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The CMS Quarterly Provider Update
October 2004


What's New



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10/22/2004

    REGULATIONS PUBLISHED

    CMS-1265-F, entitled "Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2005," was released. This regulation affects Home Health Agencies. View CMS-1265-F

    CMS-1302-N, entitled "Medicare Program; Town Hall Meeting on the Medicare Provider Feedback Group (MPFG) November 16, 2004," was released. This regulation is a Meeting Notice. View CMS-1302-N

    CMS-1484-N, entitled "Medicare Program; November 22, 2004, Meeting of the Practicing Physicians Advisory Council," was released. This regulation is a Meeting Notice. View CMS-1484-N

    CMS-4078-N, entitled "Medicare Program: Meeting of the Advisory Panel on Medicare Education--November 30, 2004," was released. This regulation is a Meeting Notice. View CMS-4078-N

    INSTRUCTIONS RELEASED -- MANUALIZATION/CORRECTION/CLARIFICATION

    Transmittal 11 of the Medicare General Information, Eligibility, and Entitlement Manual, entitled "Manual Revision Regarding Waiver of Annual Deductible and Coinsurance for Both ASC Facility, and ASC/Hospital Outpatient Department Physician Services," was released. This instruction affects Ambulatory Surgical Centers. View the complete text of Transmittal 11 (PDF - 68 KB)

    Transmittal 316 of the Medicare Claims Processing Manual, entitled "Clarification of Messgaes in Chapter 1, Section 10.1.1.1 to Match Official Listing on the WPC-EDI Web Site," was released. This instruction affects Non-Physician Practitioners and Physicians.
    View the complete text of Transmittal 316     (PDF - 53 KB)

    Transmittal 317 of the Medicare Claims Processing Manual, entitled "Clarification to Chapter 26 of the Internet Only Manual (IOM)," was released. This instruction affects Clinical Diagnostic Laboratories, Ambulatory Surgical Centers, Physicians and Non-Physician Practitioners.
    View the complete text of Transmittal 317     (PDF - 99 KB)

    Transmittal 318 of the Medicare Claims Processing Manual, entitled "Clarification of CR 3176 - Payment amounts for ESRD drug administration supplies: HCPCS A4657 and A4913," was released. This instruction affects Independent Diagnostic Testing Facilities.
    View the complete text of Transmittal 318     (PDF - 82 KB)

    Transmittal 322 of the Medicare Claims Processing Manual, entitled "Release Medlearn Article for Change Request (CR) 2813 (End Stage Renal Disease Reimbursement for Automated Multi-channel Chemistry Test(s)).," was released. This instruction affects Clinical Diagnostic Laboratories.
    View the complete text of Transmittal 322     (PDF - 57 KB)

    INSTRUCTIONS RELEASED -- MID-QUARTER

    Transmittal 315 of the Medicare Claims Processing Manual, entitled "Temporary Change in Carrier Jurisdictional Pricing Rules for Purchased Diagnostic Services," was released. This instruction affects Clinical Diagnostic Laboratories and Physicians.
    View the complete text of Transmittal 315     (PDF - 84 KB)

    Transmittal 320 of the Medicare Claims Processing Manual, entitled "Reminder Notice of the Implementation of the Ambulance Transition Schedule," was released. This instruction affects Ambulance.
    View the complete text of Transmittal 320     (PDF - 85 KB)

    Transmittal 324 of the Medicare Claims Processing Manual, entitled "Quarterly Update to Correct Coding Initiative (CCI) edits, Version 11.0, Effective January 1, 2005," was released. This instruction affects All Providers.
    View the complete text of Transmittal 324     (PDF - 86 KB)

    Transmittal 325 of the Medicare Claims Processing Manual, entitled "New Waived Tests-January 1, 2005," was released. This instruction affects Clinical Diagnostic Laboratories.
    View the complete text of Transmittal 325     (PDF - 604 KB)

    Transmittal 328 of the Medicare Claims Processing Manual, entitled "2005 Annual Update for Skilled Nursing Facility (SNF) Consolidated Billing for the Common Working File (CWF) and Medicare Carriers," was released. This instruction affects Clinical Diagnostic Laboratories.
    View the complete text of Transmittal 328     (PDF - 138 KB)

    INSTRUCTIONS RELEASED --
    MID-QUARTER - ADMINISTRATION AUTHORIZED

    Transmittal 334 of the Medicare Claims Processing Manual, entitled "Payment of Beneficiary Submitted Flu Claims and Flu Claims Submitted by Non-Enrolled Providers," was released. This instruction affects Physicians and Non-Physician Practitioners. View the complete text of Transmittal 334 (PDF - 55 KB)

10/15/2004

    INSTRUCTIONS RELEASED -- MANUALIZATION/CORRECTION/CLARIFICATION

    Transmittal 25 of the Medicare National Coverage Determinations Manual, entitled "Percutaneous Transluminal Angioplasty (PTA)," was released. This instruction affects All Providers.
    View the complete text of Transmittal 25     (PDF - 45 KB)

    Transmittal 314 of the Medicare Claims Processing Manual, entitled "Percutaneous Transluminal Angioplasty (PTA)," was released. This instruction affects All Providers.
    View the complete text of Transmittal 314     (PDF - 119 KB)

    INSTRUCTION RELEASED -- MID-QUARTER

    Transmittal 313 of the Medicare Claims Processing Manual, entitled "Remittance Advice Remark Code and Claim Adjustment Reason Code Update," was released. This instruction affects All Providers.
    View the complete text of Transmittal 313     (PDF - 163 KB)
10/13/2004

    INSTRUCTION RELEASED -- MANUALIZATION/CORRECTION/CLARIFICATION

    Transmittal 311 of the Medicare Claims Processing Manual, entitled "Instructions for Completion of Form CMS-1450," was released. This instruction affects All Providers.
    View the complete text of Transmittal 311     (PDF - 2 MB)

10/08/2004

    INSTRUCTION RELEASED -- MANUALIZATION/CORRECTION/CLARIFICATION

    Transmittal 426 of the Medicare Provider Reimbursement Manual - Part 1, entitled "For Assets Acquired On or After May 1, 2004," was released. This instruction affects Hospitals.
    View the complete text of Transmittal 426     (PDF - 34 KB)

10/07/2004

    REGULATIONS PUBLISHED

    CMS-1249-CN, entitled "Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Corrections," was released. This regulation affects Skilled Nursing Facilities. View CMS-1249-CN

    CMS-1360-CN, entitled "Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Fiscal Year 2005; Correction," was released. This regulation affects Hospitals. View CMS-1360-CN

    CMS-1428-CN2, entitled "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2005 Rates; Corrections," was released. This regulation affects Hospitals. View CMS-1428-CN2

10/04/2004

    INSTRUCTION RELEASED -- MID-QUARTER

    Transmittal 114 One-Time Notification Manual, entitled "Payment Allowances for the Influenza Virus Vaccine (CPT 90658) and the Pneumoccocal Vaccine (CPT 90732)," was released. This instruction affects All Providers.
    View the complete text of Transmittal 114     (PDF - 72 KB)

10/01/2004

    INSTRUCTIONS RELEASED -- MANUALIZATION/CORRECTION/CLARIFICATION

    Transmittal 23 of the Medicare National Coverage Determinations Manual, entitled "Treatment of Obesity," was released. This instruction affects All Providers.
    View the complete text of Transmittal 23     (PDF - 56 KB)

    Transmittal 24 of the Medicare National Coverage Determinations Manual, entitled "Update to Chapter 1, Section 220.6 - Dementia and Neurodegenerative Diseases ," was released. This instruction affects Hospitals and Physicians.
    View the complete text of Transmittal 24     (PDF - 55 KB)

    Transmittal 306 of the Medicare Claims Processing Manual, entitled "Full Replacement of CR 3415, 3rd Update to the 2004 Medicare Physician Fee Schedule Database," was released. This instruction affects All Providers.
    View the complete text of Transmittal 306     (PDF - 122 KB)

    INSTRUCTION RELEASED -- MID-QUARTER

    Transmittal 309 of the Medicare Claims Processing Manual, entitled "Fiscal Year (FY) 2005 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) and Other Bill Processing Changes Related to the IPPS Final Rule," was released. This instruction affects Hospitals.
    View the complete text of Transmittal 309     (PDF - 229 KB)

10/01/2004

    **NEW RELEASE - October 2004
    The October 2004 issue of the CMS Quarterly Provider Update (QPU) was released.

    View the October 2004 QPU
    View the QPU Archive



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View The October 2004 CMS Quarterly Provider Update Table of Contents

View The CMS Quarterly Provider Update Archive

Last Modified on Wednesday, October 27, 2004  
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