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Medicare Monthly Review

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July 2018, Issue 2018-07

In This Issue

National Government Services – Articles for Part A and Part B Providers
Revised LCDs and Articles: June–July 2018
Non-emergent HBO Therapy Prior Authorization Model Ended 2/28/2018
National Government Services – Articles for Part A Providers
340B-Acquired Drugs Medicare Reimbursement and Appeals
Part A Inpatient Date of Service Reporting and Split Billing
Part A Outpatient Date of Service Reporting and Split Billing
CMS Articles for Part A and Part B Providers CR/MM/SE #
Provider Enrollment – Unlicensed Residents SE18008
New Medicare Beneficiary Identifier (MBI) Get It, Use It  SE18006 Revised
Prohibition Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) Program SE1128 Revised
Claim Status Category and Claim Status Codes Update MM10777
Update of Internet Only Manual (IOM), Medicare Claims Processing Manual, Publication 100-04, Chapter 18 - Preventive and Screening Services, and Chapter 35 - Independent Diagnostic Testing Facility (IDTF) MM10735
July Quarterly Update for 2018 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule  MM10707
Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – July 2018 Update MM10624 Revised
Provider/Supplier Reporting of Adverse Legal Actions MM10558
E/M Service Documentation Provided By Students (Manual Update) MM10412 Revised
Comprehensive ESRD Care (CEC) Model Telehealth – Implementation
MM10314 Revised
CMS Articles for Part A Providers CR/MM/SE #
Recent and Upcoming Improvements in Hospice Billing and Claims Processing  SE18007
Quarterly Update to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS)
 MM10818 Revised
July 2018 Update of the Hospital Outpatient Prospective Payment System (OPPS)
MM10781 Revised
July 2018 Integrated Outpatient Code Editor (I/OCE) Specification Version 19.2 MM10699 Revised
Revisions to the Telehealth Billing Requirements for Distant Site Services MM10583 Revised
Global Surgical Days for Critical Access Hospital (CAH) Method II
MM10425 Revised
CMS Articles for Part B Providers CR/MM/SE #
Medicare Coverage for Chiropractic Services – Medical Record Documentation Requirements for Initial and Subsequent Visits
SE 1601 Revised
July 2018 Update of the Ambulatory Surgical Center (ASC) Payment System
MM10788 Revised
New Q Code for In-Line Cartridge Containing Digestive Enzyme(s)
CMS MLN Connects® Weekly Provider eNews
MLNConnects for June 28, 2018
New Medicare Card Mailing Update – Wave 3 Begins, Wave 1 Ends
MLNConnects for June 21, 2018
MLNConnects for June 14, 2018
MLNConnects for June 7, 2018

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 website.

CMS publishes the Quarterly Provider Update (QPU) at the beginning of each quarter to inform providers and suppliers about the following:

  • Regulations and major policies under development during the quarter
  • Regulations and major policies completed or cancelled
  • New or revised manual instructions

Article Key: CR = Change Request; MM = Medicare Learning Network Matters article; SE = Medicare Learning Network Matters Special Edition article

Contact information can be found in the Contact Us section of our website.

Medicare policies can be accessed from the Medical Policy Center section of our website.

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