What's New for DME

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.

May | April | March | February

May

09 May 2008

• Provider Authentication by Medicare Provider Contact Centers (SE0814) (JSM08285)
  
• There is a new Medical Review FAQ:
  
  • Power Mobility Devices FAQs - ATS/ATP Requirements
  
  
• CMS to Host National Provider Education Call on the DMEPOS Competitive Bidding Program - May 13, 2008 (CMS Message 2008-05-01)
  
• Attention All DME MAC Electronic Submitters and Vendors - Helpful Tips for Contacting CEDI During the Transition
  
• June ACT Call Information Updated - Overview of the DMEPOS Competitive Bidding Program
  
• Repairs and Replacement for Beneficiary Owned Equipment
  

02 May 2008

• Attention All DME MAC Electronic Submitters and Vendors - CEDI Urgent Reminder
  
• The March 2008 CERT Newsletter is now available
  

April

25 April 2008

• Important Exceptions and Special Circumstances that Occur under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program - The third in a series of articles on the new DMEPOS competitive bidding program (SE0807)
  
• Establish Pre-Payment Auto-denial Edits in Applicable States for DMEPOS Suppliers of Oxygen and Oxygen Equipment (DME MACs only) (MM5929)
  
• New HCPCS Codes for the April 2008 Update (MM5981)
  
• CMS Medicare News - Week Ending April 18, 2008
  
• CEDI Listserv
  
• CEDI Frequently Asked Questions
  
• Attention All DME MAC Electronic Submitters and Vendors - CEDI Transition Deadline for Jurisdictions A and D is Drawing Near
  
• Revised ABN Form - Effective March 3, 2008
  
• Top Ten Refractive Lens Claim Denials
  
• New Online Education Tutorial - Skilled Nursing Facility and Consolidated Billing
  
• Revised Online Education Tutorial - Coordination of Benefits & Medicare Secondary Payer
  
• March ACT Call Audio files now Available
  
• There is a new Medical Review FAQ:
  
  • Urological Supplies - Policy Changes FAQ
• The IVR User Guide and Flowchart have been revised
  
• New and Updated Frequently Asked Questions (FAQs) are now available
  

23 April 2008

• Medicare Shared Systems Modifications Necessary to Accept and Crossover to Medicaid National Drug Codes (NDC) and Corresponding Quantities Submitted on CMS-1500 Paper Claims (MM5835)
  

17 April 2008

• CR 5550 Clarification - Signature Requirements (MM5971)
  
• The CMS Online Manual System: A Web-based Manual System for Medicare Contractors, Providers and State Agencies brochure
  
• CMS Medicare News - Week Ending April 11, 2008
  
• Presentation handouts for the DME MAC A Spring 2008 Educational In-Person Seminars have been posted
  
• Billing Reminder: Item 24E on CMS-1500 Claim Form or Electronic Equivalent
  
• Oral Anticancer Drug Policy Clarification
  
• There are 2 new Medical Review Bulletins:
  
  • Nebulizers - Brovana and Perforomist - Instructions for New HCPCS Codes, April 2008
  • Knee Orthoses - New Policy Summary
• The following Fee Schedules have been added or revised:
  
  • There are no April Updates to the 2008 Jurisdiction A DME MAC Fee Schedule
  • April 2008 Quarterly Average Sales Price Medicare Part B Drug Pricing File
  • 2nd Quarter 2008 Oral Anticancer Drug Fees

11 April 2008

• CMS Medicare News - Week Ending April 04, 2008
  
• Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: Grandfathering, Repair and Replacement, Mail Order Diabetic Supplies and Advanced Beneficiary Notices (ABNs) - The second in a series of articles on the new DMEPOS competitive bidding program (SE0806)
  
• Pre-Bidding Activities for the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (SE0811)
  
• National Provider Identifier (NPI): Understanding the Readiness of Other Health Plans, Steps to Facilitate a Smooth Transition to NPI-Only Medicare Billing & More! (CMS Message 2008-04-04)
  
• Incorrect Allowable for Billing Labor (E1340)
  
• Updated Healthcare Provider Taxonomy Code (HPTC) List Codes Effective April 1, 2008 (CR5951)
  
• 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 website at www.cms.hhs.gov/HCPCSReleaseCodeSets/02_HCPCS_Quarterly_Update.asp. Changes are effective on the date indicated on the update.
  

10 April 2008

• A new Medical Review Bulletin has been posted: Nebulizers - Policy Revisions
  
• The Nebulizers Local Coverage Determination (LCD) has been revised
  

04 April 2008

• DME MAC Express Plus Upgrade for CEDI
  
• Nebulizers - HCPCS Code Changes
  
• Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Accreditation 101: Audio Conference/ Q&A Session (CMS Message 2008-04-02)
  
• Attention All Providers: Reduce Duplicate Denials
  
• April 2008 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files (MM5982)
  
• Overview of New Medicare Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) - The first in a series of articles on the implementation of this program (SE0805)
  
• Announcing the Release of the Revised CMS-855 Medicare Enrollment Applications (SE0810)
  

March

28 March 2008

• Effective April 1, 2008 - New IVR and Direct Customer Service Access
• CMS Medicare News - Week Ending March 21, 2008
• National Provider Identifier (NPI): May 23rd is Only Two Months Away, Be Prepared! (CMS Message 2008-03-21)
• DME MAC A Supplier Manual - All Chapters have been revised and a new Medical Review chapter 12 was added
• CMS has announced the single payment amounts for Round 1 of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program. Visit the CMS web site at http://www.cms.hhs.gov/CompetitiveAcqforDMEPOS/ to view additional information. To view the Press Release, please click: http://www.cms.hhs.gov/apps/media/press_releases.asp

21 March 2008

• CMS Medicare News - Week Ending March 14, 2008
• Time To Get Accredited For DMEPOS Competitive Bidding (CMS Message 2008-03-17)
• Process Change for Invalid Beneficiary Identifying Information
• Telephone Reopenings Process Improvement & Telephone Number Change
• March is National Colorectal Cancer Awareness Month (CMS Message 2008-03-18)
• Incorrect Denials on Claims for Dispensing Fee Codes G0333 and Q0513
• DME MAC Electronic Trading Partners Must Transition to CEDI Soon
• Additional Clarification to Chapter 17, Section 40, Regarding Processing of Drug Claims with the JW Modifier (MM5923)
• The following Local Coverage Determinations (LCDs) have been added or revised:
  • Ankle-Foot/Knee-Ankle-Foot-Orthosis
  • Cervical Traction Devices
  • Continuous Positive Airway Pressure System (CPAP)
  • Enteral Nutrition
  • External Infusion Pumps
  • Glucose Monitors
  • Hospital Beds and Accessories
  • Intravenous Immune Globulin
  • Knee Orthoses
  • Oral Anticancer Drugs
  • Orthopedic Footwear
  • Ostomy Supplies
  • Oxygen and Oxygen Equipment
  • Patient Lifts
  • Power Mobility Devices
  • Respiratory Assist Devices
  • Surgical Dressings
  • Urological Supplies
  • Wheelchair Options and Accessories
  • Wheelchair Seating
• There are 4 new Medical Review Bulletins:
  • LCD and Policy Article Revisions - Summary for March 2008
  • Continuous Passive Motion Machine Coding Guidelines
  • Intravenous Immune Globulin - New Policy
  • Knee Orthoses - New Policy

18 March 2008

• Finalized schedule for Spring 2008 Educational In-Person Seminars
• New Interactive Voice Response Application - User Guide

14 March 2008

• DME MAC Jurisdiction A Resource Number 7 - March 2008 is now available
• Clarification of CMS-1500 Claim Form - Item 25 (or electronic equivalent)
• Coming in April - New Interactive Voice Response Application
• Opportunity to Participate in Third Annual Medicare Contractor Provider Satisfaction Survey (MCPSS) Ends in April (SE0804)
• Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update (MM5942)
• The article Importance of Supplying Correct Provider Identification Information Required in Items 17, 17a, 24K, and 33 of the Form CMS-1500 (12-90), and the Electronic Equivalent has been revised. (SE0529)

7 March 2008

• NPI Implementation - Key Date Reminder
• Clarification of CMS-1500 Claim Form - Items 24I and 24J (or electronic equivalent)
• NPI March 1st Milestone (CMS Message 2008-02-29)
• CMS Medicare News - Week Ending February 29, 2008
• Claim Status Category Code and Claim Status Code Update (MM5947)
• Additional Information on Reporting a National Provider Identifier (NPI) for Ordering/Referring and Attending/Operating/Other/Service facility for Medicare Claims (MM5890)
• The Winter 2008 Pulse of CMS is now available.
• The Common Electronic Data Interchange (CEDI) Testing Status and Important Transition Updates
• The Medicare Appeals Process: Five Levels to Protect Providers, Physicians and Other Suppliers brochure has been updated and is now available to order print copies or as a downloadable PDF file. To view the PDF file, go to http://www.cms.hhs.gov/MLNProducts/downloads/MedicareAppealsProcess.pdf or to order hard copies, please visit the MLN Product Ordering Page at http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident=kc0001&loc=5 on the CMS website.

February

29 February 2008

• Change in the Amount in Controversy Requirement for Administrative Law Judge Hearings and Federal District Court Appeals (MM5897)
• Items and Special Services Having Special DME Review Considerations (MM5909)
• Adjudicating Claims for Immunosuppressive Drugs When Medicare Did Not Pay for the Original Transplant (MM5916)
• The Centers for Medicare & Medicaid Services (CMS) has reposted the recent scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set to incorporate new changes. The revised update has been posted to the HCPCS website at http://www.cms.hhs.gov/HCPCSReleaseCodeSets/02_HCPCS_Quarterly_Update.asp

22 February 2008

• Upcoming Critical Dates for Medicare’s Fee-for-Service (FFS) Implementation of the National Provider Identifier (NPI) (SE0802)
• New "K" Code for Replacement Interface Material (MM5900)
• The article Reporting of Hematocrit or Hemoglobin Levels on All Claims for the Administration of Erythropoiesis Stimulating Agents (ESAs), Implementation of New Modifiers for Non-ESRD ESA Indications, and Reporting of Hematocrit or Hemoglobin Levels on all Non-ESRD, Non-ESA Claims Requesting Payment for Anti-Anemia Drugs (MM5699) has been revised
• NPI: NPPES Info for Organization Providers, Importance of "Complete" Medicare Enrollment Applications & a New MLN Matters Article (CMS Message 2008-02-15)

15 February 2008

• The article Medicare’s Implementation of the National Provider Identifier (NPI): The Second in the Series of Special Edition MLN Matters Articles on NPI-Related Activities (SE0555) has been rescinded
• Common Electronic Data Interchange Web Site Available and Other Important CEDI Transition Information
• March ACT Call Information Updated
• CMS Medicare News - Week Ending February 01, 2008
• CMS Medicare News - Week Ending February 08, 2008
• Notification of Favorable Redetermination Decisions

8 February 2008

• Medicare Fee for Service Legacy Provider IDs Prohibited on Form CMS-1500 Claims after NPI Required Date (MM5858)
  
• Support Income Tax Reporting (MM5816)
  
• The article Clarification Regarding the Coordination of Benefits Agreement (COBA) Medigap Claim-based Crossover Process (MM5837) has been revised.
  
• Revised 2008 Durable Medical Equipment Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule Files - Correction (JSM 08165)
  
• New Medicare Learning Network Product: "Guided Pathways to Medicare Resources for Medicare Fee-for-Service Health Care Professionals" (CMS Message 2008-01-31)
  
• February is American Heart Month (CMS Message 2008-02-04)
  
• NPI: Attention Fee-for-Service (FFS) Medicare Physicians, Non-Physician Practitioners & Other Suppliers! (CMS Message 2008-01-30)
  

1 February 2008

• COBA List on CMS Web Site (CR 5837)
  
• Clarification Regarding the Coordination of Benefits Agreement (COBA) Medigap Claim-based Crossover Process (MM5837)
  
• NPI: Enforcement of the Compliance Date, Clarifying Medicare's Key Implementation Dates, Testing Medicare Claims & More! (CMS Message 2008-01-25)
  
• Notice of Revision to the American National Standards Institute (ANSI) X12N 837 Professional Health Care Claim Companion Document (JSM08070)
  
• Healthcare Common Procedure Coding System (HCPCS) Update (CMS Message 2008-01-29)
  

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05/09/2008