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Medicare & Medicaid
Future Internet-Only Manual Updates

These issuances are future updates to the manuals based on the implementation date.  This update includes revisions communicated through March 19, 2004.  The specific sections in the manuals will be updated to reflect these changes on the implementation date.

Table of Contents

FILE	COMM DATE	PUB NO	SUBJECT	IMPL DATE	CR NUM
January-March 2004 Updates
R108CP (247 kb)	02/27/2004	100-04	Type of Service Corrections, Chapter 26, Section 10.7  CR 3018	03/29/2004	3018
R110CP (241 kb)	02/27/2004	100-04	New Requirement for Payment of Drugs  CR 3078	03/29/2004	3078
R11MSP (303 kb)	02/27/2004	100-05	MSP Policy for Certain Services  CR 3064	03/29/2004	3064
April-June 2004 Updates
R7BP (139 kb)	03/05/2004	100-02	Policy Changes to Reflect Billing for Darbepoetin Alfa and Epoetin	04/01/2004	3119
R8NCD (279 kb)	03/19/2004	100-03	Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT)	04/01/2004	2988
R13CP (119 kb) R13CP1 (99 kb) R13CP2 (139 kb)	10/31/2003	100-04	Adjustments of Episode Payment-Confirming OASIS Assessment Items, Adjustment of Episode Payment-Therapy Threshold, Adjustment of Episode Payment-Hospitalization Within 14 Days of Start of Care Attachment: Business Requirements Attachment: Manual Instruction-Chapter 10	04/01/2004	2928
R23CP (221 kb) R23CP1 (127 kb) R23CP2 (171 kb)	10/31/2003	100-04	Carriers Standard Systems would price the payment of referred services Attachment: Business Requirements Attachment: Manual Instruction-Chapter 16	04/01/2004	2193
R25CP (112 kb) R25CP1 (131 kb) R25CP2 (82 kb) R25CP3 (209 kb) R25CP4 (239 kb) R25CP5 (141 kb)	10/31/2003	100-04	Billing Non-Covered Charges to Fiscal Intermediaries - Summary and New Instructions Attachment: Business Requirements Attachment A Attachment B Attachment: Manual Instruction-Chapter 1 Manual Instruction-Chapter 10	04/01/2004	2634
R101CP (258 kb)	02/20/2004	100-04	Restoring Composite Rate Exceptions for Pediatric Facilities	04/01/2004	3119
R121CP (537 kb)	03/19/2004	100-04	Manualization of Place of Service Code Set Program Memorandum Revision to Group Home Code Description	04/01/2004	3087
R2MSP	10/17/2003	100-05	CONFIDENTIAL	04/01/2004	2252
R66PI (261 kb)	02/20/2004	100-08	Progressive Corrective Action Program Memorandum and Providing Updated Instructions on How Contractors Must Identify, Verify, and Correct Billing Errors	04/02/2004	3124
R6BP (264 kb)	01/23/2004	100-02	Intravenous Immune Globulin	04/05/2004	3059
R15CP (283 kb)	10/31/2003	100-04	Implementation Guide Edits	04/05/2004	2819
R16CP (119 kb) R16CP1 (127 kb) R16CP2 (56 kb)	10/31/2003	100-04	Payment Limit for Purchased Services Attachment: Business Requirements Attachment: Manual Instruction	04/05/2004	2919
R17CP (104 kb) R17CP1 (92 kb) R17CP2 (97 kb)	10/31/2003	100-04	Correct Payments to terminated home health agencies under the Home Health Payment System Attachment: Business Requirements Attachment: Manual Instruction-Chapter 10	04/05/2004	2927
R28CP (245 kb)	11/07/2003	100-04	Consolidation of the Claims Crossover Process & the Adding of CWF Crossover Disposition Indicators	04/05/2004	2962
R49CP (248 kb)	12/19/2003	100-04	HIPAA X12N 837 Health Care Claim Transaction Must be rejected by the FI	04/05/2004	2879
R50CP (271 kb)	12/19/2003	100-04	New K Codes	04/05/2004	2967
R57CP (292 kb)	01/02/2004	100-04	Implementation of the HIPAA Interchange Control Header	04/05/2004	3001
R58CP (241 kb)	01/02/2004	100-04	April Quarterly DMEPOS Fee Schedule Update	04/05/2004	3014
R63CP (303 kb)	01/16/2004	100-04	Chapter 4, Section(s) 250, 250.1 250.2 and 250.6	04/05/2004	3051
R66CP (232 kb)	01/16/2004	100-04	Quarterly Update to Correct Coding Initiative Edits, Version 10.1, Effective April 1, 2004	04/05/2004	2997
R67CP (280 kb)	01/16/2004	100-04	Coding/Testing Phases of CR 2631	04/05/2004	3039
R68CP (270 kb)	01/16/2004	100-04	Chapter 3, Section(s) 30.1, 30.1.1	04/05/2004	3052
R71CP (322 kb)	01/23/2004	100-04	Changes to the Laboratory National Coverage Determination Edit Software	04/05/2004	3032 & 3072
R74CP (253 kb)	01/23/2004	100-04	Intravenous Immune Globulin	04/05/2004	3060
R92CP (366 kb)	02/06/2004	100-04	Apr. Qtrly Update to Jan. 2004 Annual Update of HCPCS Codes Used for SNF Consolidated Billing Enforcement	04/05/2004	3070
R93CP (171 kb)	02/06/2004	100-04	Reason Codes	04/05/2004	3122
R102CP (94 kb)	02/20/2004	100-04	New CLIA Waived Tests - April 1, 2004	04/05/2004	3061
R104CP (247 kb)	02/20/2004	100-04	DMERCS & VIPS & NCD #s	04/05/2004	3141
R105CP (258 kb)	02/20/2004	100-04	First Update to the 2004 Medicare Physician Fee Schedule Database	04/05/2004	3128
R109CP (318 kb)	02/27/2004	100-04	Updated Policy and Claims Processing Instructions for ABPM CR 2726	04/05/2004	2726
R112CP (263 kb)	02/27/2004	100-04	04/04 Changes to OPPS CR 3144	04/05/2004	3144
R113CP (192 kb)	02/27/2004	100-04	Claims Requiring Adjustment as a Result of April 2004 Changes to the OPPS CR 3145	04/05/2004	3145
R116CP (293 kb)	03/05/2004	100-04	ESRD Miscellaneous Code Processing Clarification	04/05/2004	3019
R117CP (199 kb)	03/05/2004	100-04	Instructions for downloading the Medicare zip code file	04/05/2004	3160
R118CP (537 kb)	03/05/2004	100-04	Policy Changes to Reflect Billing for Darbepoetin Alfa and Epoetin	04/05/2004	2984
R119CP (183 kb)	03/19/2004	100-04	MMA Drug Pricing Update-Drug Exceptions	04/05/2004	3161
R120CP (255 kb)	03/19/2004	100-04	January Medicare OCE Specifications  Version 19.1R1	04/05/2004	3155
R24FM (81 kb)	10/31/2004	100-06	Update of the Provider Statistical and Reimbursement Reporting System for Version 32.0	04/05/2004	2953
R53PI (105 kb) R53PI1 (107 kb) R53PI2 (134 kb) R53PI3 (74 kb)	10/31/2003	100-08	Prepayment Edits Attachment: Business Requirements Attachment: Manual Instruction-Chapter 3 Attachment: CR 2916 Qs&As;	04/05/2004	2916
R54PI (105 kb) R54PI1 (107 kb) R54PI2 (100 kb)	10/31/2003	100-08	Denials Attachment: Business Requirements Attachment: Manual Instruction	04/05/2004	2936
R62PI (166 kb)	01/23/2004	100-08	FMR Report	04/05/2004	3062
R4COM (862 kb)	03/05/2004	100-09	Provider/Supplier Communications	04/05/2004	3118
R4SS (5683 kb)	03/05/2004	100-17	Federal Laws	04/05/2004	3106
R13MSP (2996 kb)	03/19/2004	100-05	Update to the ECRS User Guide v7.0 and Quick Reference Card v7.0	04/19/04	3174
R5ESRD (493 kb)	03/12/2004	100-14	Chapter 4 - Information Management	04/26/2004	n/a
R6ESRD (237 kb)	03/12/2004	100-14	Chapter 6 - Community Information and Resources	04/26/2004	n/a
R7ESRD (635 kb)	03/12/2004	100-14	Chapter 7 - Sanctions and ESRD Complaints and Grievances	04/26/2004	n/a
July-September 2004 Updates
R103CP (272 kb)	02/20/2004	100-04	Chapter 4, Section 250.2, Optional Method for Outpatient Services: Cost-Based Facility Services Plus 115 Percent	07/01/2004	3114
R88CP (507 kb)	02/06/2004	100-04	Implementation of Changes to Payment for Ambulance Services Required by Section 414 of MMA	07/05/2004	3099
R37FM (187 kb)	03/19/2004	100-06	Update of the PS&R Reporting System	07/05/2004	3131
R7NCD (184 kb)	03/19/2004	100-03	Electrical Stimulation and Electromagnetic Therapy for the Treatment of Wounds	07/06/2004	3149
R78CP (329 kb)	02/06/2004	100-04	Medicare Incentive Payments for Physician Care	07/06/2004	3108
R79CP (299 kb)	02/06/2004	100-04	ESRD Reimbursement for AMCC Tests	07/06/2004	2813
R80CP (332 kb)	02/06/2004	100-04	Extend Medicare Coverage for Certain Colorectal Cancer Screenings at SNF	07/06/2004	2874
R81CP (2141 kb)	02/06/2004	100-04	Update of UB-92 Codes	07/06/2004	3012
R82CP (341 kb)	02/06/2004	100-04	ESRD Data for Use In Adjudicating Claims	07/06/2004	3066
R83CP (225 kb)	02/06/2004	100-04	New "K" Codes for Wheelchair Cushions	07/06/2004	3069
R84CP (238 kb)	02/06/2004	100-04	Chapter 24, Section 40.7.3	07/06/2004	3095
R85CP (472 kb)	02/06/2004	100-04	Processing of Claims for Referred Services for a Independent Clinical Diagnostic Laboratory	07/06/2004	3090
R86CP (267 kb)	02/06/2004	100-04	Health Insurance Portability and Accountability Act (HIPAA) X12N837 Professional II	07/06/2004	3050
R87CP (284 kb)	02/06/2004	100-04	Expansion of Transfer Policy Under Inpatient Payment Prospective System (IPPS)	07/06/2004	2934
R89CP (362 kb)	02/06/2004	100-04	The Elimination of the 90-day Grace Period for HCPCS Codes	07/06/2004	3093
R90CP (248 kb)	02/06/2004	100-04	Bundled Services for SNF	07/06/2004	2944
R91CP (264 kb)	02/06/2004	100-04	Processing Non-covered HH PPS Charges	07/06/2004	3077
R94CP (368 kb)	02/06/2004	100-04	More Info on MSNs About SNFs	07/06/2004	3098
R97CP (291 kb)	02/06/2004	100-04	Implementation of New Medicare Redetermination Notice	07/06/2004	2620
R98CP (645 kb)	02/06/2004	100-04	Consolidation of the Claims Crossover Process-Additional CWF Functionality	07/06/2004	3109
R99CP (257 kb)	02/09/2004	100-04	HIPAA X12N 837 Coordination of Benefits Gap Fill Additional	07/06/2004	3100
R100CP (257 kb)	02/13/2004	100-04	Outpatient Clinical Laboratory/Tests Furnished by Hospitals With Fewer Than 50 Beds	07/06/2004	3130
R107CP (503 kb)	02/24/2004	100-04	HIPAA X12N 837 Health Care Claim Implementation Guide Editing Additional Instruction CR 3031	07/06/2004	3031
R114CP (347 kb)	02/27/2004	100-04	Changes in Payment Floor Calculation for Claims Submitted Electronically in a non-HIPAA CR 2981	07/06/2004	2981
R115CP (200 kb)	03/05/2004	100-04	DMERCs and VIPS, Processing NDC Number - Clarification to CR 3141	07/06/2004	3148
R7MSP (214 kb)	02/06/2004	100-05	MSP FOR HH PPS	07/06/2004	2954
R8MSP (316 kb)	02/06/2004	100-05	Common Working File MSP Modifications	07/06/2004	2775
R9MSP (276 kb)	02/06/2004	100-05	Converting HIPAA Individual Relation	07/06/2004	3116
R10MSP (160 kb)	02/13/2004	100-05	Update to the Shared Systems to Send the Appropriate Medicare Fee Schedule Amounts to the Updated MSPPAY Software	07/06/2004	2955
R32FM (229 kb)	02/06/2004	100-06	Expanded Identification and Working load Reporting for CMS Medicare Systems	07/06/2004	3023
R33FM (207 kb)	02/06/2004	100-06	Coordination of Medicare and Complementary Insurance Programs	07/06/2004	3109
R68PI	02/25/2004	100-08	Program Requirements to Support Medical Review of HH PPS  CR 2519	07/06/2004	2519
October-December 2004 Updates
R35FM (364 kb)	02/09/2004	100-06	Unsolicited/Voluntary Refund Requirements	10/04/2004	1444
January-March 2005 Updates
R3GI (319 kb)	03/12/2004	100-01	New Part B Annual Deductible	01/01/2005	3121

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