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National Government Services, Inc.

A Combined Part A And Part B Newsletter

December 2006

MIR-2006-12AB

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:

Information Issued by National Government Services for Part A and Part B Providers
Part A (Speciality)	Part B (Speciality)	Location	Title
H, S, E	A	All	Ambulance Inflation Factor for CY 2007
A	A	All	Annual Update of HCPCS Codes Used for Home Health Consolidated Billing
A	A	All	Application Update to Medicare Deductible, Coinsurance, and Premium Rates for 2007
H, S, E	A	All	Changes to the Laboratory NCD Edit Software for January 2007
A	A	All	CWF Duplicate Claim Edit for the Technical Component of Radiology and Pathology Laboratory Services Provided to Hospital Inpatients
A	A	All	CWF Southwest Host Dark Day on Saturday, December 2, 2006
A	A	All	Flu Season Is Here!
A	A	All	Hospice Payment System Fact Sheet
H	C, P	All	Implementation of an Ultrasound Screening for Abdominal Aortic Aneurysms (AAA)
A	A	All	Implementation of Revised Fee Schedule Amounts for New HCPCS Codes for Power Mobility Devices
H, S	A	All	Information Regarding Fix to Correct NPI Information within the 837 Institutional Crossover Claim Files
H	A	All	Laboratory Competitive Bidding
A	A	All	MMA-Reopenings and Revisions of Claim Determinations and Decisions
A	A	All	NPI: Get It, Share It, Use It
S	A	All	Returning Paper Claims Received from Clearinghouses
A	A	All	Skilled Nursing Facility PPS Fact Sheet

Information Issued by National Government Services for Part A Providers
Part A (Speciality)	Location	Title
H	All	Clarification on Billing for Cryosurgery of the Prostate Gland
H	All	Critical Access Hospital (CAH) Annual Election of Method II for Outpatient Services
H	All	FY 2007 Inpatient PPS, Long-Term Care Hospital and Inpatient Psychiatric Facility PPS Changes – Correction
H	All	Hospital Outpatient Prospective Payment System Fact Sheet
H, E	All	Line-Item Billing Requirement for End Stage Renal Disease (ESRD) Claims
A	All	MMA- Sunset of the Provider Nomination Provision and the Policy to Assign Providers the Local Fiscal Intermediary (FI)
H	All	New Edits to Enforce Proper Transfer Coding and Payment in Inpatient Rehabilitation Facility PPS
A	All	Notification and Testing of an Integrated Outpatient Code Editor for the July 2007 Release
H, S, O	All	Outpatient Therapy Cap Exceptions Clarifications
H	All	Reporting and Payment of No-Cost and Reduced-Cost Devices Furnished by OPPS Hospitals
H, S	All	Reporting of Taxonomy Codes to Identify Provider Subparts on Institutional Claims
H	All	Revenue Code 068X on Critical Access Hospital Claims
A	All	Uniform Billing (UB-04) Implementation – UB-92 Replacement
H	All	Update to CR5304 Article Published in November 2006 MIR About CPT Code 90736
P	All	Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FT 2007

Information Issued by National Government Services for Part B Providers
Part B (Speciality)	Location (State Appreviation)	Title
A	All	Cap Billing: Do Not Bill a Prescription Order Number More Than Once
B	All	Carrier Jurisdiction for Ambulance Supplier Claims
A	All	MMA- Competitive Acquisition Program (CAP) for Part B Drug - Appeals
A	All	Multiple Procedure Reduction on the Technical Component (TC) of Certain Diagnostic Imaging Procedures and Cap on the TC of Imaging Procedures
A	All	Processing All Diagnosis Codes Reported on Claims Submitted to Carriers
P	All	Reporting the NPI on Physician Claims for Clinical Diagnostic Services Purchased Outside of the Local Carrier’s Jurisdiction

This key is provided as a convenience to alert providers/suppliers to articles with topics that may pertain to their particular field. This key is not a guarantee that information in other articles will not also apply. It is each provider’s/supplier’s responsibility to become familiar with the contents of each newsletter.

Part A Key: A-All Providers, C-Community Mental Health Centers (CMHC), E-Renal Dialysis (ESRD) Providers, F-Federally Qualified Health Centers (FQHC), H-Hospitals, M-Home Health Providers,
O-Comprehensive Outpatient Rehabilitation Facilities (CORF) and Outpatient Physical Therapy Providers, P-Hospice Providers, R-Rural Health Center (RHC), 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, Q-Mental Health R-Radiology, S-Surgery, T-Nephrology, U-Urology, V-Chiropractor, W-Ophthalmology & Optometry, X-Podiatry, Y-Radiation Z-Oncology, NA-Not Applicable

Contact Information can be found on each of the National Government Services legacy Web sites which can be accessed though: http://www.NGSMedicare.com.

Medicare policies can be found on our Web site in the Local Coverage Determination section. You can access these through the http://www.NGSMedicare.com homepage. Providers without access to the Internet can request hard copies from National Government Services.

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.NGSMedicare.com.