What’s New for DMEPOS - DME MAC Jurisdiction A

Below you will find a listing of current Medicare changes and updates to the website pertinent to the Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) for Jurisdiction A. Please join the DME MAC A Listserve to ensure that you receive notification of updates.

July | June | May | April

July

02 July 2009

Implementation of New Provider Contact Center Technology
Proposed DMEPOS Regulatory Updates (CMS Message 2009-07-02)
Department of Health & Human Services (HHS) Rescinds Medicaid Regulations (CMS Message 2009-06-30)
Therapeutic Shoes - Withdrawal of Policy Article
DME MAC A Supplier Manual - Chapters 2, 3 and 5 have been reviewed and updated
The 2009 DME MAC Jurisdiction A Symposium Speakers & Exhibitors page has been updated

01 July 2009

Test Your Knowledge - The Oxygen Quiz is Now Available

June

26 June 2009

Crossover Claims Impacted by Common Working File (CWF) Southeast Host Site Problem (JSM 09333)
HHS Announces Initiatives in Support of the “Year of Community Living” (CMS Message 2009-06-22)
Statement by HHS Secretary Kathleen Sebelius the 10th Anniversary of the U.S. Supreme Court Decision Olmstead v. L.C. (CMS Message 2009-06-22)
Recovery Act and Health Information Technology Now Available on the CMS Web site! (CMS Message 2009-06-23)
Meeting Minutes for the May 2009 Provider Outreach & Education Advisory Group Meeting are now available
The 2009 DME MAC Jurisdiction A Symposium Program Schedule page has been updated
Expiration of Medicare Processing of Certain Indian Health Service (IHS) Part B Claims - Sunset of Section 630 of the Medicare Modernization Act (MMA) of 2003 for Payment of Indian Health Services (IHS) (SE0912)
Review of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) (MM6468)

25 June 2009

Registration for the 2009 DME MAC Jurisdiction A Symposiums is now Open
The 2009 DME MAC Jurisdiction A Symposium Speakers & Exhibitors page has been updated
LCD and Policy Article Revisions - Summary for June 25, 2009
PAP and RAD Devices LCDs Revised
The following Local Coverage Determinations (LCDs) / Medical Policies have been revised:
- Automatic External Defibrillators (L13613)
- Canes and Crutches (L11496)
- Cervical Traction Devices (L15844)
- Cold Therapy (L5038)
- Commodes (L11497)
- Enteral Nutrition (L5041)
- Epoetin (L11463)
- Eye Prostheses (L11529)
- Facial Prostheses (L5046)
- Home Dialysis Supplies and Equipment (L11498)
- Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (L11528)
- Respiratory Assist Devices (L11504)

19 June 2009

CMS Change Request 6507 - VMS Modifications to Implement the Common Electronic Data Interchange (CEDI) System, Part III, NCPDP 5.1 Implementation (CEDI Message regarding CR6507)
FDA Consumer Alert: Warning Consumers of a Tainted Skin Sanitizer (CMS Message 2009-06-15)
Revised Certificate of Medical Necessity (CMN) Web-Based Training Course (CMS Message 2009-06-17)
June 15th - 21st is National Men's Health Week and June 21st is Father's Day! (CMS Message 2009-06-16)
The Centers for Medicare & Medicaid Services (CMS) has posted the July 2009 ASP pricing files and crosswalks, which are available for download at: http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a1_2009aspfiles.asp (CMS Message 2009-06-15)
New and Updated Frequently Asked Questions (FAQs) are now available
Scam Alert - The Centers for Medicare & Medicaid Services (CMS) has posted the The Centers for Medicare & Medicaid Services (CMS) has become aware of a scam where perpetrators are sending faxes to physician offices posing as the Medicare carrier or Medicare Administrative Contractor (MAC). The fax instructs physician staff to respond to a questionnaire to provide an account information update within 48 hours in order to prevent a gap in Medicare payments. The fax may have the CMS logo and/or the contractor logo to enhance the appearance of authenticity

Medicare FFS providers, including physicians, non-physician practitioners, should be wary of this type of request. If you receive a request for information in the manner described above, please check with your contractor before submitting any information. Medicare providers should only send information to a Medicare contractor using the address found in the download section of the CMS.gov website found at http://www.cms.hhs.gov/MLNGenInfo/ or http://www.cms.hhs.gov/MedicareProviderSupEnroll

18 June 2009

LCD and Policy Article Revisions - Summary for June 2009
The following Local Coverage Determinations (LCDs) / Medical Policies have been revised:
- Oxygen and Oxygen Equipment (L11468)
- Therapeutic Shoes for Persons with Diabetes (L11535)

15 June 2009

The article Crossover Claims Impacted by Common Working File (CWF) Pacific Host Site Problem that occurred on May 04, 2009 (JSM 09321) has been revised.

12 June 2009

DME MAC Jurisdiction A Resource Number 12 - June 2009 is now available
VMS Modifications to Implement the Common Electronic Data Interchange (CEDI) System, Part III, NCPDP 5.1 Implementation (CR6507)
New Drug/Biological Health Care Procedure Code System (HCPCS) Codes for July 2009 Update (MM6477)
October Quarterly Update to 2009 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement (MM6503)
July Quarterly Update for 2009 for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) (MM6511)
Crossover Claims Impacted by Common Working File (CWF) Pacific Host Site Problem that occurred on May 04, 2009 (JSM 09321)
Healthcare Common Procedure Coding System (HCPCS) Coding Decision and Preliminary Medicare Payment Decision for Negative Pressure Wound Therapy (NPWT) Devices (CMS Message 2009-06-10)
National Cancer Survivors Day (CMS Message 2009-06-08)
The written and audio transcripts of the ICD-10-CM/PCS Implementation and General Equivalence Mappings (Crosswalks) National Provider Conference Call, which was conducted by the Centers for Medicare & Medicaid Services on May 19, 2009, are now available in the Downloads Section at http://www.cms.hhs.gov/ICD10/06a_2009_CMS_Sponsored_Calls.asp (CMS Message 2009-06-12)

05 June 2009

Payment for Maintenance and Servicing of Certain Oxygen Equipment as a Result of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 - CR 6509 RESCINDS AND FULLY REPLACES CR 6404 (MM6509)
Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC), and Medicare Remit Easy Print (MREP) Update (MM6453)
The article Discontinuance of the Unique Physician Identification Number (UPIN) Registry (MM5584) has been revised
The article Influenza Pandemic Emergency - The Medicare Program Prepares (SE0836) has been revised
2009 Fees for Repair or Nonroutine Service for Durable Medical Equipment (DME) (JSM09213)
REMINDER: CMS to Host First National Medicare Fee-For-Service (FFS) Provider Education Call on HIPAA Version 5010 - June 9, 2009 (CMS Message 2009-06-03)
Roll-out: Medicare Competitive Bidding Program for DMEPOS, Round One Rebid (CMS Message 2009-05-29)
GET READY FOR COMPETITIVE BIDDING! (CMS Message 2009-05-29)
Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC), and Medicare Remit Easy Print (MREP) Update (CR6453)
The Second in Series: General Equivalence Mappings – ICD-9-CM to and from ICD-10-CM and ICD-10-PCS Fact Sheet (May 2009), which provides basic information about the General Equivalence Mappings (GEM) including possible users of the GEMs, why the GEMs are needed, and how the GEMs files are formatted as well as Reimbursement Mappings information, is now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10Mappingfctsht.pdf

04 June 2009

01 June 2009

Test Your Knowledge - The Revised Medicare Basics Quiz is Now Available

May

29 May 2009

The article Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Supplier Accreditation Requirements (SE0903) has been revised.
Ostomy Supplies - Billing Reminder
Final Agenda for the Next Meeting of the Program Advisory and Oversight Committee (PAOC) (CMS Message 2009-05-28)

27 May 2009

2009 DME MAC Jurisdiction A Symposiums - Unraveling the Mysteries of Medicare - The DME MAC Jurisdiction A Provider Outreach & Education Team is excited to announce that we will be hosting two Educational Symposiums offering a dynamic range of topics and speakers. In addition, attendees will have the opportunity to interact directly with various Medicare Contractors and State DMEPOS Associations in order to enhance their educational experience and get the most out of this excellent opportunity.
Save the Dates - DME MAC Jurisdiction A Symposiums - Unraveling the Mysteries of Medicare

26 May 2009

DME MAC Jurisdiction A is excited to introduce 3 new Self-Service Tools. These Self-Service Tools are available to help with common calculations that may be necessary when making billing decisions on Medicare claims. Our new tools include:
- An Enteral Nutrition Units of Service Calculator
- A Five Year Useful Lifetime Calculator
- A Reconsideration Request Calculator

22 May 2009

July 2009 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files (MM6471)
The article The ICD-10 Clinical Modification/Procedure Coding System (CM/PCS)—The Next Generation of Coding (SE0832) has been revised.
May 19th is World Hepatitis Day (CMS Message 2009-05-19)
May is Older Americans Month (CMS Message 2009-05-20)
CMS to Host First National Provider Education Call on HIPAA Version 5010 - June 9, 2009 (CMS Message 2009-05-15)

15 May 2009

Modification of the Common Working File (CWF) Copybook to Transmit “WC” Qualifier Alpha Codes to Various Systems. (supplement to CR 5371) (MM6438)
Mandatory Claims Submission and its Enforcement (SE0908)
Training Medicare Patients on Use of Home Glucose Monitors and Related Billing Information (SE0905)
The article Clarification about the Medical Privacy of Protected Health Information (SE0726) has been revised
Reminder and New/Revised Materials for ICD-10-CM/PCS Conference Call (CMS Message 2009-05-12)
PAOC Meeting on the Implementation of the Medicare DMEPOS Competitive Bidding Program (CMS Message 2009-05-08)
A new Medicare Secondary Payer Fact Sheet (April 2009), which provides a general overview of the MSP provisions for individuals involved in the admission and billing procedures at provider, physician, and other supplier settings is now available in downloadable format from the Medicare Learning Network at: http://www.cms.hhs.gov/MLNProducts/downloads/MSP_Fact_Sheet.pdf

08 May 2009

New from the Medicare Learning Network (MLN): The Centers for Medicare & Medicaid Services (CMS) Releases a New MLN Matters Article of Particular Interest - SE0904 - An Introductory Overview of the HIPAA 5010 The implementation of HIPAA 5010 presents substantial changes in the content of the data that providers submit with their claims, as well as the data available to them in response to their electronic inquiries. This Special Edition MLN Matters article alerts providers of these HIPAA changes and how they need to plan for their implementation. (CMS Message 2009-05-05)
General Equivalence Mappings - ICD-9-CM to and from ICD-10-CM and ICD-10-PCS (Fact Sheet): The General Equivalence Mappings - ICD-9-CM To and From ICD-10-CM and ICD-10-PCS (Fact Sheet) (March 2009), which provides information and resources regarding the General Equivalence Mappings that were developed as a tool to assist with the conversion of International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) codes to International Classification of Diseases, 10th Edition (ICD-10) and the conversion of ICD-10 codes back to ICD-9-CM, is now available in print format from the Centers for Medicare & Medicaid Services Medicare Learning Network. To place your order, visit http://www.cms.hhs.gov/MLNGenInfo/, scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page” (CMS Message 2009-05-05)

07 May 2009

Travel Oxygen

01 May 2009

Test Your Knowledge - The Glucose Quiz is Now Available
An Introductory Overview of the HIPAA 5010 (SE0904)
Important Information Regarding the Centers for Medicare & Medicaid Services (CMS) National Claims Crossover Process (SE0909)
Results of Advance Determination of Medicare Coverage (ADMC) Review
CERT Documentation Checklist
June ACT Call Information Now available - Glucose Monitor Billing Q&A
March ACT Call Audio Now available
Podiatrists and DMEPOS Accreditation - Podiatrists are exempt from the accreditation requirement. While they were not specifically listed as an exempt provider in MIPPA, they are included under the definition of a physician as defined in section 1861(r) of the Social Security Act. The Pedorthists are not exempt from the accreditation requirement at this time.
Information on Swine Flu - For the most current information about swine flu, visit the Centers for Disease Control and Prevention (CDC) web site at: http://www.cdc.gov/swineflu. You will find consumer and provider fact sheets, current information, and steps you can take to protect yourself against infection. At the CDC site, you will also be able to download a widget that you can post to your own website to help your patients get the most current and accurate information.

April

28 April 2009

New and Updated Frequently Asked Questions (FAQs) are now available

23 April 2009

Informational Sessions Scheduled May 4, 5 & 11, 2009 Regarding CMS' Recovery Audit Contractor (RAC) Program (CMS Message 2009-04-25)
Centers for Medicare & Medicaid Services Special Open Door Forum: Medicare Provider & Supplier Enrollment, April 30, 2009 (CMS Message 2009-04-24)
Statement on the DMEPOS Competitive Bidding Program Centers for Medicare & Medicaid Services (CMS Message 200904-23)
Supplies and Accessories Used With Beneficiary Owned Equipment - April 2009 Clarification

17 April 2009

Surety Bonds for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) (MM6392)
Payment for Maintenance and Servicing of Certain Oxygen Equipment as a Result of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 (MM6404)
Medicare Remit Easy Print (MREP) Version 2.6 (CEDI Message 2009-04-16)
Registration Now Open for Next National Conference Call for Providers Regarding ICD-10 (CMS Message 2009-04-14)
Medicare Announces Funding for State Health Insurance Counseling Programs for 2009 - Funding Designed to Help People With Medicare (CMS Message 2009-04-09)

14 April 2009

The following Fee Schedules have been added:
- April 2009 Quarterly Average Sales Price Medicare Part B Drug Pricing File
- 2nd Quarter 2009 Oral Anticancer Drug Fees
The following Fee Schedules have been revised:
- January 2009 Quarterly Average Sales Price Medicare Part B Drug Pricing File
- April 2008 Quarterly Average Sales Price Medicare Part B Drug Pricing File
- 1st Quarter 2009 Oral Anticancer Drug Fees

10 April 2009

Interim Action to Process Claims for L5670 until Skilled Nursing Facility (SNF) Consolidated Billing Files Can Be Updated with the October 2009 Quarterly Release (JSM09234)
The Centers for Medicare & Medicaid Services is pleased to announce the scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set. These changes have been posted to the HCPCS web page at http://www.cms.hhs.gov/HCPCSReleaseCodeSets/02_HCPCS_Quarterly_Update.asp. Changes are effective on the date indicated on the update.
The General Equivalence Mappings - ICD-9-CM To and From ICD-10-CM and ICD-10-PCS Fact Sheet (March 2009), which provides information and resources regarding the General Equivalence Mappings that were developed as a tool to assist with the conversion of International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) codes to International Classification of Diseases, 10th Edition (ICD-10) and the conversion of ICD-10 codes back to ICD-9-CM, is now available in downloadable format from the Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10_GEM_factsheet.pdf. The General Equivalence Mappings information discussed in this fact sheet has also been posted in the CMS Frequently Asked Questions database at https://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_alp.php?p_sid=l2s5Zouj.
The finalized schedule for our Spring Educational Webinar Sessions is now available.

09 April 2009

FAQ - Complex Rehab Repair Issues

06 April 2009

New versions of the DME MAC A IVR User Guide , the DME MAC A IVR Call Flow , and the DME MAC A IVR Tip Sheet / Eligibility Check List are now available.

03 April 2009

Instructions for Utilizing 837 Professional Claim Adjustment Segments (CAS) for Medicare Secondary Payer (MSP) Part B Claims (This CR rescinds and fully replaces CR6211) (MM6427)
The article Instructions for Utilizing 837 Professional Claim Adjustment (CAS) Segments for Medicare Secondary Payer (MSP) Part B Claims (MM6211) has been rescinded.
ICD-10-Clinical Modifications (CM)/Procedure Coding System (PCS) Conference Call Transcripts - The audio transcripts of the ICD-10-CM/PCS Conference Calls that were sponsored by the Centers for Medicare & Medicaid Services in 2008 for Hospital Staff (October 14), Other Part A and Part B Providers (November 12), and Physicians (November 17) are now available and can be accessed in the Downloads Section at http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp (CMS Message 2009-04-01)
CMS Announces the use of the Revised CMS-855S Enrollment Application for DMEPOS Suppliers - Recently, the Centers for Medicare and Medicaid Services (CMS) announced the use of the revised CMS-855S enrollment application to be used by DMEPOS suppliers for initial enrollment, reactivations, reenrollments and to report changes of information. The application revision includes new sections for reporting surety bond information and accreditation exempt drugs and pharmaceuticals. Other changes to the application include the posting of the business’ hours of operation and the addition of Supplier Standard 26. In accordance with CMS instruction, the NSC shall no longer accept initial submissions of the previous version of the 855-S form received after June 1, 2009. The revised application form is available on the CMS Web site. Additional information can also be obtained on the NSC Web site.

01 April 2009

Test Your Knowledge - The Comprehensive Error Rate Testing (CERT) Quiz is Now Available

07/02/2009