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Medicare MAC News
Week of November 9th to 16th
Jump to your News!
Palmetto GBA
CGS
Noridian
WPS
NGS
Novitas
First Coast
Palmetto GBA
Home Health & Hospice
November 10 - Internet Only Manual Update, Pub. 100-04, Chapter 11 - This Change Request (CR) Rescinds and Fully Replaces CR 11807
November 10 - Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)
November 10 - Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2021
November 10 - Manual Updates Related to the Hospice Election Statement and the Implementation of the Election Statement Addendum
November 10 - Manual Updates Related to the Hospice Election Statement and the Implementation of the Election Statement Addendum
JJ Part A
November 10 - Implementation of Changes in the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Dialysis Furnished for Acute Kidney Injury (AKI) in ESRD Facilities for Calendar Year (CY) 2021
November 10 - Updates to Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) Claims
JJ Part B
See above section, nothing new to report
JJ Part B
See above section, nothing new to report
JM Part A
See above section, nothing new to report
JM Part B
See above section, nothing new to report
Palmetto National Supplier Clearinghouse MAC
November 11 - 2020 Licensure Updates
Top
CGS
Home Health & Hospice
November 10 - Hospice End of Life (EOL) Service Intensity Add-on (SIA) Payment
November 10 - Top Claim Submission Errors: Duplicate Claims and Requests for Anticipated Payment (RAPs)
November 10 - Clarification to the New Eligibility From and Through Date Fields
November 11 - CMS Takes Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment
November 12 - Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2021
November 12 - Manual Updates Related to the Hospice Election Statement and the Implementation of the Election Statement Addendum
November 13 - COVID-19 Vaccine Codes and PC-ACE Software Update
J15 Part A
November 12 - International Classification of Diseases, 10th Revision (ICD10) and Other Coding Revisions to National Coverage Determination (NCDs)--April 2021
J15 Part B
See above section, nothing new to report
JC DME
November 11 - Claim Payment Alert—Claims Processed with Incorrect MUE Values – UPDATED 11/11/2020
November 12 - Billing of Powered L-Coded Items – Correct Coding – Revised
November 12 - L1690 PREFABRICATED BILATERAL LUMBO-SACRAL HIP ORTHOSIS – Correct Coding
November 12 - L1005 – Tension Based Scolosis Orthosis and Accessory Pads, Includes Fitting and Adjustment – Correct Coding
November 12 - L1005 – Tension Based Scolosis Orthosis and Accessory Pads, Includes Fitting and Adjustment – Correct Coding
November 12 - Dear Physician – CERT Enteral Nutrition
November 12 - Incorrect Use of HCPCS Codes for Custom Fit Orthotics
JB DME
See above section, nothing new to report
Top
Noridian
General news
Nothing new to report
JE Part A
November 10 - Patient Status Codes Page Updated
November 10 - Updates to SNF PDPM Claims
November 10 - Implementation of Changes in the ESRD PPS and Payment for Dialysis Furnished for AKI in ESRD Facilities for CY 2021
November 10 - Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) - Revised
November 12 - Long Term Care Hospital (LTCH) Webinar - December 17, 2020
November 12 - Comprehensive Outpatient Rehabilitation Facility (CORF) Services Webinar - December 15, 2020
November 12 - Transurethral Waterjet Ablation of the Prostate Final Local Coverage Determination (LCD); Billing and Coding: Transurethral Waterjet Ablation of the Prostate Final Local Coverage Article (LCA) - Effective December 27, 2020
November 12 - Quarterly Medicare Updates - A/B Webinars
November 12 - Provider-Based Billing Webinar - December 15, 2020
November 12 - Billing and Coding: MolDX: CYP2C9 and/or VKORC1 Gene Testing for Warfarin Response Retirement - Effective November 04, 2020
November 12 - Billing and Coding: MolDX: CYP2B6 Test Retirement - Effective November 04, 2020
November 12 - Billing and Coding: UGT1A1 Gene Analysis Retirement - Effective November 04, 2020
November 12 - Billing and Coding: MolDX: SLCO1B1 Genotype Retirement - Effective November 04, 2020
November 12 - Billing and Coding: MolDX: IHC Indications for Breast Pathology - R1
November 12 - Billing and Coding: MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels - R10
November 12 - Billing and Coding: Serum Magnesium - R2
JE Part B
See above section, nothing new to report
JF Part A
See above section, nothing new to report
JF Part B
See above section, nothing new to report
JA DME
November 10 - Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) - Revised
November 10 - Knee Orthoses Webinar - December 10, 2020
November 10 - DME Basics-Background Knowledge Webinar - November 24, 2020
November 10 - Competitive Bid Round 2021 Webinar - November 25, 2020
November 12 - Nationwide Expansion of the Condition of Payment Prior Authorization Program for Lower Limb Prosthetics
November 12 - L1005 - Tension Based Scoliosis Orthosis And Accessory Pads, Includes Fitting And Adjustment - Correct Coding
November 12 - Incorrect Use of HCPCS Codes for Custom Fit Orthotics
November 12 - L1690 Prefabricated Bilateral Lumbo-sacral Hip Orthosis - Correct Coding
November 12 - Billing of Powered L-Coded Items - Correct Coding - Revised
November 13 - MLN Connects Special Edition - November 12, 2020 - COVID-19 Vaccine Codes and PC-ACE Software Update
JD DME
See above section, nothing new to report
Top
Wisconsin Physicians Service Government Health Administrators (WPS)
J5 Part A
Nothing new to report
J5 Part B
Nothing new to report
J8 Part A
Nothing new to report
J8 Part B
Nothing new to report
Top
NGS
J6 Home Health
Nothing new to report
J6 Part A
November 13 - REMINDER: ANNUAL MANDATORY DEADLINE FOR SUBMITTING LOW-VOLUME ESRD FACILITY ADJUSTMENT REQUESTS FOR CY 2021 ARE DUE BY 12/31/2020
J6 Part B
Nothing new to report
JK Home Health
Nothing new to report
JK Part A
Nothing new to report
JK Part B
Nothing new to report
Top
Novitas
JL Part A
November 12 - Billing and Coding: Urodynamic Services - Non-invasive (A58541)
November 12 - Billing and Coding: Thrombolytic Agents (A55237)
November 12 - Treatment of Chronic Venous Insufficiency of the Lower Extremities (A58378)
November 12 - Transurethral Waterjet Ablation of the Prostate (A58377)
November 12 - Response to Comments: Endovenous Stenting (A58394)
November 12 - Endovenous Stenting (L37893)
November 12 - Billing and Coding: Treatment of Chronic Venous Insufficiency of the Lower Extremities (A55229)
November 12 - Treatment of Chronic Venous Insufficiency of the Lower Extremities (L34924)
November 12 - Billing and Coding: Transurethral Waterjet Ablation of the Prostate (A58243)
November 12 - Transurethral Waterjet Ablation of the Prostate (L38712)
JL Part B
See above section, nothing new to report
JH Part A
See above section, nothing new to report
JH Part B
See above section, nothing new to report
Top
First Coast
JN Part A
Nothing new to report
JN Part B
Nothing new to report