractor, W-Ophthalmology, X-Podiatry, Q-Oncology, NA-Not Applicable

This bulletin should be shared with all health care practitioners and managerial members of the provider staff. Bulletins are available at no cost from our Web site at www.empiremedicare.com.