The CMS Quarterly Provider Update
October 2004
Instructions
Released Last Quarter
INSTRUCTIONS
|
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Medicare Benefit Policy Manual (Pub. 100-02)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 12 (PDF - 95 KB) |
Chiropractic Billing | 10/04/2004 |
| 17 (PDF - 69 KB) |
Incident-To Services on Form CMS-1500 | 10/04/2004 |
| 19 (PDF - 47 KB) |
Hospital Services Covered Under Part B | 10/12/2004 |
Medicare Claims Processing Manual (Pub. 100-04)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 95 (PDF - 244 KB) |
Elimination of the 90-Day Grace Period for ICD-9-CM Codes | 10/04/2004 |
| 144 (PDF - 67 KB) |
Critical Access Hospital (CAH) Distinct Part Units | 10/04/2004 |
| 146 (PDF - 103 KB) |
Clarification of IV Drug Administration to ESRD Beneficiairies | 10/04/2004 |
| 149 (PDF - 1.7 MB) |
Update to the Claims Processing Manual, Chapter 25, Section 60 | 10/04/2004 |
| 152 (PDF - 356 KB) |
Inclusion of Core-Based Statistical Area (CBSA) Data Elements to the Provider Specific Files | 10/04/2004 |
| 155 (PDF - 999 KB) |
Implementation of the Analysis and Design Phases of the HPSA | 10/04/2004 |
| 156 (PDF - 219 KB) |
Clarification of Payments and Billing Procedures for Hospitals Subject to the Maryland Waiver | 10/04/2004 |
| 157 (PDF - 999 KB) |
Implementation of the Analysis and Design Phases of the Physician Scarcity Bonus | 10/04/2004 |
| 160 (PDF - 81 KB) |
Section 511 of the MMA Act of 2003 Special Adjustment for SNF PPS Rates for AIDS | 10/04/2004 |
| 163 (PDF - 80 KB) |
Ambulance & SNF | 10/04/2004 |
| 165 (PDF - 73 KB) |
Enhancement to HH Conslidated Billing Edits | 10/04/2004 |
| 166 (PDF - 42 KB) |
DMERCs Remittance on-Off Switch for Unassigned Claims | 10/04/2004 |
| 167 (PDF - 3.1 MB) |
Discontinued Use of Revenue Code 0910 | 10/04/2004 |
| 175 (PDF - 89 KB) |
(HIPAA) X12N 837 (IG) ICD-9 Procedure Codes, Value Codes, Occurrence Codes, Occurrence Span Codes, and Direct Data Entry (DDE) | 10/04/2004 |
| 176 (PDF - 55 KB) |
Instructions for Downloading the Medicare Zip File | 10/04/2004 |
| 185 (PDF - 71 KB) |
Change to the CWF SNF Consoliated Billing (CB) Edits for Drugs Administered During an Ambulance Transport | 10/04/2004 |
| 190 (PDF - 74 KB) |
End Stage Renal Disease Reimbursement for Automatic Mult-Channel Chemistry (AAMC) Test | 10/04/2004 |
| 197 (PDF - 74 KB) |
Emergency Hospital Outpatient billing of Epotein Alfa and Dabepoetin Alfa (Aranesp) | 10/04/2004 |
| 199 (PDF - 215 KB) |
Medicare Need for a Specific Line Item Date of Service (LIDOS) for Each Revenue Code on ALL Outpatient Claims | 10/04/2004 |
| 200 (PDF - 83 KB) |
Update to CWF Edits for SNF Consolidated Billing to Expand the Bypass for Pharmacy Services | 10/04/2004 |
| 210 (PDF - 2.4 MB) |
Medicare Contractor Annual Update of the International Classification of Diseases | 10/04/2004 |
| 222 (PDF - 50 KB) |
SNF CB Requirements for DMEPOS | N/A |
| 224 (PDF - 94 KB) |
October Quarterly Update to 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing Enforcement | 10/04/2004 |
| 225 (PDF - 88 KB) |
Changes to the Laboratory National Coverage Determination (NCD)Edit Software for October 2004 | 10/04/2004 |
| 226 (PDF - 87 KB) |
Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement | 10/04/2004 |
| 242 (PDF - 64 KB) |
Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.3, Effective October 1, 2004. | 10/04/2004 |
| 254 (PDF - 238 KB) |
October 2004 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 5.3 | 10/04/2004 |
| 255 (PDF - 73 KB) |
October Update to the Medicare Outpatient Code Editor (OCE) Version 20.0 for Bills From Hospitals that are not Paid Under the Outpatient Prospective Payment System (OPPS) | 10/04/2004 |
| 258 (PDF - 118 KB) |
New Waived Tests - October 1, 2004 | 10/04/2004 |
| 263 (PDF - 70 KB) |
Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2005 | 10/04/2004 |
| 264 (PDF - 86 KB) |
Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2005 | 10/04/2004 |
| 268 (PDF - 58 KB) |
Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2005 | 10/04/2004 |
| 271 (PDF - 91 KB) |
Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2005 | 10/04/2004 |
| 272 (PDF - 58 KB) |
October Quarterly Update For 2004 | 08/10/2004 |
| 275 (PDF - 63 KB) |
The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2003 for Inpatient Prospective Payment System (IPPS) Hospitals | 10/04/2004 |
| 278 (PDF - 118 KB) |
3rd Update to the 2004 Medicare Physician Fee Schedule Database | 10/04/2004 |
| 288 (PDF - 68 KB) |
Fiscal Year (FY) 2005 Payment for Services Furnished in Ambulatory Surgical Centers (ASCs) | 10/01/2004 |
| 299 (PDF - 89 KB) |
Use of Condition Code 44, "Inpatient Admission Changed to Outpatient" | 10/12/2004 |
Medicare Secondary Payer Manual (Pub. 100-05)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 15 (PDF - 96 KB) |
Interest on MSP Recovery Claims | 10/04/2004 |
| 18 (PDF - 86 KB) |
Application of the Medicare Secondary Payer for the Working Aged Provision and the Medicare Secondary for the Disabled Provision to Former Spouses and Certain Family Members with Coverage Under the Federal Employees Health Benefits (FEHB) Program | 11/29/2004 |
Medicare Financial Management Manual (Pub. 100-06)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 41 (PDF - 212 KB) |
Change in Interest for MSP Overpayments | 10/04/2004 |
| 49 (PDF - 131 KB) |
Procedures For Re-Issuance and Stale Dating of Medicare Checks | 08/16/2004 |
| 51 (PDF - 13 KB) |
Notice of New Interest Rate for Medicare Overpatments and Underpatyments | 08/09/2004 |
| 52 (PDF - 67 KB) |
Notice of New Interest Rate for Medicare Overpatments and Underpatyments | 08/09/2004 |
Medicare Managed Care Manual (Pub. 100-16)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 56 (PDF - 61 KB) |
Chapter 11 | N/A |
| 61 (PDF - 322 KB) |
Emergency and Urgently Needed Services | N/A |
Demonstrations (Pub. 100-19)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 1 (PDF - 24 KB) |
Virginia Cardiac Surgery Initiative Demonstration - M9odifications & Corrections to CR 2382 | 10/04/2004 |
| 3 (PDF - 107 KB) |
Demonstration Project to Clairfy the Definition of Homebound | 10/04/2004 |
| 4 (PDF - 78 KB) |
Use of Group Health Plan Payment System to Pay Capitated Payments to Non Health Plan Demonstrations Serving Medicare Fee For Service Beneficiaries | 10/04/2004 |
One-Time Notification (Pub. 100-20)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 84 (PDF - 57 KB) |
Reporting Medicare Secondary Payer (MSP) Information on the Health Insurance Protability and Accountability Act of 1996 X12N 83 | 10/04/2004 |
| 109 (PDF - 30 KB) |
CWF Analysis to Process Claims Per the Renovated Override Code Billing Instructions for ADVATE rAHF-PFM on Medicare Claims | 09/27/2004 |
| 112 (PDF - 80 KB) |
Billing Instructions for ADVATE rAHF-PFM on Medicare Claims | 09/27/2004 |
MANUALIZATIONS/CORRECTIONS/CLARIFICATIONS |
Medicare Provider Reimbursement Manual, Part 2 (Pub. 15-2)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 6 (PDF - 51 KB) |
For Cost Reporting Periods End On or After March 31, 2002 | N/A |
Medicare Benefit Policy Manual(Pub. 100-02)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 18 (PDF - 138 KB) |
Revised Requirements for Chiropractic Billing of Active/Corrective Treatment and Maintenance Therapy. Full Replacement of CR 3063 | 10/04/2004 |
| 21 (PDF - 224 KB) |
Medicare Comprehensive Outpatient Rehabilitation Facility Coverage | 10/25/2004 |
Medicare National Coverage Determinations Manual(Pub. 100-03)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 19 (PDF - 30 KB) |
Blood-Derived Products for Chronic Non-Healing Wounds | 07/23/2004 |
Medicare Claims Processing Manual (Pub. 100-04)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 228 (PDF - 96 KB) |
General Policy | 08/16/2004 |
| 229 (PDF - 164 KB) |
Additional Clarification of Bill Types 22x and 23x Submitted by Skilled Nursing Facilities (SNFs) With Instructions for Involuntarily Moving a Beneficiary Out of the SNF and Ending a Benefit Period | 8/19/2004 |
| 234 (PDF - 70 KB) |
Standardized Responses to Provider Inquiries Regarding the Negotiated Laboratory National Coverage Determinations (NCDs) Edit Software | 10/04/2004 |
| 273 (PDF - 57 KB) |
Modification of CMS's Medicare Contingency Plan for HIPAA Implementation | 07/06/2004 |
| 274 (PDF - 45 KB) |
Good Cause Waiver of Late Claim Filing Payment Reduction Penalty | 09/14/2004 |
| 282 (PDF - 47 KB) |
Good Cause Waiver of Late Claim Filing Payment Reduction Penalty | 09/14/2004 |
| 284 (PDF - 64 KB) |
DMERCs Only-Appeals of Duplicate Claims | 09/27/2004 |
| 295 (PDF - 100 KB) |
MSN Messages and Reason Codes for Mammography | N/A |
| 298 (PDF - 79 KB) |
MSN and ANSI Messages for Mammography Claims | 09/25/2004 |
| 300 (PDF - 92 KB) |
Payment For Outpatient End Stage Renal Disease (ESRD)-Related Services | 10/18/2004 |
| 302 (PDF - 108 KB) |
Nursing Facility Visits (Codes 99301 -99313) | 10/25/2004 |
| 304 (PDF - 171 KB) |
Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit | 10/25/2004 |
Medicare Secondary Payer Manual (Pub. 100-05)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 17 (PDF - 71 KB) |
Clarification of CR 3064 | 08/16/2004 |
| 19 (PDF - 82 KB) |
Clarification of MSP Rules in Relation to a Temporary Leave of Absence | 10/25/2004 |
State Operations Provider Certification Manual(Pub. 100-07)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 2 (PDF - 83 KB) |
Provider Identification Numbers | N/A |
Medicare Managed Care Manual(Pub. 100-16)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 57 (PDF - 47 KB) |
Chapter 7 Revisions | N/A |
| 58 (PDF - 42 KB) |
Chapter 5 Revisions | N/A |
| 59 (PDF - 66 KB) |
Chapter 2 | N/A |
| 60 (PDF - 363 KB) |
Chapter 3 | N/A |
| 62 (PDF - 275 KB) |
Revisions to Chapter 13 - Medicare+Choice Beneficiary Grievances, Organization Determinations and Appeals | N/A |
One-Time Notification (Pub. 100-20)
| TRANSMITTAL NUMBER |
SUBJECT | IMPLEMENTATION DATE |
|---|---|---|
| 93 (PDF - 59 KB) |
Temporary SNF Extension | 07/09/2004 |
| 106 (PDF - 74 KB) |
MMA Drug Pricing Update - Payment Limit Update for J9045 (Carboplatin injection) | 09/24/2004 |
| 116 (PDF - 82 KB) |
Notification of Medlearn Matters (MM) Article for Confidential Change Request (CR) 3301 | N/A |
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Return to The October 2004 CMS Quarterly Provider Update Table of Contents
Centers for Medicare & Medicaid Services