Medicare Monthly Review:Issue 2008-4 April 2008

	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

April 2008

Issue 2008-4

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 (State)	Title
A	A	All	Coming in April – New National Government Services Web Site
H	P, N, M	All	Correction to LCD and SIA in Notice: Polysomnography and Sleep Studies
H, S	P, N, E	All	Drug Article Added to “Coverage for Label and Off-Label Uses”
H, S	P, N, E	All	Drugs and Biologicals – Coverage for Label and Off-Label Uses
A	A	All	How Can You Help Decrease the CERT Error Rate?
H	P, N, S	All	Medical Policy Article – Sentinel Lymph Note Biopsy
H, S	P, N, E	All	Medical Policy Unit Updates for April 1, 2008
H	P, N, S	All	Medical Policy Update – Apligraft Article/Dermagraft Article
A	A	All	Medical Policy Update – Submission of LCD Reconsiderations
H, S, E	P, N, E	All	Medical Policy Update for Erythropoiesis Stimulating Agents
A	A	All	National Government Services Post Office Box Consolidation
A	A	All	We Need Your Feedback

Information Issued by National Government Services for Part A Providers
Part A (Speciality)	Location (State)	Title
H, S, E	NY, CT, DE	Part A Retired LCD for IVIG
H, S	IL, IN, KY, OH	Policy Consolidation in National Government Services
H, S	NY, CT, DE	Policy Consolidation in National Government Services
H	All	Retired LCD for Audiologic/Vestibular Function Tests
H	IL, IN, KY, OH	Retired LCD for Dental Services
H, S, E	All	Retired LCD for IVIG
H, S	All	What’s New? Part A Updates for April 2008

Information Issued by National Government Services for Part B Providers
Part B (Speciality)	Location (State)	Title
P, N, E, L	All	Medicare Policy Update-Retired LCDs and SIAs
E	All	Part B Retired LCD for IVIG
A	All	Place of Service Reminder
P, N, E, L	All	Consolidation in National Government Services

Information Issued by CMS Pertaining to Part A and Part B Providers
Part A (Speciality)	Part B (Speciality)	Location (State)	Title
A	A	All	Change in Amount in Hearings (CR5897)
A	A	All	Claim Status Category Code and Claim Status Code Update (CR5947)
H	P, N, R	All	Clarification of Bone Mass Measurement (CR5847)
H	P, N, Z	All	Erythropoiesis Stimulating Agents in Neoplastic Conditions (CR5818 –Revised)
A	A	All	Healthcare Provider Taxonomy Codes Update for April 2008 (CR5951)
A	A	All	Payment Allowance Update for Influenza Vaccine and PPV (CR5910-Revised)
H, S, E	E, D, M, P, Q, S	All	Processing of Drug Claims with the JW Modifier (CR5923)
H	P, N Q	All	Psychological and Neuropsychological Tests (CR5204–Revised)
A	A	All	Remittance Advice Remark Code/Claim Adjust Reason Code Update (CR5942)
H	P, N	All	Reporting NPI for Ordering/Referring and Attending/Operating/Other Service Facility for Medicare Claims (CR5890-Revised)
A	A	All	Third Annual Medicare Contractor Provider Satisfaction Survey (SE0804)
H, S, O	H, P, N	All	Update to Audiology Policies (CR5717)

Information Issued by CMS Pertaining to Part A Providers
Part A (Speciality)	Title
H	April 2008 IRF PPS Pricer Changes (CR5965)
H	Billing for the Oral Three-Drug Combination Anti-Emetic (CR5655-Revised)
H	Changes to LTCH PPS Pricer Based on SCHIP Extension Act of 2007 (CR5955)
H	CORF Billing Requirement Updates for FY 2008 (CR5898)
H	Home Health Agencies Providing DME in Competitive Bidding Areas (CR5868)
H	January 2008 Update of Hospital OPPS – Manualization (CR5946)
H	LUPA Add-on Payments under the Refined HH PPS (CR5877-Revised)
H	Processing Claims Incorrectly Editing for an Operating Physician (JSM-08186)
H	Refinement in Cost Reporting Because of Recalibrating DRGs (CR5928)
H, S	SNF Inpatient Billing for No-Payment/Medicare Advantage Claims (CR5840)

Information Issued by CMS Pertaining to Part B Providers
Part B (Speciality)	Title
A	Collapsing Medicare PTAN to Ensure One-to-One NPI Match (CR5906)
L	HCPCS Codes Subject to and Excluded from CLIA Edits (CR5926)
P, N	Hospital Observation Services and Inpatient Care Services (CR5791)
P, N	Initial Hospital Care Services and Observation or Inpatient Service (CR5793)
P, N	Manualization of Payment for ESRD Related Services (CR5931)
L	New Waived Tests (CR5913)
E	Part B CAP Quarterly Drug List Update (CR5948)
P, N	Payment for Inpatient Hospital Visits – General (CR5792)
A	Quarterly Update to Correct Coding Initiative Edits (CR5936)
L	SCHIP Extension Act of 2007: Independent Lab Billing for TC of Pathology (CR5943-Revised)
P, N	Subsequent Hospital Visits and Hospital Discharge Day Management (CR5794)
A	Supplying Correct Provider Identification Information (SE0529-Revised)
E	System Changes for Prescription Order Number for the CAP for Drugs and Biologicals
P	Teaching Physician Requirements for ESRD Monthly Capitation Payment (ESRD MCP)

Provider Outreach and Education Training Seminars

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.