Search Frequenty Asked Questions

Normal Fonts Larger Fonts Printer Version Email this page Submit Feedback Questions & Answers About CMS Return to cms.hhs.gov Home Normal Fonts Larger Fonts Email this page Submit Feedback Questions & Answers About CMS Return to cms.hhs.gov Home
Return to cms.hhs.gov Home    Return to cms.hhs.gov Home

  


  Professionals   Governments   Consumers   Public Affairs

Medicare & Medicaid
2004 Program Transmittals | Program Memos

Program transmittals are used to communicate new or changed policies, and/or procedures that are being incorporated into a specific CMS program manual. The cover page (or transmittal page) summarizes the new changed material, specifying what is changed. To sort the Table of Contents, click your mouse on any column heading. To reverse the order of the sort, click on the sort order icon (Sorted in Decreasing Order or Sorted in Increasing Order).

Table of Contents

SIZE FILE Adobe PDF Icon Sorted in Decreasing Order  COMM DATE MANUAL SUBJECT IMPL DATE CR NUM
157 kb R25BP 11/5/2004 PUB 100-02 Implementation of Coverage of Religious Nonmedical Health Care Institution (RNHCI) Items and Services Furnished in the Home, MMA section 706. 4/4/2005 3529
182 kb R357CP 11/5/2004 PUB 100-04 Implementation of Coverage of Religious Nonmedical Health Care Institution Items and Services Furnished in the Home, MMA section 706. 4/4/2005 3529
129 kb R361CP 11/5/2004 PUB 100-04 MMA Drug Pricing Update - Payment Limit for J0207 (Amifostine) 12/6/2004 3552
42 kb R362CP 11/5/2004 PUB 100-04 Update to the Prospective Payment System (PPS) for Home Health Agencies for Calendar Year (CY) 2005 1/3/2005 3556
159 kb R363CP 11/5/2004 PUB 100-04 2005 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment 1/3/2005 3526
187 kb R86PI 11/5/2004 PUB 100-08 Payment for Emergency Medical Treatment and Labor Act (EMTALA) - Mandated Screening and Stabilization Services 11/22/2004 3437
186 kb R87PI 11/5/2004 PUB 100-08 Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial 4/4/2005 3363
203 kb R8DEMO 11/5/2004 PUB 100-19 New Requirements for Low Vision Rehabilitation Demonstration Billing 4/4/2005 3346
31 kb R125OTN 11/5/2004 PUB 100-20 Instructions Applicable to the Audit of Hospitals that are Part of an Affiliated Group in Relation to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments 12/6/2004 3558
139 kb R26BP 11/4/2004 PUB 100-02 Inclusion of Forteo as a Covered Osteoporosis Drug and Clarification of Manual Instructions Regarding Osteoporosis Drugs 4/4/2005 3524
221 kb R359CP 11/4/2004 PUB 100-04 Annual Type of Service (TOS) 1/5/2005 3519
153 kb R358CP 11/4/2004 PUB 100-04 Inclusion of Forteo as a Covered Osteoporosis Drug and Clarification of Manual Instructions Regarding Osteoporosis Drugs 4/4/2005 3524
24 Kb R59FM 11/4/2004 PUB 100-06 Notice of New Interest Rate for Medicare Overpayments and Underpayments. 11/12/2004 3453
204 kb R352CP 11/3/2004 PUB 100-04 Three Places after the Decimal Point for ASP drug file 4/4/2005 3436
157 kb R353CP 11/3/2004 PUB 100-04 DMERC - Revision to CR 2631 Requirements for DMERC claims 4/4/2005 3261
37 kb R346CP 11/1/2004 PUB 100-04 Three Places after the Decimal Point for ASP drug file 4/4/2005 3436
58 kb R349CP 11/1/2004 PUB 100-04 Annual Type of Service (TOS) 1/3/2005 3519
132 kb R13GI 10/29/2004 PUB 100-01 Medicare Termination of Beneficiaries With End Stage Renal Disease (ESRD) 4/4/2005 2923
161 kb R335CP 10/29/2004 PUB 100-04 Incorrect Reporting of Miles, Times, Units, Services (MTUS) Indicator When a Drug is Billed in the NCPDP Format Using an NDC Code 4/4/2005 3435
157 kb R345CP 10/29/2004 PUB 100-04 DMERC - Revision to CR 2631 Requirements for DMERC claims 1/4/2005 3261
147 kb R336CP 10/29/2004 PUB 100-04 Indian Health Service (IHS) or Tribal Hospitals including Critical Access Hospitals (CAH) Payment Methodology for Inpatient Social Admissions and Outpatient Services Occurring During Concurrent Stays 4/4/2005 3452
182 kb R337CP 10/29/2004 PUB 100-04 Change in Hospital Type of Bill for Billing Diagnostic and Screening Mammographics 4/4/2005 3469
145 kb R338CP 10/29/2004 PUB 100-04 Remonal of the Skilled Nursing Facility (SNF) No Pay File 1/3/2005 3534
31 kb R340CP 10/29/2004 PUB 100-04 Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement 1/3/2005 3525
161 kb R341CP 10/29/2004 PUB 100-04 Implementation of the Medicare Physician Fee Schedule (MPFS) National Abstract File for Purchased Diagnostic Tests and Interpretations 4/4/2005 3481
42 kb R343CP 10/29/2004 PUB 100-04 Clarification: Modifiers for Transportation of Portable X-rays (R0075) 4/4/2005 3280
119 kb R350CP 10/29/2004 PUB 100-04 Editing for Part B Carriers and Durable Medical Equipment Regional Carriers (DMERCs) for Duplicate Claims in Process at the Same Time 4/4/2005 3347
144 kb R348CP 10/29/2004 PUB 100-04 January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective January 1, 2005 1/3/2005 3539
97 kb R347CP 10/29/2004 PUB 100-04 Inpatient Rehabilitation Facility (IRF) Classification Requirements 11/29/2004 3503
52 kb R351CP 10/29/2004 PUB 100-04 Editing of Hospitals and Skilled Nursing Facilities Part B Inpatient Services (Full Replacement of Change Request 3366) 1/3/2005 3531
130 kb R20MSP 10/29/2004 PUB 100-05 Medicare Secondary Payer (MSP) Savings Report Redesign 4/6/2005 3181
182 kb R21MSP 10/29/2004 PUB 100-05 Instructions on Processing Certain Types of Medicare Secondary Payer (MSP) Claims and to Balance the Outbound Remittance Advice 4/4/2005 3407
39 kb R3SOM 10/29/2004 PUB 100-07 Medicare Systems Acceptance of New Provider Numbers for Federally Qualified Health Centers (FQHC) 4/4/2005 3537
27 kb R121OTN 10/29/2004 PUB 100-20 Modification to Fiscal Intermediary Standard System (FISS) Regarding Common Working File Initiated Adjustments 4/4/2005 3330
32 kb R122OTN 10/29/2004 PUB 100-20 Shared System and CWF Renovation of Override Code Process and Recognition of Four 2-byte Modifier Fields on the Part B Query Record - For MCS Phased Implementation Approach Only 4/4/2005 3434
128 kb R123OTN 10/29/2004 PUB 100-20 Instructions For Pricing Trepostinil (Q4077) 11/29/2004 3533
24 kb R24BP 10/29/2004 PUB 100-20 Revision of §300.5.1, Chapter 15 of the Medicare Benefit Policy Manual to include 22x TOB as an applicable TOB for Diabetes Self-Management Training. 1/3/2005 3531
248 kb R124OTN 10/29/2004 PUB 100-20 Common Working File (CWF) Duplicate Claim Edit for Referred Clinical Diagnostic and Purchased Diagnostic Services 4/4/2005 3551
55 kb R334CP 10/25/2004 PUB 100-04 Payment of Beneficiary Submitted Flu Claims and Flu Claims Submitted by Non-Enrolled Providers 11/26/2004 3555
68 kb R11GI 10/22/2004 PUB 100-01 Manual Revision Regarding Waiver of Annual Deductible and Coinsurance for Both ASC Facility, and ASC/Hospital Outpatient Department Physician Services 11/22/2004 3471
41 kb R12GI 10/22/2004 PUB 100-01 New Policy and Refinements on Billing Noncovered Charges to Fiscal Intermediaries (FIs) 4/4/2005 3416
84 kb R315CP 10/22/2004 PUB 100-04 Temporary Change in Carrier Jurisdictional Pricing Rules for Purchased Diagnostic Services 11/22/2004 3464
99 kb R317CP 10/22/2004 PUB 100-04 Clarification to Chapter 26 of the Internet Only Manual (IOM) N/A 3431
82 kb R318CP 10/22/2004 PUB 100-04 Clarification of CR 3176 - Payment amounts for ESRD drug administration supplies: HCPCS A4657 and A4913 11/22/2004 3451
53 kb R316CP 10/22/2004 PUB 100-04 Clarification of Messgaes in Chapter 1, Section 10.1.1.1 to Match Official Listing on the WPC-EDI Web Site N/A 3462
87 kb R319CP 10/22/2004 PUB 100-04 CORF/OPT Edit for Billing Inappropriate Supplies 4/4/2005 3468
85 kb R320CP 10/22/2004 PUB 100-04 Reminder Notice of the Implementation of the Ambulance Transition Schedule 1/3/2005 3473
74 kb R321CP 10/22/2004 PUB 100-04 Instructions for Downloading the Medicare Zip Code File 4/4/2005 3482
57 kb R322CP 10/22/2004 PUB 100-04 Release Medlearn Article for Change Request (CR) 2813 (End Stage Renal Disease Reimbursement for Automated Multi-channel Chemistry Test(s)). 10/29/2004 3501
140 kb R324CP 10/22/2004 PUB 100-04 Quarterly Update to Correct Coding Initiative (CCI) edits, Version 11.0, Effective January 1, 2005 1/3/2005 3491
181 kb R323CP 10/22/2004 PUB 100-04 Update Regarding the Use of American Dental Association's (ADA) Current Dental Terminology (CDT) Codes on Medicare Contractors' Web Sites and Other Electronic Media 11/22/2004 3499
55 kb R326CP 10/22/2004 PUB 100-04 Invalid Diagnosis Code Editing - Second Phase 4/4/2005 3260
604 kb R325CP 10/22/2004 PUB 100-04 New Waived Tests-January 1, 2005 1/3/2005 3484
167 kb R327CP 10/22/2004 PUB 100-04 Clarification to IOM Chapter 17, Section 80.4 regarding claims for Blood Clotting Factors 11/22/2005 3370
130 kb R328CP 10/22/2004 PUB 100-04 2005 Annual Update for Skilled Nursing Facility (SNF) Consolidated Billing for the Common Working File (CWF) and Medicare Carriers 1/3/2005 3535
257 kb R329CP 10/22/2004 PUB 100-04 DMERC Only - Payment to Providers/Suppliers Qualified to Bill Medicare for Prosthetics and Certain Custom-Fabricated Orthotics 7/5/2005 3373
260 kb R332CP 10/22/2004 PUB 100-04 New Policy and Refinements on Billing Noncovered Charges to Fiscal Intermediaries (FIs) 4/4/2005 3416
20 kb R330CP 10/22/2004 PUB 100-04 DMERC-Beneficiary Submitted Claims, Process First Claim 4/4/2005 3233
80 kb R56FM 10/22/2004 PUB 100-06 Revision to Balancing Requirement on Form 5, Line 10, of the Contractor Reporting of Operational and Workload Data (Crowd) 11/22/2005 3486
112 kb R84PI 10/22/2004 PUB 100-08 Payment for Emergency Medical Treatment and Labor Act (EMTALA) - Mandated Screening and Stabilization Services 11/22/2004 3437
121 kb R85PI 10/22/2004 PUB 100-08 Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial 4/4/2005 3363
111 kb R57FM 10/22/2004 PUB 100-08 Revised Reporting Requirements for Contractor Reporting of Operational Workload Data (CROWD) Health Professional Shortage Area (HPSA) Quarterly Report (CMS Form 1565E, CROWD Form S) 4/4/2005 3472
59 kb R119OTN 10/22/2004 PUB 100-20 Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing 4/4/2005 3495
68 kb R120OTN 10/22/2004 PUB 100-20 Override of Common Working File (CWF) Edit for Observation Services Exceeding 48 Hours 4/4/2005 3311
45 kb R25NCD 10/15/2004 PUB 100-03 Percutaneous Transluminal Angioplasty (PTA) 10/12/2004 3489
163 kb R313CP 10/15/2004 PUB 100-04 Remittance Advice Remark Code and Claim Adjustment Reason Code Update 1/3/2005 3466
163 kb R314CP 10/15/2004 PUB 100-04 Percutaneous Transluminal Angioplasty (PTA) 10/12/2004 3489
59 kb R118OTN 10/15/2004 PUB 100-20 Shared Systems Maintainers Hours for Resolution of Problems Detected as a Result of Implementation of Change Request 2525 and Change Request 2527 1/3/2005 3536
2065 kb R311CP 10/13/2004 PUB 100-04 Instructions for Completion of Form CMS-1450 1/5/2005 3417
104 kb R23BP 10/8/2004 PUB 100-02 Revised Requirements for Chiropractic Billing of Active/Corrective Treatment and Maintenance Therapy. Full Replacement of CR 3063 10/4/2004 3449
69 kb R55FM 10/8/2004 PUB 100-06 Reporting Appeals Redetermination Information On Forms CMS-2591 and 2590 11/15/2004 3448
34 kb R426PR1 10/8/2004 PUB 15-1 For Assets Acquired On or After May 1, 2004 N/A N/A
89 kb R114OTN 10/4/2004 PUB 100-20 Payment Allowances for the Influenza Virus Vaccine (CPT 90658) and the Pneumoccocal Vaccine (CPT 90732) 10/4/2004 3490
55 kb R24NCD 10/1/2004 PUB 100-03 Update to Chapter 1, Section 220.6 - Dementia and Neurodegenerative Diseases 10/4/2004 3426
56 kb R23NCD 10/1/2004 PUB 100-04 Treatment of Obesity 10/1/2004 3502
56 kb R305CP 10/1/2004 PUB 100-04 Disabling the CWF 57x3 Consistency Error Code 1/3/2005 3470
80 kb R308CP 10/1/2004 PUB 100-04 Two New Medicare Summary Notice (MSN) Messages for Parental Pumps - DMERC only 10/4/2004 3506
189 kb R306CP 10/1/2004 PUB 100-04 Full Replacement of CR 3415, 3rd Update to the 2004 Medicare Physician Fee Schedule Database. 10/4/2004 3505
229 kb R309CP 10/1/2004 PUB 100-04 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 10/4/2004 3459
127 kb R310CP 10/1/2004 PUB 100-04 Billing Requirements for Positron Emission Tomography (PET) Scans for Dementia and Neurodegenerative Diseases 10/4/2004 3426
53 kb R117OTN 9/29/2004 PUB 100-20 New Remark Code Message for Use with Claims for Parenteral Pumps - (DMERC) Only 10/4/2004 3405
91 kb R22BP 9/24/2004 PUB 100-02 Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit 6/28/2004 3226
224 kb R21BP 9/24/2004 PUB 100-02 Medicare Comprehensive Outpatient Rehabilitation Facility Coverage 10/25/2004 3315
171 kb R304CP 9/24/2004 PUB 100-04 Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit 6/28/2004 3226
1378 kb R303CP 9/24/2004 PUB 100-04 Instructions for Completion of Form CMS-1450 1/5/2005 3417
108 kb R302CP 9/24/2004 PUB 100-04 Nursing Facility Visits (Codes 99301 -99313) 10/25/2004 3096
82 kb R19MSP 9/24/2004 PUB 100-05 Clarification of MSP Rules in Relation to a Temporary Leave of Absence 10/25/2004 3447
72 kb R54FM 9/24/2004 PUB 100-06 Notification to Providers of Intent to Complete a Post-Payment Audit 10/25/2004 3441
82 kb R116OTN 9/24/2004 PUB 100-20 Notification of Medlearn Matters (MM) Article for Confidential Change Request (CR) 3301 N/A 3465
92 kb R300CP 9/17/2004 PUB 100-04 Payment For Outpatient End Stage Renal Disease (ESRD)-Related Services 10/18/2004 3414
209 kb R301CP 9/17/2004 PUB 100-04 Editing Of Hospital And Skilled Nursing Facility Part B Inpatient Services 1/3/2005 3366
99 kb R267CP 9/16/2004 PUB 100-04 Crossover Patients in New Long Term Care Hospitals (LTCH) 1/3/2005 3391
164 kb R10GI 9/10/2004 PUB 100-01 Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year 2005 1/3/2005 3463
47 kb R19BP 9/10/2004 PUB 100-02 Hospital Services Covered Under Part B 10/12/2004 3444
93 kb R21NCD 9/10/2004 PUB 100-03 Magnetic Resonance Spectroscopy for Diagnosing Brain Tumors 9/10/2004 3425
79 kb R298CP 9/10/2004 PUB 100-04 MSN and ANSI Messages for Mammography Claims 9/25/2004 2617
134 kb R297CP 9/10/2004 PUB 100-04 Reasonable Charge Update for 2005 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, Therapeutic Shoes, and Certain Intraocular Lenses 1/3/2005 3430
89 kb R299CP 9/10/2004 PUB 100-04 Use of Condition Code 44, "Inpatient Admission Changed to Outpatient" 10/12/2004 3444
275 kb R62MCM 9/10/2004 PUB 100-16 Revisions to Chapter 13 - Medicare+Choice Beneficiary Grievances, Organization Determinations and Appeals N/A N/A
389 kb R113OTN 9/10/2004 PUB 100-20 Implementation of Section 921 of the Medicare Modernization Act (MMA) - Provider Customer Service Program 1/5/2005 3376
80 kb R112OTN 9/10/2004 PUB 100-20 Billing Instructions for ADVATE rAHF-PFM on Medicare Claims 9/27/2004 3331
14 kb R295CP 9/3/2004 PUB 100-04 MSN Messages and Reason Codes for Mammography 9/25/2004 2617
52 kb R296CP 9/3/2004 PUB 100-04 Payment Denial for Medicare Services Furnished to Alien Beneficiaries Who Are Not Lawfully Present in the United States N/A 2825
322 kb R61MCM 9/3/2004 PUB 100-16 Emergency and Urgently Needed Services N/A N/A
64 kb R6P229 9/3/2004 PUB 15-2-29 For Cost Reporting Periods End On or After March 31, 2002 N/A N/A
62 kb R285CP 8/27/2004 PUB 100-04 Addition of Physician Assistants, Nurse Practitioners and Clinical Nurse Specialists as Emergency On-Call Providers for Critical Access Hospitals (CAHs) 1/3/2005 3228
68 kb R288CP 8/27/2004 PUB 100-04 Fiscal Year (FY) 2005 Payment for Services Furnished in Ambulatory Surgical Centers (ASCs) 10/1/2004 3394
70 kb R283CP 8/27/2004 PUB 100-04 2005 Healthcare Common Procedure Coding System (HCPCS) Annual Update reminder 1/3/2005 3422
64 kb R284CP 8/27/2004 PUB 100-04 DMERCs Only-Appeals of Duplicate claims 9/27/2004 3371
101 kb R286CP 8/27/2004 PUB 100-04 Medicare Physician Fee Schedule Database (MPFSDB) 2005 File Layout 1/3/2005 3421
30 kb R287CP 8/27/2004 PUB 100-04 Schedule for Completing the Calendar Year (CY) 2005 Fee Schedule Updates and the Participating Physician Enrollment Procedures 8/27/2004 3409
364 kb R289CP 8/27/2004 PUB 100-04 File Descriptions and Instructions for Retrieving the 2005 Pricing Files through CMS's Mainframe Telecommunications System 1/3/2005 3428
128 kb R290CP 8/27/2004 PUB 100-04 October 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS) 10/4/2004 3420
83 kb R291CP 8/27/2004 PUB 100-04 Use of Transmission Date in the Service Date/Assessment Date Field for Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) Claims 1/3/2005 3433
86 kb R18MSP 8/27/2004 PUB 100-05 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 3120
699 kb R53FM 8/27/2004 PUB 100-06 Change Request 3367, Debt Collection System (DCS), replaces Change Request 2952, Debt Collection System (DCS) 9/27/2004 3367
210 kb R83PI 8/27/2004 PUB 100-08 PIM Revisions for Chapter 4 9/27/2004 3379
70 kb R6DEMO 8/27/2004 PUB 100-19 Revision of CR 3269 for the Demonstration Project to Clarify the Definition of Homebound (Homebound Demonstration) 1/3/2005 3432
129 kb R107OTN 8/27/2004 PUB 100-20 CWF Analysis to Process Claims Per the Renovated Override Code Processing (re: CR3190) and CWF Analysis to Review System Edits for Additional 2-byte Modifiers Added in CR3190. (Phase 2) 1/3/2005 3320
40 kb R108OTN 8/27/2004 PUB 100-20 New Remark Code Message for Use with Claims for Parenteral Pumps - Durable Medical Equipment Regional Carrier (DMERC) Only 9/27/2004 3405
30 kb R109OTN 8/27/2004 PUB 100-20 CWF Analysis to Process Claims Per the Renovated Override Code Billing Instructions for ADVATE rAHF-PFM on Medicare Claims 9/27/2004 3331
29 kb R110OTN 8/27/2004 PUB 100-20 MMA Drug Pricing Update-Payment Limits for J1000 (Depo-estradiol cypionate inj) 9/27/2004 3418
32 kb R111OTN 8/27/2004 PUB 100-20 Creation of CWF Auxilliary Files and Associated Logic to Properly Calculate Medicare-Equivalent Deductibles for VA Claims 1/3/2005 3450
74 kb R106OTN 8/24/2004 PUB 100-20 MMA Drug Pricing Update-Payment Limits for J9045 (Carboplatin injection) and J9310 (Rituximab cancer treatment) 9/24/2004 3419
47 kb R282CP 8/20/2004 PUB 100-04 Good Cause Waiver of Late Claim Filing Payment Reduction Penalty 9/14/2004 3402
83 kb R2SOM 8/20/2004 PUB 100-07 Provider Identification Numbers N/A 3245
66 kb R59MCM 8/20/2004 PUB 100-16 Chapter 2 N/A N/A
363 kb R60MCM 8/20/2004 PUB 100-16 Chapter 3 N/A N/A
57 kb R273CP 8/13/2004 PUB 100-04 Modification of CMS's Medicare Contingency Plan for HIPAA Implementation 7/6/2004 2981
45 kb R274CP 8/13/2004 PUB 100-04 Good Cause Waiver of Late Claim Filing Payment Reduction Penalty 9/14/2004 3042
63 kb R275CP 8/13/2004 PUB 100-04 The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2003 for Inpatient Prospective Payment System (IPPS) Hospitals 10/4/2004 3403
114 kb R276CP 8/13/2004 PUB 100-04 Further Information Related to CR 3175, Distinct Part Units of Critical Access Hospitals (CAHs) 1/3/2005 3399
118 kb R278CP 8/13/2004 PUB 100-04 3rd Update to the 2004 Medicare Physician Fee Schedule Database 10/4/2004 3415
47 kb R57MCM 8/13/2004 PUB 100-16 Chapter 7 Revisions N/A N/A
42 kb R58MCM 8/13/2004 PUB 100-16 Chapter 5 Revisions N/A N/A
85 kb R5DEMO 8/13/2004 PUB 100-19 Use of Group Health Plan Payment System to Pay Capitated Payments to Non-Health Plan Demonstration/Program Sites Serving Medicare Fee For Service Beneficiaries- Updated List of Plan Numbers 1/3/2005 3423
58 kb R272CP 8/10/2004 PUB 100-04 October Quarterly Update For 2004 10/4/2004 3377
91 kb R271CP 8/4/2004 PUB 100-04 Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2005 10/4/2004 3386
65 kb R269CP 8/3/2004 PUB 100-04 Number of Drug Pricing Files That Must Be Maintained Online for Medicare 1/3/2005 3231
111 kb R270CP 8/3/2004 PUB 100-04 Update to the Frequency of Billing 1/3/2005 3382
33 kb R52FM 8/3/2004 PUB 100-06 Notice of New Insterest Rate for Medicare Overpayments and Underpayments 8/9/2004 2831
13 kb R51FM 8/2/2004 PUB 100-06 Notice of New Interest Rate for Medicare Overpatments and Underpatyments 8/9/2004 2831
44 kb R8GI 7/30/2004 PUB 100-01 Standard Terminology for Claims Processing Systems 1/3/2005 3086
25 kb R18NCD 7/30/2004 PUB 100-03 Islet Cell Transplantation 10/4/2004 3385
30 kb R19NCD 7/30/2004 PUB 100-03 Blood-Derived Products for Chronic Non-Healing Wounds 7/23/2004 3384
238 kb R254CP 7/30/2004 PUB 100-04 October 2004 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 5.3 10/4/2004 3395
73 kb R255CP 7/30/2004 PUB 100-04 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) 10/4/2004 3396
29 kb R256CP 7/30/2004 PUB 100-04 Use of Group Health Plan Payment System/MMCS to Pay Capitated Payments to Chronic Care Improvement Organizations Serving Medicare Fee-For-Service Beneficiaries under Section 721 of the MMA 1/3/2005 3410
31 kb R257CP 7/30/2004 PUB 100-04 Shared Systems Changes for Medicare Part B Drugs for ESRD Independent Dialysis Facilities 1/3/2005 3332
118 kb R258CP 7/30/2004 PUB 100-04 New Waived Tests - October 1, 2004 10/4/2004 3372
38 kb R259CP 7/30/2004 PUB 100-04 Scheduled Release for October Updates to Software Programs and Pricing/Coding Files 1/3/2005 3397
42 kb R260CP 7/30/2004 PUB 100-04 Cryosurgery of the Prostate 1/3/2005 3168
37 kb R261CP 7/30/2004 PUB 100-04 Billing and Requirements for Islet Cell Transplantation for Beneficiaries in a National Institutes of Health (NIH) Clinical Trial 10/4/2004 3385
70 kb R263CP 7/30/2004 PUB 100-04 Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2005 10/4/2004 3378
86 kb R264CP 7/30/2004 PUB 100-04 Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index and the Hospice Pricer for FY 2005 10/4/2004 3386
58 kb R268CP 7/30/2004 PUB 100-04 Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2005 10/4/2004 3368
84 kb R266CP 7/30/2004 PUB 100-04 Revision of Common Working File (CWF) Editing for Same-Day, Same- Provider Acute Care Readmissions 1/3/2005 3389
114 kb R50FM 7/30/2004 PUB 100-06 Unsolicited/Voluntary Refunds 10/4/2004 3274
114 kb R95OTN 7/30/2004 PUB 100-20 Modification to Post-payment Adjustment Process for Home Health Prospective Payment System Claims Failing to Report Prior Inpatient Discharges 1/3/2005 3400
69 kb R101OTN 7/30/2004 PUB 100-20 Change of the Premera Blue Cross Medicare Part A Plan Under Contract to BCBSA to a Part A Fiscal Intermediary Contract with Noridian Mutual Insurance Company in the States of Washington and Alaska 10/4/2004 3380
46 kb R102OTN 7/30/2004 PUB 100-20 Update to the Healthcare Provider Taxonomy Codes (HPTC)/Medicare Specialty Code Crosswalk 1/3/2005 3259
27 kb R103OTN 7/30/2004 PUB 100-20 ANSI X12 Transaction 835 Flat File and Companion Document Correction for Carriers and DMERCs, and Deletion of a Hard Coded Reason Code A2 that Has Been Deactivated 1/3/2005 3236
210 kb R241CP 7/23/2004 PUB 100-04 Processing Part B Claims for Indian Health Services (HIS 1/3/2005 3288
250 kb R240CP 7/23/2004 PUB 100-04 Expansion of the Existing Interrupted Stay Policy Under Long Term Care Hospital (LTCH) Prospective Payment System 1/3/2005 3279
143 kb R230CP 7/23/2004 PUB 100-04 Update to the Claims Status Codes 1/3/2005 3361
23 kb R231CP 7/23/2004 PUB 100-04 Indian Health Service (IHS) or Tribal Critical Access Hospital (CAH) Payment Methodology for Inpatient and Outpatient Services 1/3/2005 3235
70 kb R234CP 7/23/2004 PUB 100-04 Standardized Responses to Provider Inquiries Regarding the Negotiated Laboratory National Coverage Determinations (NCDs) Edit Software 10/4/2004 3374
54 kb R235CP 7/23/2004 PUB 100-04 Instructions for Downloading the Medicare Zip Code File 1/3/2005 3340
100 kb R236CP 7/23/2004 PUB 100-04 2005 DMEPOS Pricing File Record Layout Expansion and New Pricing Procedures for Certain DMEPOS Items Based on Modifiers 1/3/2005 3300
57 kb R237CP 7/23/2004 PUB 100-04 Implementation of Patient Status Code 65, Discharged/Transferred to a Psychiatric Hospital or Psychiatric Distinct Part Unit of a Hospital 1/3/2005 3364
74 kb R238CP 7/23/2004 PUB 100-04 Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Institutional Health Care Claim Implementation Guide (IG) Additional Updates 1/3/2005 3321
111 kb R239CP 7/23/2004 PUB 100-04 Update to the Frequency of Billing 1/3/2005 3382
64 kb R242CP 7/23/2004 PUB 100-04 Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.3, Effective October 1, 2004. 10/4/2004 3349
67 kb R243CP 7/23/2004 PUB 100-04 Patient Status Code and Reason for Patient Visit for the Hospital Outpatient Prospective Payment System (OPPS) 1/3/2005 2800
65 kb R244CP 7/23/2004 PUB 100-04 Number of Drug Pricing Files That Must Be Maintained Online for Medicare 1/3/2005 3231
141 kb R248CP 7/23/2004 PUB 100-04 DMERC/Local Carriers/SADMERC - Drug Pricing Limits as of January 1, 2005 1/5/2005 3232
73 kb R249CP 7/23/2004 PUB 100-04 New Medicare Summary Notice Message 31.18 1/3/2005 2989
133 kb R250CP 7/23/2004 PUB 100-04 Coordination of Benefits Agreement (COBA) Claims Selection Options 1/3/2005 3404
204 kb R251CP 7/23/2004 PUB 100-04 Editing Of Hospital And Skilled Nursing Facility Part B Inpatient Services 1/3/2005 3366
72 kb R252CP 7/23/2004 PUB 100-04 Paper Remittance Advice format change to accommodate the forced balancing amount to balance at the claim level as well as the provider level, a flat file change, and a change in the companion document for fiscal intermediaries (FIs). 1/3/2005 3344
79 kb R253CP 7/23/2004 PUB 100-04 Fiscal Intermediary Shared System (FISS) Changes to Allow for Provider Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills 1/3/2005 3308
284 kb R81PI 7/23/2004 PUB 100-08 Implementation of the Quarterly Strategy Analysis 8/23/2004 3294
72 kb R82PI 7/23/2004 PUB 100-08 Home Health Demand Bills 8/23/2004 3266
66 kb R97OTN 7/23/2004 PUB 100-20 Implementation of the Business Segment Identifier (BSI) in the Healthcare Integrated General Ledger Accounting System (HIGLAS) 1/3/2005 3362
52 kb R94OTN 7/23/2004 PUB 100-20 Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing 1/3/2005 3316
57 kb R96OTN 7/23/2004 PUB 100-20 Annual Changes to the Amount in Controversy (AIC) Thresholds for the Administrative Law Judge (ALJ) and Judicial Review Levels of the Claim Appeals Process as Required by Section 940 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 10/1/2004 3354
81 kb R98OTN 7/23/2004 PUB 100-20 Change to Previous Transmittal Regarding the Discontinued Use of Revenue Code 0910 10/4/2004 3343
454 kb R99OTN 7/23/2004 PUB 100-20 This One-Time Notification is a Full Replacement for Transmittal 86 (CR 3142) Interface File from Recovery Management and Accounting System (ReMAS 1/3/2005 3383
9 kb R100OTN 7/23/2004 PUB 100-20 This transmittal is rescinded and replaced with Transmittal 103, dated July 30, 2004 N/A 3236
164 kb R229CP 7/20/2004 PUB 100-04 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 3323
96 kb R228CP 7/16/2004 PUB 100-04 General Policy 8/16/2004 3267
71 kb R17MSP 7/16/2004 PUB 100-05 Clarification of CR 3064 8/16/2004 3267
131 kb R49FM 7/16/2004 PUB 100-06 Procedures For Re-Issuance and Stale Dating of Medicare Checks 8/16/2004 2951
137 kb R80PI 7/16/2004 PUB 100-08 PIM Fraud and Abuse Complaint Screening Revisions 8/16/2004 3341
88 kb R225CP 7/9/2004 PUB 100-04 Changes to the Laboratory National Coverage Determination (NCD)Edit Software for October 2004 10/4/2004 3358
87 kb R226CP 7/9/2004 PUB 100-04 Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement 10/4/2004 3350
94 kb R224CP 7/9/2004 PUB 100-04 October Quarterly Update to 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing Enforcement 10/4/2004 3348
97 kb R227CP 7/9/2004 PUB 100-04 Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision 8/9/2004 3222
9 kb R48FM 7/9/2004 PUB 100-06 This transmittal is rescinded and replaced with Transmittal 50, dated July 30, 2004. N/A 3274
128 kb R79PI 7/9/2004 PUB 100-08 Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision 8/9/2004 3222
61 kb R56MCM 7/9/2004 PUB 100-16 Chapter 11 N/A N/A
59 kb R93OTN 7/9/2004 PUB 100-20 Temporary SNF Extension 7/9/2004 3352
289 kb R17NCD 7/2/2004 PUB 100-03 Manualization of the Negotiated Clinical Diagnostic Laboratory National Coverage Determinations N/A 2130
50 kb R222CP 7/2/2004 PUB 100-04 SNF CB Requirements for DMEPOS N/A 2453
151 kb R223CP 7/2/2004 PUB 100-04 PET Scans and Related Claims Processing N/A 3304
117 kb R92OTN 7/2/2004 PUB 100-20 Additional Instructions Related to the "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments 7/16/2004 3353
345 kb R7GI 6/25/2004 PUB 100-01 HIPAA Privacy Act N/A 2484
53 kb R16NCD 6/25/2004 PUB 100-03 Cardiac Pacemaker 4/30/2004 3369
70 kb R213CP 6/25/2004 PUB 100-04 Payment to Bank 7/25/2004 3079
90 kb R214CP 6/25/2004 PUB 100-04 MSN Messages 9/25/2004 2617
302 kb R220CP 6/25/2004 PUB 100-04 Implementation of Section 414 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 7/6/2004 3099
280 kb R221CP 6/25/2004 PUB 100-04 Medicare IRF Classification Requirements 7/1/2004 3334
64 kb R216CP 6/25/2004 PUB 100-04 Manualization of INR Monitoring N/A 2323
24 kb R215CP 6/25/2004 PUB 100-04 Implementation of Skilled Nursing Facility Consolidated Billing CWF Edit for Therapy Codes Considered Separately Payable Physician Services 7/6/2004 2944
557 kb R47FM 6/25/2004 PUB 100-06 Expanded Identification and Workload Reporting for CMS Medicare Systems 10/4/2004 3256
51 kb R89OTN 6/25/2004 PUB 100-20 Shared System Maintainer Hours for Resolution of Problems Detected As A Result of Implementation of CR 2525 and CR 2527 10/4/2004 3305
59 kb R90OTN 6/25/2004 PUB 100-20 MMA Drug Pricing Update-Payment Limits for J7308 (Levulan Kerastick) and J9395 (Faslodex) 7/25/2004 3312
69 kb R17BP 6/18/2004 PUB 100-02 Incident-To Services on Form CMS-1500 10/4/2004 3242
62 kb R15NCD 6/18/2004 PUB 100-03 NCD: Sensory Nerve Conduction Threshold Test (sNCTs) (NOTE THAT Change Request (CR) 3339 CONSTITUTES A TECHNICAL CORRECTION TO PREVIOUSLY ISSUED CR 2988 dated 03/19/04. CR 2988 ORIGINALLY COMMUNICATED ON MARCH 19, 2004 VIA RO-2541, SHOULD BE DISCARDED AND REPLACED WITH CR 3339. 4/1/2004 3339
62 kb R207CP 6/18/2004 PUB 100-04 Expansion of Policy Where Patient is a Member of a Medicare Advantage (MA) Organization For Only a Portion of the Billing Period to Include Inpatient Rehabilitation Facilities (IRF) and Long Term Care Hospitals (LTCH) 7/19/2004 3309
153 kb R208CP 6/18/2004 PUB 100-04 Long Term Care Hospital Prospective Payment System (LTCH PPS) Fiscal Year 2005-Update 7/6/2004 3335
56 kb R209CP 6/18/2004 PUB 100-04 Correction to CR 2944, Transmittal 90, Issued on February 6, 2004 7/6/2004 3333
2387 kb R210CP 6/18/2004 PUB 100-04 Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) 10/4/2004 3303
63 kb R211CP 6/18/2004 PUB 100-04 Elimination of Regulations for Written Statement of Intent (SOI) 7/19/2004 3310
56 kb R46FM 6/18/2004 PUB 100-06 Installation of Version 33.0 of the Provider Statistical and Reimbursement (PS&R) Reporting System-Modification of CR 3131 8/31/2004 3313
970 kb R12P236 6/18/2004 PUB 15-2-36 Chapter 36, Hospital and Hospital Healthcare Complex Cost Report, Form CMS 2552-96 N/A N/A
93 kb R15BP 6/15/2004 PUB 100-02 Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit N/A 3226
174 kb R205CP 6/15/2004 PUB 100-04 Nurse Practitioners As Attending Physicians in the Medicare Hospice Benefit N/A 3226
76 kb R14NCD 6/10/2004 PUB 100-03 Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee 7/11/2004 3281
215 kb R199CP 6/10/2004 PUB 100-04 Medicare Need for a Specific Line Item Date of Service (LIDOS) for Each Revenue Code on ALL Outpatient and Inpatient Part B Claims 10/4/2004 3337
83 kb R200CP 6/10/2004 PUB 100-04 Update to the Common Working File Edits for Skilled Nursing Facility (SNF) Consolidated Billing (CB) to Expand the Bypass for Pharmacy Services. 10/4/2004 3277
92 kb R201CP 6/10/2004 PUB 100-04 IOM Manualization of Indian Health Services N/A 3302
69 kb R202CP 6/10/2004 PUB 100-04 Revised Updated SNF NO PAY File for July 2004 7/6/2004 3338
68 kb R203CP 6/10/2004 PUB 100-04 Billing Payment in a Health Professional Shortage Area 7/6/2004 3336
230 kb R204CP 6/10/2004 PUB 100-04 Medicare HIPAA Electronic Claims Compliance Report N/A 3306
187 kb R78PI 6/10/2004 PUB 100-08 Medical Review (MR) Progressive Corrective Action (PCA) for Part A 10/4/2004 3111
88 kb R88OTN 6/10/2004 PUB 100-20 Clarification and Revision of Change Request (CR) 3084, Implementation of Section 508(f) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173) 7/6/2004 3342
111 kb R194CP 6/4/2004 PUB 100-04 July 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS): Payment for Drugs, Biologicals and Radiopharmaceuticals 7/6/2004 3322
349 kb R195CP 6/4/2004 PUB 100-04 July 2004 Update of the Hospital Outpatient Prospective Payment System (OPPS) 7/6/2004 3324
42 kb R196CP 6/4/2004 PUB 100-04 Payment Denial for Medicare Services Furnished to Alien Beneficiaries Who Are Not Lawfully Present in the U. S. N/A 2825
74 kb R197CP 6/4/2004 PUB 100-04 Emergency Hospital Outpatient billing of Epotein Alfa (EPO) and Darbepoetin Alfa (Aranesp) 10/4/2004 3184
132 kb R198CP 6/4/2004 PUB 100-04 End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry Test(s) 1/3/2005 2813
301 kb R6GI 5/28/2004 PUB 100-01 CMS policy for testing quarterly release of the Medicare shared systems and the CWF 8/1/2004 3011
95 kb R12BP 5/28/2004 PUB 100-02 Chiropractic Billing 10/4/2004 3063
108 kb R13BP 5/28/2004 PUB 100-02 Diabetes Self Management Training Services 6/28/2004 3185
108 kb R14BP 5/28/2004 PUB 100-02 Changes in the Medicare Benefit Policy Manual-Chapter 10 7/1/2004 3225
75 kb R13NCD 5/28/2004 PUB 100-03 Removal of Coding from National Coverage Determination on Stem Cell Transplantation 7/6/2004 3265
536 kb R184CP 5/28/2004 PUB 100-04 July Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 5.2 7/6/2004 3314
71 kb R185CP 5/28/2004 PUB 100-04 Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Drugs and Electrocardiogram (EKG) Testing Provided During an Ambulance Transport 10/4/2004 3212
76 kb R186CP 5/28/2004 PUB 100-04 July Update to the Medicare Outpatient Code Editor (OCE) Version 19.2 For Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System 7/6/2004 3319
101 kb R187CP 5/28/2004 PUB 100-04 Billing Requirements for Hyperbaric Oxygen (HBO) Therapy for the Treatment of Diabetic Wounds of the Lower Extremities 6/28/2004 3172
77 kb R188CP 5/28/2004 PUB 100-04 Hospital Outpatient Billing and Payment under OPPS for New, Unclassified Drugs or Biologicals Approved by the FDA After January 1, 2004, But Before Assignment of a Product-Specific Drug/Biological HCPCS Code 7/6/2004 3287
2061 kb R189CP 5/28/2004 PUB 100-04 Updated SNF Help File Available for Calendar Year 2004 6/28/2004 3252
74 kb R190CP 5/28/2004 PUB 100-04 End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry (AMCC) Tests 10/4/2004 3239
54 kb R191CP 5/28/2004 PUB 100-04 Skilled Nursing Facility Consolidated Billing L Codes - DMERCs and Fis 6/28/2004 3295
49 kb R192CP 5/28/2004 PUB 100-04 Healthcare Common Procedure Coding System (HCPCS) Correction 7/6/2004 3282
401 kb R45FM 5/28/2004 PUB 100-06 Addition of Instructions for Form CMS-2591 to Chapter 6 N/A N/A
67 kb R76PI 5/28/2004 PUB 100-08 Clarification of Complex Medical Review 6/28/2004 3211
851 kb R77PI 5/28/2004 PUB 100-08 Instructions for Carriers, DMERCs, FIs, and full PSCs when interacting with the Comprehensive Error Rate Testing (CERT) Contractor (i.e., handling appeals of CERT-initiated denials, contacting non-responders, tracking over/underpayments 6/28/2004 3229
57 kb R84OTN 5/28/2004 PUB 100-20 Reporting Medicare Secondary Payer (MSP) Information on the Health Insurance Portability and Accountability Act of 1996 (HIPAA) X12N 837 Created Via Free Billing Software 10/4/2004 3284
98 kb R85OTN 5/28/2004 PUB 100-20 CD-ROM Initiative for Distribution of the Annual Disclosure, Dear Doctor Letter and Participation Enrollment Material 6/28/2004 3292
464 kb R86OTN 5/28/2004 PUB 100-20 Interface File from Recovery Management and Accounting System (ReMAS) N/A 3142
19 kb R17HMO 5/28/2004 PUB 75 Rescission of Transmittal 16 N/A N/A
85 kb R87OTN 5/26/2004 PUB 100-20 Instructions Related to "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments 6/14/2004 3247
102 kb R183CP 5/21/2004 PUB 100-04 Skilled Nursing Facility (SNF) Consolidated Billing: Services Furnished Under an "Arrangement" With an Outside Entity 7/1/2004 3248
107 kb R16MSP 5/21/2004 PUB 100-05 Update Medicare Secondary Payer (MSP) Group Health Plan Recovery Demand Letters to Employers and Insurers for Data Match and Non-Data Match Debts 7/6/2004 3216
102 kb R1SOM 5/21/2004 PUB 100-07 Release of Basic Manual N/A N/A
313 kb R6COM 5/21/2004 PUB 100-09 Provider/Supplier Communications - Revisions and Additions to Existing Contractor Requirements 6/21/2004 3179
56 kb R53MCM 5/21/2004 PUB 100-16 Chapter 11, Contracts With Medicare+Choice Organizations N/A N/A
49 kb R54MCM 5/21/2004 PUB 100-16 Chapter 19, Managed Care and M+C Systems Requirements N/A N/A
18 kb R55MCM 5/21/2004 PUB 100-16 Chapter 10, Organization Compliance With State Law and Pre-emption by Federal Law 12/8/2003 N/A
42 kb R16HMO 5/21/2004 PUB 75 Retirement of Manual N/A N/A
170 kb R182CP 5/17/2004 PUB 100-04 Updated SNF NO PAY File for July 2004 7/6/2004 3275
55 kb R176CP 5/14/2004 PUB 100-04 Instructions for Downloading the Medicare Zip Code File 10/4/2004 3270
168 kb R177CP 5/14/2004 PUB 100-04 Updated SNF NO PAY File for July 2004 7/6/2004 3275
45 kb R178CP 5/14/2004 PUB 100-04 Evaluation and Management Service Codes N/A 2321
59 kb R179CP 5/14/2004 PUB 100-04 Clarification to CR 3069 - New "K" Codes for Wheelchair Cushions 7/6/2004 3289
156 kb R180CP 5/14/2004 PUB 100-04 Hospital Partial Hospitalization Services Billing Requirements N/A 3297
89 kb R175CP 5/14/2004 PUB 100-04 Additional Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Institutional Health Care Claim Implementation Guide (IG) Instruction and Clarification of Transmittal 107/Pub 100-04 (CR 3031) 10/4/2004 3264
55 kb R181CP 5/14/2004 PUB 100-04 Instructions for Downloading the Medicare Zip Code File 7/6/2004 3198
96 kb R75PI 5/14/2004 PUB 100-08 Informing Beneficiaries About Which Local Medical Review Policy (LMRP) and/or Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) is Associated with Their Claim Denial 10/4/2004 3089
78 kb R4DEMO 5/14/2004 PUB 100-19 Use of Group Health Plan Payment System to Pay Capitated Payments to Non Health Plan Demonstrations Serving Medicare Fee For Service Beneficiaries 10/4/2004 3283
130 kb R83OTN 5/14/2004 PUB 100-20 Additional Health Insurance Health Insurance Portability and Accountability Act (HIPAA) Coordination of Benefits (COB) Information for Trading Partners 6/14/2004 3255
278 kb R81OTN 5/14/2004 PUB 100-20 Requirement for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), Fiscal Intermediaries (FIs), and Full Program Safeguard Contractors (PSCs) to Encourage Providers to Submit Medical Records to the Comprehensive Error Rate Testing (CERT) Contractor for Use in the November 2004 Improper Medicare Fee-For-Service (FFS) Payments Report 4/30/2004 3157
263 kb R82OTN 5/14/2004 PUB 100-20 Changes in Determining Rural Status of Hospitals for Transitional Outpatient Payments (TOPs) for 2004 6/1/2004 3214
77 kb R5GI 5/7/2004 PUB 100-01 Chapter 7 - Contract Administrative Requirements N/A 2765
97 kb R10BP 5/7/2004 PUB 100-02 Chapter 6, Hospital Services Covered Under Part B N/A 3298
35 kb R168CP 5/7/2004 PUB 100-04 Chapter 12, Physician/Practitioner Billing N/A 1756
62 kb R169CP 5/7/2004 PUB 100-04 Chapter 1, General Billing Requirements N/A 2631
130 kb R170CP 5/7/2004 PUB 100-04 Chapter 1, General Billing Requirements N/A 2815
62 kb R171CP 5/7/2004 PUB 100-04 July Quarterly Update for 2004 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule 7/6/2004 3253
541 kb R172CP 5/7/2004 PUB 100-04 New Waived Tests - July 1, 2004 7/6/2004 3254
74 kb R173CP 5/7/2004 PUB 100-04 2nd Update to the 2004 Medicare Physician Fee Schedule Database 7/6/2004 3286
55 kb R174CP 5/7/2004 PUB 100-04 Healthcare Common Procedure Coding System (HCPCS) Corrections Involving 0040T and A9603 7/6/2004 3258
98 kb R73PI 5/7/2004 PUB 100-08 Program Integrity Management Reporting System (PIMR) Section 7.2 of the Program Integrity Manual (PIM) 6/10/2004 2646
69 kb R52MCM 5/7/2004 PUB 100-16 Chapter 17, Subchapter A, TEFRA Cost-Based Payment Process and Principles 5/7/2004 N/A
107 kb R3DEMO 5/7/2004 PUB 100-19 Demonstration Project to Clarify the Definition of Homebound - Section 702 of MMA 10/4/2004 3269
63 kb R79OTN 5/7/2004 PUB 100-20 18-Month Moratorium on Physician Self-Referrals to Specialty Hospitals; Processing of Form CMS-855A Applications to Become a Medicare Certified Hospital 6/7/2004 3193
51 kb R80OTN 5/7/2004 PUB 100-20 Medicare Systems Acceptance of New Provider Numbers for Home Health Agencies 10/4/2004 3245
136 kb R4GI 4/30/2004 PUB 100-01 Scheduled Release for July Updates to Software Programs and Pricing/Coding Files 6/1/2004 3278
47 kb R12NCD 4/30/2004 PUB 100-03 Cardiac Pacemakers 4/30/2004 3290
61 kb R150CP 4/30/2004 PUB 100-04 Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.2, Effective July, 1, 2004. 7/6/2004 3244
356 kb R152CP 4/30/2004 PUB 100-04 Inclusion of Core-Based Statistical Area (CBSA) Data Elements to the Provider Specific Files 10/4/2004 3272
73 kb R165CP 4/30/2004 PUB 100-04 Enhancement to Home Health Consolidated Billing Edits 10/4/2004 3186
81 kb R154CP 4/30/2004 PUB 100-04 Remittance Advice Remark Code and Claim Adjustment Reason Code Update 7/6/2004 3227
219 kb R156CP 4/30/2004 PUB 100-04 Clarification of payments and billing procedures for hospitals subject to the Maryland waiver. 10/4/2004 3200
432 kb R158CP 4/30/2004 PUB 100-04 Consolidation of the Claims Crossover Process: Full-scale Implementation of the Coordination of Benefits Agreement (COBA) Initiative 10/4/2004 3273
162 kb R159CP 4/30/2004 PUB 100-04 National 1-800-MEDICARE (1-800-633-4227) Implementation (section 923(d) of MMA) 6/1/2004 3195
694 kb R153CP 4/30/2004 PUB 100-04 Type of Service Corrections 10/4/2004 3189
13 kb R161CP 4/30/2004 PUB 100-04 Informing Beneficiaries about whicl local Medical Review Policy (LMRP) and /or Local Coverage Determinatin (LCD) and o/or National Coverage Determination (NCD) is associated with their claim denia 10/4/2004 3089
95 kb R162CP 4/30/2004 PUB 100-04 Key Shop and Optical Character Recognition (OCR)/Image Character Recognition (ICR) Output Mapping 10/4/2004 3180
80 kb R163CP 4/30/2004 PUB 100-04 Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site Other than a Physician's Office or Hospital 10/4/2004 3196
13 kb R164CP 4/30/2004 PUB 100-04 End Stage Renal Disease (ESRD) Reimbursement for Automated Multi-Channel Chemistry Test(s) 7/6/2004 2813
3182 kb R167CP 4/30/2004 PUB 100-04 Discontinued Use of Revenue Code 0910 10/4/2004 3194
42 kb R166CP 4/30/2004 PUB 100-04 New DMERC/VIPS Systems Requirement 10/4/2004 2761
81 kb R160CP 4/30/2004 PUB 100-04 Section 511 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Special Adjustment for Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Rates for Acquired Immune Deficiency Syndrome (AIDS) 10/4/2004 3291
96 kb R15MSP 4/30/2004 PUB 100-05 Change in Interest Calculation for Medicare Overpayments and Underpayments and Medicare Secondary Payer (MSP) Recoveries 10/4/2004 3163
99 kb R40FM 4/30/2004 PUB 100-06 Modification of CROWD Form 5 10/4/2004 3257
373 kb R42FM 4/30/2004 PUB 100-06 Unsolicited/Voluntary Refunds 10/4/2004 3274
274 kb R43FM 4/30/2004 PUB 100-06 Expanded Identification and Workload Reporting for CMS Medicare Systems 10/4/2004 3256
212 kb R41FM 4/30/2004 PUB 100-06 Change in Interest Calculation for Medicare Overpayments and Underpayments and Medicare Secondary Payer (MSP) Recoveries 10/4/2004 3163
64 kb R44FM 4/30/2004 PUB 100-06 Notice of New Interest Rate for Medicare Overpayments and Underpayments 5/7/2004 2830
76 kb R2DEMO 4/30/2004 PUB 100-19 Virginia Cardiac Surgery Initiative Demonstration - Modifications & Corrections to Change Request 2382 10/4/2004 3199
52 kb R76OTN 4/30/2004 PUB 100-20 Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act (HIPAA) Transaction Release Testing 10/4/2004 3178
81 kb R77OTN 4/30/2004 PUB 100-20 Instructions Related to "Redistribution of Unused Resident Positions," Section 422 of the Medicare Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education (GME) Payments 6/4/2004 3247
67 kb R78OTN 4/30/2004 PUB 100-20 Renovate Override Code Processing In Common Working File 10/4/2004 3190
84 kb R9BP 4/23/2004 PUB 100-02 Arrangements for Physical, Occupational, and Speech Language Pathology Services (PT, OT, SLP) 5/24/2004 3134
67 kb R144CP 4/23/2004 PUB 100-04 Distinct Part Units for Critical Access Hospitals 10/4/2004 3175
381 kb R145CP 4/23/2004 PUB 100-04 Data Element Requirements Matrix - Carrier 5/24/2004 3164
301 kb R146CP 4/23/2004 PUB 100-04 Clarification of Billing for Separately Billable ESRD Drugs 10/4/2004 3176
79 kb R147CP 4/23/2004 PUB 100-04 Payment for Chemotherapy Administration Services, Nonchemotherapy Drug Infusion Services, and Drug Injection Services 5/24/2004 3192
100 kb R148CP 4/23/2004 PUB 100-04 Incident-To Services on Form CMS-1500 5/24/2004 3138
69 kb R130aCP 4/23/2004 PUB 100-04 Chapter 32, Billing Instructions for Special Services N/A 2323
1721 kb R149CP 4/23/2004 PUB 100-04 General Instructions for Completion of Form CMS-1450 for Billing 10/4/2004 3183
73 kb R74PI 4/23/2004 PUB 100-08 SNF Certification and Recertification 5/24/2004 3150
437 kb R5COM 4/23/2004 PUB 100-09 Manual Instruction for Update Beneficiary Services Sections 5104 (MCM) and 2958 (MIM), and Beneficiary Services Section 20 of the Internet-Only Manual (IOM) 5/24/2004 3097
213 kb R73OTN 4/23/2004 PUB 100-20 Revised American National Standards Institute X12N 837 Professional Health Care Claim Companion Document 5/24/2004 3177
48 kb R74OTN 4/23/2004 PUB 100-20 Emergency Correction Regarding Correction to Healthcare Common Procedure Coding System (HCPCS) Codes for Low Osmolar Contrast Material 5/24/2004 3187
46 kb R75OTN 4/23/2004 PUB 100-20 One time instructions for audit intermediary cost reporting processes to accommodate claims processing error that prevented some supply charges from being reported on home health prospective payment system claims 5/24/2004 3147
66 kb R143CP 4/19/2004 PUB 100-04 Updated SNF NO PAY File for April 2004 4/19/2004 3238
42 kb R11NCD 4/16/2004 PUB 100-03 Manualization NCD: Acupuncture for Fibromyalgia/Osteoarthritis 4/6/2004 3250
53 kb R140CP 4/16/2004 PUB 100-04 Hospital Concerns Regarding Changing of Patient Status Code Due to Common Working File Edit 7272 5/23/2004 3240
538 kb R141CP 4/16/2004 PUB 100-04 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2004 7/6/2004 3210
58 kb R142CP 4/16/2004 PUB 100-04 Manualization for 2502 N/A 2502
54 kb R39FM 4/16/2004 PUB 100-06 Installation of Version 34.0 of the Provider Statistical and Reimbursement (PS&R) Reporting System 10/4/2004 3182
58 kb R72PI 4/16/2004 PUB 100-08 Automated Prepayment 5/1/2004 3088
45 kb R51MCM 4/16/2004 PUB 100-16 Chapter 2, End Stage Renal Disease N/A N/A
54 kb R71OTN 4/16/2004 PUB 100-20 Update to the Healthcare Provider taxonomy Codes (HPTC) Version 4.0 5/17/2004 3188
14 kb R72OTN 4/16/2004 PUB 100-20 Changes in Determining Rural Status of Hospitals for Transitional Outpatient Payments (TOPs) for 2004 6/1/2004 3214
287 kb R136CP 4/9/2004 PUB 100-04 Addition of Two "WW" Codes to Identify Xeloda (Capecitabine) 7/6/2004 3169
205 kb R137CP 4/9/2004 PUB 100-04 Manualization of Section 4118 of the Medicare Carriers Manual, Part 3 N/A 3134
1607 kb R138CP 4/9/2004 PUB 100-04 The Consolidation of the Claims Crossover Process: Smaller-Scale Initial Implementation 7/6/2004 3218
183 kb R14MSP 4/9/2004 PUB 100-05 Chapter 5, Contractor Prepayment Processing Requirements N/A 2074
229 kb R38FM 4/9/2004 PUB 100-06 Chapter 1, Budget Preparation 7/6/2004 3218
352 kb R70PI 4/9/2004 PUB 100-08 New Requirements for Self-Administered Drug (SAD) Exclusion List Articles in the Medicare Coverage Database (MCD) 5/10/2004 3136
849 kb R71PI 4/9/2004 PUB 100-08 Rewrite of the Program Integrity Manual (except Chapter 10), Transmittal Page, Business Requirements, Table of Contents, Chapters 1 and 2. 5/10/2004 3030
2134 kb R71PI1 4/9/2004 PUB 100-08 Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 3 and 4 5/10/2004 3030
761 kb R71PI2 4/9/2004 PUB 100-08 Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 5 and 6 5/10/2004 3030
4370 kb R71PI3 4/9/2004 PUB 100-08 Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 7, 8, 9 and 12 5/10/2004 3030
689 kb R71PI4 4/9/2004 PUB 100-08 Rewrite of the Program Integrity Manual (except Chapter 10), Chapters 13 and 11 5/10/2004 3030
795 kb R71PI5 4/9/2004 PUB 100-08 Rewrite of the Program Integrity Manual (except Chapter 10), Exhibits 5/10/2004 3030
151 kb R49MCM 4/9/2004 PUB 100-16 Chapter 4, Benefits and Beneficiary Protection N/A N/A
434 kb R50MCM 4/9/2004 PUB 100-16 Chapter 20, Managed Care and M+C Systems Business Requirements N/A N/A
198 kb R69OTN 4/9/2004 PUB 100-20 Carrier Only* Shared System Maintainer Hours for Resolution of Problems Detected As A Result of Implementation of CR 2525 and CR 2527 N/A 3146
227 kb R70OTN 4/9/2004 PUB 100-20 How Fiscal Intermediary's are to Record Coinsurance Amounts from The Provider Statistical and Reimbursement (PS&R) Report for Providers Who Elected to Accept Reduced Coinsurance for Outpatient Prospective Payment System (OPPS) Services 5/10/2004 3166
1466 kb R10NCD 4/6/2004 PUB 100-03 NCD is being released N/A N/A
1500 kb R133CP 4/2/2004 PUB 100-04 Billing NonCovered Charges to Fiscal Intermediaries - Summary and New Instructions - Clarification 4/16/2004 3115
13 kb R134CP 4/2/2004 PUB 100-04 Instructions for Downloading the Medicare Zip Code File. 7/6/2004 3198
187 kb R135CP 4/2/2004 PUB 100-04 Purchased Diagnostic Test - Carriers N/A 1658
97 kb R48MCM 4/2/2004 PUB 100-16 Grievances, Organization Determinations, and Appeals N/A N/A
13 kb R67OTN 4/2/2004 PUB 100-20 Requirement for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), Fiscal Intermediaries (FIs), and Full Program Safeguard Contractors (PSCs) to Encourage Providers to Submit Medical Records to the Comprehensive Error Rate Testing (CERT) Contractor for Use in the November 2004 Improper Medicare Fee-For-Service (FFS) Payments Report 4/30/2004 3157
190 kb R68OTN 4/2/2004 PUB 100-20 Transmittal 49 Implementation Date Extension 7/6/2004 3197
413 kb R9NCD 4/1/2004 PUB 100-03 NCD - Ocular Photodynamic Therapy (OPT) With Verteporfin for Age-Related Macular Degeneration (AMD) 4/1/2004 3191
1433 kb R132CP 3/30/2004 PUB 100-04 April 2004 Update of the Hospital Outpatient Prospective Payment System 4/5/2004 3154
202 kb R125CP 3/26/2004 PUB 100-04 Manualization of the Sacral Nerve Stimulation N/A 2532
295 kb R126CP 3/26/2004 PUB 100-04 Manualization Clarification of ICD-9 Coding N/A 2857
334 kb R127CP 3/26/2004 PUB 100-04 2004 Jurisdiction List 5/26/2004 3139
233 kb R128CP 3/26/2004 PUB 100-04 Manualization of Deep Brain Stimulation N/A 2553
183 kb R129CP 3/26/2004 PUB 100-04 Additional Information and Corrections to Previous Transmittals Regarding Healthcare Common Procedure Coding System (HCPCS) Codes and Modifiers for Low Osmolar Contrast Material, Orthotics, and Durable Medical Equipment 4/26/2004 3143
218 kb R130CP 3/26/2004 PUB 100-04 Chapter 32, Billing Instructions for Special Services N/A 2323
322 kb R131CP 3/26/2004 PUB 100-04 New Payment Allowance Percentages for DMERC Drugs 3/26/2004 3153
689 kb R69PI 3/26/2004 PUB 100-08 Streamlining Enrollment Requirements 4/26/2004 3159
200 kb R63OTN 3/26/2004 PUB 100-20 Durable Medical Equipment Regional Carriers (DMERCs) - DeWall Posture Protector Orthotic Body Jacket (L0430): Continuation of CMS' Policy Stated in CR 2711 (B-03-025) dated April 11, 2003. N/A 3224
298 kb R64OTN 3/26/2004 PUB 100-20 Implementation of Sections 401, 402, 504 and 508(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173 4/5/2004 3158
223 kb R65OTN 3/26/2004 PUB 100-20 Implementation of Section 508(f) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173) 4/26/2004 3084
184 kb R7NCD 3/19/2004 PUB 100-03 Electrical Stimulation and Electromagnetic Therapy for the Treatment of Wounds 7/6/2004 3149
13 kb R8NCD 3/19/2004 PUB 100-03 Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT) 4/1/2004 2988
255 kb R120CP 3/19/2004 PUB 100-04 April Update to the January Medicare Outpatient Code Editor (OCE) Specifications Version 19.1 R1 For Bills From Hospitals That Are Not Paid Under The Outpatient Prospective Payment System 4/5/2004 3155
537 kb R121CP 3/19/2004 PUB 100-04 Manualization of Place of Service (POS) Code Set Program Memorandum; Revision to Group Home Code Description 4/1/2004 3087
173 kb R122CP 3/19/2004 PUB 100-04 Revision to Required Messages in Change Request (CR) 2944, Implementation of Skilled Nursing Facility (SNF) Consolidated Billing Edit for Therapy Codes Considered Separately Payable Physician Services 7/6/2004 3156
1104 kb R123CP 3/19/2004 PUB 100-04 April Outpatient Code Editor (OCE) Specifications Version 5.1 4/5/2004 3170
332 kb R124CP 3/19/2004 PUB 100-04 Electrical Stimulation and Electromagnetic Therapy for the Treatment of Wounds 7/6/2004 3149
2996 kb R13MSP 3/19/2004 PUB 100-05 Updates to the Electronic Correspondence Referral System (ECRS) User Guide v7.0 and Quick Reference Card v7.0 4/19/2004 3174
187 kb R37FM 3/19/2004 PUB 100-06 Installation of Version 33 of the Provider Statistical and Reimbursement (PS&R) Reporting System. 7/5/2004 3131
140 kb R62OTN 3/19/2004 PUB 100-20 Physician Self-Referral Prohibition; 18-Month Moratorium on Physician Investment in Specialty Hospitals 4/2/2004 3036
702 kb R12P232 3/19/2004 PUB 15-2-32 Home Health Agency Cost Report N/A N/A
109 kb R5P238 3/19/2004 PUB 15-2-38 Electronic Reporting Specifications for Form CMS-1984-99 N/A N/A
183 kb R119CP 3/15/2004 PUB 100-04 MMA Drug Pricing Update-Drug Exceptions 4/5/2004 3161
319 kb R3GI 3/12/2004 PUB 100-01 New Part B Annual Deductible 1/3/2005 3121
253 kb R36FM 3/12/2004 PUB 100-06 Contractor Reporting of Operations and Workload Data (CROWD) for EDI N/A 2249
493 kb R5ESRD 3/12/2004 PUB 100-14 Chapter 4, Information Management 4/26/2004 N/A
237 kb R6ESRD 3/12/2004 PUB 100-14 Chapter 6, Community Information and Resources 4/26/2004 N/A
635 kb R7ESRD 3/12/2004 PUB 100-14 Chapter 7, Sanctions and ESRD Complaints and Grievances 4/26/2004 N/A
265 kb R61OTN 3/12/2004 PUB 100-20 Changes to the FY 2004 Graduate Medical Education (GME) Payments as Required by the Medicare Modernization Act of 2003 (MMA), P.L. 108-173 4/5/2004 3071
208 kb R8BP 3/5/2004 PUB 100-02 Policy Changes to Reflect Billing for Darbepoetin Alfa and Epoetin 4/5/2004 2984
200 kb R115CP 3/5/2004 PUB 100-04 DMERCs and VIPS, Processing NDC Numbers - Clarification to CR 3141 7/6/2004 3148
293 kb R116CP 3/5/2004 PUB 100-04 ESRD- Miscellaneous Code Processing Clarification 4/5/2004 3019
199 kb R117CP 3/5/2004 PUB 100-04 Instructions for downloading the Medicare zip code file. 4/5/2004 3160
537 kb R118CP 3/5/2004 PUB 100-04 Frequency Limitations for Darbepoetin Alfa (trade name Aranesp) For Treatment Of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis. 4/5/2004 2984
413 kb R12MSP 3/5/2004 PUB 100-05 Interim Non-Systems Solution: Converting Health Insurance Portability and Accountability Act (HIPAA) Individual Relationship Codes to Common Working File (CWF) Patient Relationship Codes 3/19/2004 3117
862 kb R4COM 3/5/2004 PUB 100-09 Provider/Supplier Communications - Revisions and Additions to Existing Contractor Requirements 4/5/2004 3118
5683 kb R4SSM 3/5/2004 PUB 100-17 Medicare Business Partners Systems Security (a.k.a. CMS Business Partners Systems Security Manual) 4/5/2004 3106
247 kb R108CP 2/27/2004 PUB 100-04 Type of Service (TOS) Corrections 3/29/2004 3018
318 kb R109CP 2/27/2004 PUB 100-04 Updated Policy and Claims Processing Instructions for Ambulatory Blood Pressure Monitoring (ABPM) 4/5/2004 2726
241 kb R110CP 2/27/2004 PUB 100-04 New Requirements for payment of drugs furnished in independent dialysis facilities and paid outside of the composite rate for dates of service (DOS) starting on January 1, 2004. Drugs furnished in this setting will be paid at the lower of billed charges or 95 percent Average Wholesale Price (AWP) for the calendar year 2004. These changes have been established with the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, PL 108-173. 3/29/2004 3078
225 kb R111CP 2/27/2004 PUB 100-04 Payment For Services Provided Under a Contractual Agreement 3/12/2004 3083
192 kb R113CP 2/27/2004 PUB 100-04 Claims Requiring Adjustment As a Result of April 2004 Changes to the Outpatient Prospective Payment System (OPPS) 4/5/2004 3145
347 kb R114CP 2/27/2004 PUB 100-04 Modification of CMS' Medicare Contingency Plan for HIPPA Implementation 7/6/2004 2981
303 kb R11MSP 2/27/2004 PUB 100-05 General Policy 3/29/2004 3064
525 kb R67PI 2/27/2004 PUB 100-08 The Medicare Coverage Database 3/12/2004 2976
263 kb R112CP 2/27/2004 PUB 100-08 April 2004 Changes to the Hospital Outpatient Prospective Payment System (OPPS): Payment for Drugs, Biologicals and Radiopharmaceuticals, Generic Versus Brand Name 4/5/2004 3144
503 kb R107CP 2/25/2004 PUB 100-04 Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Health Care Claim Implementation Guide (IG) Editing Additional Instruction 7/6/2004 3031
139 kb R7BP 2/20/2004 PUB 100-02 Restoring Composite Rate Exceptions for Pediatric Facilities Under the ESRD Composite Rate System 4/1/2004 3119
258 kb R101CP 2/20/2004 PUB 100-04 Restoring Composite Rate Exceptions for Pediatric Facilities Under the ESRD Composite Rate System 4/1/2004 3119
94 kb R102CP 2/20/2004 PUB 100-04 New Waived Tests--April 1, 2004 4/5/2004 3061
272 kb R103CP 2/20/2004 PUB 100-04 Optional Method for Outpatient Services: Cost-Based Facility Services Plus 115 percent Fee Schedule Payment for Professional Services 7/1/2004 3114
247 kb R104CP 2/20/2004 PUB 100-04 DMERCs and VIPS, Processing NDC Numbers 4/5/2004 3141
258 kb R105CP 2/20/2004 PUB 100-04 1st Update to the 2004 Medicare Physician Fee Schedule Database 4/5/2004 3128
261 kb R66PI 2/20/2004 PUB 100-08 Progressive Corrective Action Program Memorandum and Providing Updated Instructions on How Contractors Must Identify, Verify, and Correct Billing Errors. 4/2/2004 3124
399 kb R47MCM 2/20/2004 PUB 100-16 Chapter 7--Medicare+Choice-Enrollment and Disenrollment N/A N/A
166 kb R59OTN 2/20/2004 PUB 100-20 Temporary 5 Percent Payment Increase for Home Health Services Furnished in a Rural Area for One Year Under the Home Health Prospective Payment System (HH PPS), Change of HH PPS Annual Update from a Fiscal Year Update to a Calendar Year Update, and Adjustment of HH PPS Annual Update to the Home Health Market Basket Percentage Increase Minus 0.8 Percent 4/5/2004 3085
105 kb R425PR1 2/20/2004 PUB 15-1 Regional Medicare Swing-Bed Rates N/A N/A
1867 kb R32SOM 2/13/2004 PUB 07 Appendix C-Survey Procedures and Interpretive Guidelines for Laboratories and Laboratory Services 4/1/2004 N/A
257 kb R100CP 2/13/2004 PUB 100-04 Outpatient Clinical Laboratory Tests Furnished by Hospitals With Fewer Than 50 beds in Qualified Rural Areas 7/6/2004 3130
160 kb R10MSP 2/13/2004 PUB 100-05 Update the Part B Shared Systems to Send the Appropriate Medicare Fee Schedule Amounts to the Medicare Secondary Payer Payment (MSPPAY) Software for Psychiatric MSP Claims 7/6/2004 2955
131 kb R45MCM 2/13/2004 PUB 100-16 Chapter 13, Grievances Organization Determinations and Appeals N/A N/A
300 kb R46MCM 2/13/2004 PUB 100-16 Chapter 19, Managed Care and M+C Systems Requirements N/A N/A
219 kb R58OTN 2/13/2004 PUB 100-20 Program Integrity Management Reporting (PIMR) System Program Integrity Management Reporting System (PIMR) FY 2004 F and T Codes 4/1/2004 3110
257 kb R99CP 2/9/2004 PUB 100-04 Health Insurance Portability and Accountability Act (HIPAA) X12N 837 Coordination of Benefits (COB) Gap Fill Additional Instruction 7/6/2004 3100
364 kb R35FM 2/9/2004 PUB 100-06 Unsolicited/Voluntary Refunds 10/4/2004 1444
293 kb R2GI 2/6/2004 PUB 100-01 Scheduled Release for April Updates to Software Programs and Pricing/Coding Files 3/8/2004 3123
267 kb R86CP 2/6/2004 PUB 100-04 X12N 837 Professional Implementation Guide (IG) Edits 7/6/2004 3050
284 kb R87CP 2/6/2004 PUB 100-04 Expansion of Transfer Policy Under Inpatient Payment Prospective System 7/6/2004 2934
238 kb R84CP 2/6/2004 PUB 100-04 Additional Guidelines for Implementing the National Council for Prescription Drug Program 7/6/2004 3095
472 kb R85CP 2/6/2004 PUB 100-04 Processing of Claims for Referred Services for a Independent Clinical Diagnostic Laboratory 7/6/2004 3090
507 kb R88CP 2/6/2004 PUB 100-04 Implementation of Changes to Payment for Ambulance Services Required by Section 414 of MMA 7/5/2004 3099
362 kb R89CP 2/6/2004 PUB 100-04 The Elimination of the 90-Day Grace Period for HCPCS Codes 7/6/2004 3093
332 kb R80CP 2/6/2004 PUB 100-04 Extend Medicare Coverage for Certain Colorectal Cancer Screenings at SNFs 7/6/2004 2874
2,141 kb R81CP 2/6/2004 PUB 100-04 Update of UB-92 Codes 7/6/2004 3012
341 kb R82CP 2/6/2004 PUB 100-04 ESRD Data for Use in Adjusting Claims 7/6/2004 3066
225 kb R83CP 2/6/2004 PUB 100-04 New "K" Codes for Wheelchair Cushions 7/6/2004 3069
449 kb R76CP 2/6/2004 PUB 100-04 SNF Inpatient Part A Billing N/A 3133
331 kb R77CP 2/6/2004 PUB 100-04 Change in Methodolgy for Determining Payment for Outliers 3/8/2004 2998
329 kb R78CP 2/6/2004 PUB 100-04 Medicare Incentive Payments for Physician Care 7/6/2004 3108
299 kb R79CP 2/6/2004 PUB 100-04 ESRD Reimbursement for AMCC Tests 7/6/2004 2813
248 kb R90CP 2/6/2004 PUB 100-04 Implementation of Skilled Nursing Facility Consolidated Billing CWF Edit for Therapy Codes Considered Separately Payable Physician Services 7/6/2004 2944
264 kb R91CP 2/6/2004 PUB 100-04 Revisions to Processing of Non-covered Charges on Certain Home Health Prospective Payment System Claims 7/6/2004 3077
366 kb R92CP 2/6/2004 PUB 100-04 Updates to the January 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement 4/5/2004 3070
171 kb R93CP 2/6/2004 PUB 100-04 Remittance Advice Remark Code and Claim Adjustment Reason Code Update 4/5/2004 3122
368 kb R94CP 2/6/2004 PUB 100-04 Additional Information in Medicare Summary Notices (MSNs) to Beneficiaries about Skilled Nursing Facility (SNF) Benefits 7/6/2004 3098
645 kb R98CP 2/6/2004 PUB 100-04 Consolidation of the Claims Crossover Process: Additional Common Working File (CWF) Functionality 7/6/2004 3109
291 kb R97CP 2/6/2004 PUB 100-04 Implementation of New Medicare Redetermination Notice (MRN) 7/6/2004 2620
244 kb R95CP 2/6/2004 PUB 100-04 Elimination of the 90-Day Grace Period for ICD-9-CM Codes 10/1/2004 3094
253 kb R96CP 2/6/2004 PUB 100-04 Claims Status Codes in ASC X12N 276/277 Claims Status Health Insurance Portability and Accountability Act (HIPAA) Transactions N/A 3017
214 kb R7MSP 2/6/2004 PUB 100-05 Sending the Primary Payer Covered Charge Amount to the Medicare Secondary Payment (MSPPAY) Module for MSP Home Health Prospective Payment System (HH PPS) Claims 7/6/2004 2954
316 kb R8MSP 2/6/2004 PUB 100-05 Common Working File MSP Modifications 7/6/2004 2775
276 kb R9MSP 2/6/2004 PUB 100-05 Converting Health Insurance Portability and Accountability ct (HIPAA) Individual Relationship Codes to Common Working File (CWF) Patient Relationship Codes 7/6/2004 3116
229 kb R32FM 2/6/2004 PUB 100-06 Expanded Identification and Workload Reporting for CMS Medicare Systems 7/6/2004 3023
758 kb R34FM 2/6/2004 PUB 100-06 Chapter 7 - Internal Control Requirements Update 3/8/2004 3006
207 kb R33FM 2/6/2004 PUB 100-06 Coordination of Medicare and Complementary Insurance Programs 7/6/2004 3109
181 kb R50OTN 2/6/2004 PUB 100-20 ANSI X12 Transaction 270/271 Changes 4/5/2004 3065
174 kb R51OTN 2/6/2004 PUB 100-20 Changes in Payment for Services Furnished in Ambulatory Surgical Centers for Fiscal Year 2004 4/5/2004 3082
196 kb R52OTN 2/6/2004 PUB 100-20 Provider Data on Outbound Coordination of Benefit (COB) Files 7/6/2004 3101
154 kb R53OTN 2/6/2004 PUB 100-20 Surgical Lines with No Charges 7/6/2004 3104
166 kb R55OTN 2/6/2004 PUB 100-20 Shared System Maintainer Hours for Resolution of Problems Detected During HIPAA Transaction Release Testing 7/6/2004 3067
907 kb R56OTN 2/6/2004 PUB 100-20 Program Integrity Management Reporting (PIMR) System for Part A - Phase 4 7/6/2004 3113
592 kb R54OTN 2/5/2004 PUB 100-20 Introduction of "Medlearn Matters�Information for Medicare Providers" and Instructions for Carrier/Intermediary Use of This New Provider Education Vehicle 3/8/2004 3129
99 kb R75CP 1/30/2004 PUB 100-04 MMA Pricing File Clarifications 1/30/2004 3105
165 kb R31FM 1/30/2004 PUB 100-06 Installation of Version 31 of the Provider Statistical and Reimbursement (PS&R) Reporting System 2/16/2004 3073
224 kb R64PI 1/30/2004 PUB 100-08 Role Conditions of Participation (COPs) Requirements When Making a Payment Decision 3/2/2004 3042
264 kb R65PI 1/30/2004 PUB 100-08 Fiscal Intermediaries to Perform Medical Review on Long Term Care Hospitals 3/2/2004 2905
168 kb R48OTN 1/30/2004 PUB 100-20 Transfer of "WW" Codes for Oral Anti-Cancer Drugs Billed Using National Drug Codes (NDCs) on Durable Medical Equipment Regional Carrier (DMERC) Claims 4/1/2004 2863
148 kb R49OTN 1/30/2004 PUB 100-20 Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases 3/2/2004 3075
303 kb R63CP 1/28/2004 PUB 100-04 Special Rules for Critical Access Hospital (CAH) Outpatient Billing 4/5/2004 3051
270 kb R68CP 1/28/2004 PUB 100-04 New Requirements for Critical Access Hospitals. These changes have been established with the "Medicare Prescription Drug, Improvement, and Modernization Act" (MPDIMA) of 2003, Pub.L.�108-173 4/5/2004 3052
241 kb R30FM 1/28/2004 PUB 100-06 Notice of New Interest Rates for Medicare Overpayments and Underpayments 2/4/2004 2829
264 kb R6BP 1/23/2004 PUB 100-02 Intravenous Immune Globulin 4/5/2004 3059
158 kb R6NCD 1/23/2004 PUB 100-03 Cardiac Output Monitoring by Thoracic Electrical Bioimpedance 2/23/2004 2689
274 kb R69CP 1/23/2004 PUB 100-04 Criteria for Using the CB Modifier 2/23/2004 2906
322 kb R71CP 1/23/2004 PUB 100-04 Changes to the Laboratory National Coverage Determination (NCD) Edit Software 4/5/2004 3032
235 kb R72CP 1/23/2004 PUB 100-04 Update of Address for the Railroad Retirement Board (RRB) 2/23/2004 3034
238 kb R73CP 1/23/2004 PUB 100-04 MCE and IPPS Transfers Between Hospitals N/A 2716
253 kb R74CP 1/23/2004 PUB 100-04 Intravenous Immune Globulin 4/5/2004 3060
166 kb R62PI 1/23/2004 PUB 100-08 The Focused Medical Review Report 4/5/2004 3062
427 kb R63PI 1/23/2004 PUB 100-08 Benefit Improvement Protection Act (BIPA) 2/23/2004 3010
157 kb R43OTN 1/23/2004 PUB 100-20 Correction To The Effective Date On 9 Code Pairs in Correct Coding Initiative (CCI) Version 9.3 (Cardiology edits) 2/23/2004 3008
171 kb R44OTN 1/23/2004 PUB 100-20 Correction-CWF Edits for Inserts for Therapeutic Shoes 4/1/2004 3029
143 kb R45OTN 1/23/2004 PUB 100-20 Emergency Correction to Healthcare Common Procedure Coding System (HCPCS) Codes for Low Osmolar Contrast Material 4/5/2004 3053
174 kb R46OTN 1/23/2004 PUB 100-20 Railroad Medicare Carrier Collection of Data 2/23/2004 3041
91 kb R47OTN 1/23/2004 PUB 100-20 Implementation of the Occupational Mix Survey 2/23/2004 3043
384 kb R61CP 1/16/2004 PUB 100-04 Diagnosis coding instructions for anticipated payment and claims to conform with HIPAA requirements 2/16/2004 2992
168 kb R62CP 1/16/2004 PUB 100-04 January 2004 annual update of HCPCS codes used for Home Health Consolidated Billing Enforcement 2/16/2004 3024
174 kb R64CP 1/16/2004 PUB 100-04 Coding Change for Ventricular Assist Devices (VADs) for Beneficiaries in an Medicare+Choice (M+C) Plan 2/16/2004 3068
174 kb R65CP 1/16/2004 PUB 100-04 ANSI X12 Transaction 835 Companion Document Change for Carriers, Durable Medical Equipment Regional Carriers (DMERCs), and Fiscal Intermediaries (Fis) 2/16/2004 2948
232 kb R66CP 1/16/2004 PUB 100-04 Quarterly Update to Correct Coding Initiative (CCI) edits, Version 10.1, Effective April 1, 2004 4/5/2004 2997
280 kb R67CP 1/16/2004 PUB 100-04 Revision to CR 2912: Coding, Testing, and Implementation Phases of CR 2631 for Jurisdiction 4/5/2004 3039
144 kb R6MSP 1/16/2004 PUB 100-05 Automatic Notice of Change to MSP Auxiliary File 1/11/2004 2608
169 kb R42OTN 1/16/2004 PUB 100-20 Payment to Ambulatory Surgical Centers (ASCs) for G0260 and to Physicians for 27096 When 27096 is Performed in an ASC 2/2/2004 2979
167 kb R5BP 1/9/2004 PUB 100-02 Chapter 15, Covered Medical and Other Health Services N/A 2779
284 kb R60CP 1/9/2004 PUB 100-04 Chapter 18, Preventive and Screening Services N/A 2632
248 kb R41MCM 1/9/2004 PUB 100-16 Chapter 2, Enrollment and Disenrollment N/A N/A
223 kb R42MCM 1/9/2004 PUB 100-16 Chapter 3, Marketing N/A N/A
118 kb R43MCM 1/9/2004 PUB 100-16 Chapter 4, Benefits and Beneficiary Protection N/A N/A
93 kb R44MCM 1/9/2004 PUB 100-16 Chapter 6, Relationships With Providers N/A N/A
235 kb R41OTN 1/9/2004 PUB 100-20 Provider Education Article: New Enrollee Rights, New Provider Responsibilities in M+C Program 1/9/2004 3044
191 kb R39OTN 1/6/2004 PUB 100-20 Change in Coding on Medicare Claims for Darbepoetin Alfa (trade name Aranesp) and Epoetin Alfa (trade name Epogen, EPO) For Treatment Of Anemia In End Stage Renal Disease (ESRD) Patients On Dialysis 1/5/2004 2963
517 kb R40OTN 1/6/2004 PUB 100-20 Provider Education Article: Renewed Moratorium on Outpatient Rehabilitation Therapy Caps 1/20/2004 3045
314 kb R4BP 1/2/2004 PUB 100-02 Dentists, podiatrists, and optometrists are added to the definition/list of physicians who may opt out of Medicare 2/2/2004 3016
292 kb R57CP 1/2/2004 PUB 100-04 Implementation Guide (IG) Edits 4/5/2004 3001
241 kb R58CP 1/2/2004 PUB 100-04 April Quarterly DMEPOS Fee Schedule Update 4/5/2004 3014
388 kb R59CP 1/2/2004 PUB 100-04 New HCPCS Code for Ambulance Night Differential Charges 1/5/2004 3035
2,512 kb R29FM 1/2/2004 PUB 100-06 Revisions to Chapter 3 & 4 2/6/2004 2911
281 kb R61PI 1/2/2004 PUB 100-08 Clarification of Proof of Delivery Requirements 2/2/2004 2903
210 kb R37OTN 1/2/2004 PUB 100-20 Home Health Cost Reporting Processes 2/2/2004 2993
576 kb R38OTN 1/2/2004 PUB 100-20 Provider Education Article: 2004 Medicare Physician Fee Schedule Increase and Extension of the Annual Participation Enrollment Period 1/5/2004 3040

**The files listed above are PDF (Portable Document Format) files. In the past the transmittal cover page was all we were able to put on the Internet. PDF format enables us to put the entire transmittal on the Internet. You can view and print PDF files exactly as they were originally printed in paper form. To view these documents, you must have the Adobe Acrobat Reader, which can be downloaded at no cost by clicking here.

2003 Transmittals | 2002 Transmittals | 2001 Transmittals | 2000 Transmittals | Program Memos | Program Manuals

Last Modified on Friday, November 05, 2004