November 3 2017 Weekly Update for Users by CorroHealth

Date

PARA WEEKLY

UPDATE For Users

Improving T he Businessof HealthCare Since 1985 November 3, 2017 NEWS FOR HEALTHCARE DECISION MAKERS IN THIS ISSUE QUESTIONS & ANSWERS -

Medicare Coverage Of Pulmonary Rehab Services

CPT Nasogastric Tube Placement

ICD-10 Tubal/Ovarian Pregnancy

AND AN UPDATED AND EXPANDED LIST OF CMS UPDATES FOR 2018 2018 CODING UPDATE DOCUMENTS

The number of new or revised Med Learn (MLN Matters) articles released this week. All new and previous Med Learn articles can be viewed under the type "Med Learn", in the Advisor tab of the PARA Dat a Edit or . Click here.

-------------------------------------------------------

PARA YEAR-END HCPCS UPDATE PROCESS

The number of new or revised Transmittals released this week. All new and previous Transmittals can be viewed under the type "Transmittals" in the Advisor tab of the PARA Dat a Edit or . Click here.

PARA COMPANY NEWS ABOUT PARA SERVICES CONTACT US

FAST LINKS: Click on the link for special areas of interest: -

Administration: Pages 1-30 HIM/Coding Staff: Pages 2, 12-17 Providers: Pages 10-14,23,26 PDE Users: Pages 14, 16

Page

Dialysis: Page 26 Laboratory Services: Page 28 Finance Departments: Pages 21,23,26 Respiratory Svcs: Pages 3,10,19,23

PARA Weekly Update: November 3, 2017

MEDICARE COVERAGE OF PULMONARY REHAB SERVICES Pulmonary Rehabilitation (PR) Services are covered Medicare services as manualized in the Medicare Benefit Policy Manual (Pub. 100-02), Chapter 15, and the Medicare Claims Processing Manual (Pub. 100-04), Chapter 32, ?Covered Medical and Other Health Services.?Excerpts from each document are provided following these introductory remarks. HCPCS G0424 (Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day) may be reported for a maximum of 2 1-hour sessions per day for up to 36 sessions, with the option for an additional 36 sessions if medically necessary. Medicare covers PR services for patients with moderate to very severe chronic obstructive pulmonary disease (COPD) (defined as GOLD classification II, III, and IV), when referred by the physician treating the chronic respiratory disease. G0424 is reimbursed by Medicare at $54.55 per session (national rate without wage index adjustment.)

HCPCS G0424 represents programmatic pulmonary rehabilitation.Individualized care is also reimbursed by Medicare, but individualized services should not be billed during the same time period as a programmatic pulmonary rehab service for the same patient.Individualized services may be reported with the following code set: -

G0237- therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)

G0238- therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)

G0239- therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)

CMS has determined that a national coverage determination (NCD) for pulmonary rehabilitation ?is not appropriate at this time.?While Medicare Administrative Contractors are empowered to issue Local Coverage Determinations (LCD), no MAC currently has an LCD in effect. However, Cahaba GBA, the Medicare Administrative Contractor for Georgia, Alabama, and Tennessee, has published a Local Coverage Article for Pulmonary Rehab Services. 2

PARA Weekly Update: November 3, 2017

MEDICARE COVERAGE OF PULMONARY REHAB SERVICES The article is instructive as a concise resource for program requirements:

PARA Weekly Update: November 3, 2017

MEDICARE COVERAGE OF PULMONARY REHAB SERVICES Some MAC?s have opted to publish Frequently Asked Questions documents, such as Noridian did in 2010:

Links and excerpts from the Medicare manuals are provided below: Medicare Benefit Policy Manual, Chapter 15 ? Covered Medical and Other Health Services https:/ / www.cms.gov/ Regulations-and-Guidance/ Guidance/ Manuals/ Downloads/ bp102c15.pdf 231 - Pulmonary Rehabilitation (PR) Program Services Furnished On or After January 1, 2010 (Rev. 124, Issued: 05-07-10, Effective: 01-01-10, Implementation: 10-04-10) A pulmonary rehabilitation (PR) program is typically a physician-supervised, multidisciplinary program individually tailored and designed to optimize physical and social performance and autonomy of care for patients with chronic respiratory impairment. The main goal is to empower the individuals?ability to exercise independently. Exercise is combined with other training and support mechanisms to encourage long-term adherence to the treatment plan. Effective January 1, 2010, Medicare Part B pays for PR programs and related items and services if specific criteria is met by the Medicare beneficiary, the PR program itself, the setting in which it is administered, and the physician administering the program, as outlined below: PR Program Beneficiary Requirements: As specified in 42 CFR 410.47, Medicare covers PR items and services for patients with moderate to very severe chronic obstructive pulmonary disease (COPD) (defined as GOLD classification II, III, and IV), when referred by the physician treating the chronic respiratory 4

PARA Weekly Update: November 3, 2017

MEDICARE COVERAGE OF PULMONARY REHAB SERVICES disease. Additional medical indications for coverage for PR program services may be established through the national coverage determination process. PR Program Component Requirements: -

Physician-prescribed exercise. This physical activity includes techniques such as exercise conditioning, breathing retraining, and step and strengthening exercises. Some aerobic exercise must be included in each PR session. Both low- and high- intensity exercise is recommended to produce clinical benefits and a combination of endurance and strength training should be conducted at least twice per week.

Education or training. This should be closely and clearly related to the individual?s care and treatment and tailored to the individual?s needs, including information on respiratory problem management and, if appropriate, brief smoking cessation counseling. Any education or training must assist in achievement of individual goals towards independence in activities of daily living, adaptation to limitations, and improved quality of life (QoL).

Psychosocial assessment. This assessment means a written evaluation of an individual?s mental and emotional functioning as it relates to the individual?s rehabilitation or respiratory condition. It should include: (1) an assessment of those aspects of the individual?s family and home situation that affects the individual?s rehabilitation treatment, and, (2) a psychological evaluation of the individual?s response to, and rate of progress under, the treatment plan. Periodic re-evaluations are necessary to ensure the individual?s psychosocial needs are being met.

Outcomes assessment. These should include: (1) beginning and end evaluations based on patient-centered outcomes, which are conducted by the physician at the start and end of the program, and, (2) objective clinical measures of the effectiveness of the PR program for the individual patient, including exercise performance and self-reported measures of shortness of breath, and behavior. The assessments should include clinical measures such as the 6-minute walk, weight, exercise performance, self-reported dyspnea, behavioral measures (supplemental oxygen use, smoking status,) and a QoL assessment.

An individualized treatment plan describing the individual?s diagnosis and detailing how components are utilized for each patient. The plan must be established, reviewed, and signed by a physician every 30 days. The plan may initially be developed by the referring physician or the PR physician. If the plan is developed by the referring physician who is not the PR physician, the PR physician must also review and sign the plan prior to imitation of the PR program. It is expected that the supervising physician would have initial, direct contact with the individual prior to subsequent treatment by ancillary personnel, and also have at least one direct contact in each 30-day period. The plan must have written specificity with regards to the type, amount, frequency, and duration of PR items and services furnished to the individual, and specify the appropriate mix of services for the patient?s needs. It must include measurable and expected outcomes and estimated timetables to achieve these outcomes. 5

PARA Weekly Update: November 3, 2017

MEDICARE COVERAGE OF PULMONARY REHAB SERVICES As specified at 42 CFR 410.47(f), PR program sessions are limited to a maximum of 2 1-hour sessions per day for up to 36 sessions, with the option for an additional 36 sessions if medically necessary. PR Program Setting Requirements: PR items and services must be furnished in a physician?s office or a hospital outpatient setting. The setting must have the necessary cardio-pulmonary, emergency, diagnostic, and therapeutic life-saving equipment accepted by the medical community as medically necessary (for example, oxygen, cardiopulmonary resuscitation equipment, and a defibrillator) to treat chronic respiratory disease. All settings must have a physician immediately available and accessible for medical consultations and emergencies at all times that the PR items and services are being furnished under the program. This provision is satisfied if the physician meets the requirements for direct supervision of physician office services as specified at 42 CFR 410.26, and for hospital outpatient therapeutic services as specified at 42 CFR 410.27. PR Program Physician Requirements: Medicare Part B pays for PR services supervised by a physician only if the physician meets all of the following requirements: (1) expertise in the management of individuals with respiratory pathophysiology, (2) licensed to practice medicine in the state in which the PR program is offered, (3) responsible and accountable for the PR program, and, (4) involved substantially, in consultation with staff, in directing the progress of the individual in the PR program. The Medicare Claims Processing Manual, Chapter 32, provides specific billing instructions: http:/ / www.cms.gov/ Regulations-and-Guidance/ Guidance/ Manuals/ Downloads/ clm104c32.pdf 140.4.2.2 ? Requirements for PR Services on Institutional Claims (Rev. 1966, Issued: 05-07-10, Effective: 01-01-10, Implementation: 10-04-10) Effective for claims with dates of service on and after January 1, 2010, Medicare contractors shall pay for PR services when submitted on a type of bill (TOB) 13X and 85X only, along with revenue code 0948. All other TOBs shall be denied. ... 140.4.2.3 ? Daily Frequency Edits for PR Claims (Rev. 1966, Issued: 05-07-10, Effective: 01-01-10, Implementation: 10-04-10) Effective for claims with dates of service on or after January 1, 2010, Medicare contractors shall deny all PR claims (both professional and institutional claims) that exceed two units on the same date of service. ... 140.4.2.4 ? Edits for PR Services Exceeding 36 Sessions (Rev. 1966, Issued: 05-07-10, Effective: 01-01-10, Implementation: 10-04-10) When a beneficiary has reached 37 PR sessions, CWF shall reject the claims to the contractors if the KX modifier is not included on the claim line. Effective for claims with dates of service on or after January 1, 2010, Medicare contractors shall deny all claims (both professional and institutional claims) that exceed 36 PR sessions without a KX modifier included on the claim line. ?

PARA Weekly Update: November 3, 2017

MEDICARE COVERAGE OF PULMONARY REHAB SERVICES 140.4.2.5 ? Edits for PR Services Exceeding 72 Sessions (Rev. 1966, Issued: 05-07-10, Effective: 01-01-10, Implementation: 10-04-10) Effective for claims with dates of service on and after January 1, 2010, CWF shall reject PR claims that exceed 72 sessions. Medicare contractors shall deny PR claims that exceed 72 sessions regardless of whether the KX modifier is submitted on the claim line. ? MLN Matters MM6823 (Revised) Implemented 10/4/2010 -- Pulmonary Rehab Services http:/ / www.cms.gov/ Outreach-and-Education/ Medicare-Learning-Network-MLN/ MLNMattersArticles/ Downloads/ MM6823.pdf Pulmonary Rehabilitation (PR) is a multi-disciplinary program of care for patients with chronic respiratory impairment who are symptomatic and often have decreased daily life activities. A PR program is individually tailored and designed to optimize physical and social performance and autonomy. The program must provide an evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory impairment. In September 2007, the Centers for Medicare & Medicaid Services (CMS), in its final decision memorandum for PR Services, announced there was no basis for a national coverage determination at that time. Specifically, this decision was based on a determination by CMS that the Social Security Act did not expressly define a comprehensive PR program as a Part B benefit, and the evidence was not adequate to draw conclusions on the benefit of the individual components of PR. CMS did (and still does) cover medically reasonable and necessary respiratory treatment services in Comprehensive Outpatient Rehabilitation Facilities (CORFs), as well services to patients with respiratory impairments who are not eligible for PR but for whom local contractors determine respiratory treatment services are covered. MIPPA added payment and coverage improvements for patients with COPD and other conditions, and now provides a covered benefit for a comprehensive PR program for patients with moderate to very severe COPD under Medicare Part B effective January 1, 2010. This law authorizes a PR program, which was codified in the Physician Fee Schedule calendar year 2010 final rule at 42 CFR 410.47.Effective January 1, 2010, MIPPA provisions added a physician?supervised, comprehensive PR program for patients with moderate to very severe COPD. Medicare will pay for up to two (2) one-hour sessions per day, for up to 36 lifetime sessions (in some cases, up to 72 lifetime sessions) of PR The PR program must include the following mandatory components: 1. 2. 3. 4. 5.

Physician-prescribed exercise; Education or training; Psychosocial assessment; Outcomes assessment; and An individualized treatment plan.

PARA Weekly Update: November 3, 2017

MEDICARE COVERAGE OF PULMONARY REHAB SERVICES The following bullet points detail Medicare claims processing requirements for PR services furnished on or after January 1, 2010: -

Effective January 1, 2010, Medicare contractors will pay claims containing Healthcare Common procedure Coding System (HCPCS) code G0424 when billing for PR services, including exercise and monitoring, as described in the Medicare Benefit Policy Manual, Chapter 15, section 231, as revised by CR 6823, and the Medicare Claims Processing Manual, Chapter 32, Section 140, as revised by CR 6823. These revised documents are attached to CR 6823, which is available at http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/ downloads/R124BP.pdf (Benefit Policy Manual) and http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/ downloads/R1966CP.pdf LINK DOESN"T WORK (Claims Processing Manual) on the CMS website.

Medicare contractors will pay claims for HCPCS code G0424 (PR) only when services are provided in the following places of service (POS): 11 (physician?s office) or 22 (hospital outpatient). Medicare will deny claims for HCPCS code G0424 performed in other than, and billed without, POS 11 or 22, using the following: - Claim Adjustment Reason Code (CARC) 58 ? ?treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. NOTE: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.? - Remittance Advice Remark Code (RARC) N428 ? ?Service/ procedure not covered when performed in this place of service.? - Group Code PR (Patient Responsibility) assigning financial liability to the patient if the claim was received with a GA modifier indicating a signed Advance Beneficiary Notice (ABN) is on file or Group Code CO (Contractual Obligation) assigning financial liability to the provider if the claim is received with the GZ modifier indicating no signed ABN on file. Medicare contractors will pay claims for PR services containing HCPCS code G0424 and revenue code 0948 on Types of Bill (TOB) 13X and 85X under reasonable cost.

Contractors will pay for PR services for hospitals in Maryland under the jurisdiction of the Health Services Cost Review Commission on an outpatient basis, TOB 13X, in accordance with the terms of the Maryland waiver.

Contractors will deny claims for PR services provided in other than TOB 13X and 85X using the following: - CARC 58 ? ?Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. NOTE: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.? - RARC N428 ? ?Service/ procedure not covered when performed in this place of service.? 8

PARA Weekly Update: November 3, 2017

MEDICARE COVERAGE OF PULMONARY REHAB SERVICES

- Group Code PR assigning financial liability to the patient if the claim was received with a GA modifier indicating a signed ABN is on file or Group Code CO assigning financial liability to the provider if the claim is received with the GZ modifier indicating no signed ABN on file. -

Using the Medicare Physician Fee Schedule, Medicare contractors will also pay for PR services billed with HCPCS code G0424 and revenue code 096X, 097X, or 098X on TOB 85X from Method II critical access hospitals (CAHs). Medicare will deny PR services that exceed two units on the same date of service and, in doing so, will use the following: - CARC 119 ? ?Benefit maximum for this time period or occurrence has been reached.? - RARC N362 ? ?The number of days or units of service exceeds our acceptable maximum.? - Group Code PR assigning financial liability to the patient if the claim was received with a GA modifier indicating a signed ABN is on file or Group Code CO assigning financial liability to the provider if the claim is received with the GZ modifier indicating no signed ABN on file. Medicare will normally pay for 36 sessions of PR, but may pay up to 72 sessions when the claim(s) for sessions 37-72 includes a KX modifier. Claims for HCPCS code G0424 which exceed 36 sessions without the KX modifier will be denied using the following: -

CARC 151 ? ?Payment adjusted because the payer deems the information submitted does not support this many/ frequency of services.? Group Code PR assigning financial liability to the patient if the claim was received with a GA modifier indicating a signed ABN is on file or Group Code CO assigning financial liability to the provider if the claim is received with the GZ modifier indicating no signed ABN on file.

Medicare contractors will deny claims for HCPCS code G0424 when submitted for more than 72 sessions even where the KX modifier is present. In the denials, contractors will use the following: -

CARC B5 - ?Coverage/ program guidelines were not met or were exceeded.? Group Code PR assigning financial liability to the patient if the claim was received with a GA modifier indicating a signed ABN is on file or Group Code CO assigning financial liability to the provider if the claim is received with the GZ modifier indicating no signed ABN on file.

PARA Weekly Update: November 3, 2017

CPT NASOGASTRIC TUBE PLACEMENT

Question: What is the appropriate CPT® code(s)Nasogastric (NG) tube placement? Answer: Report CPT® code 43752, Naso- or oro- gastric tube placement for insertion of a NG tube when a physician performs the procedure. CPT code 43752 code description states physician skill required and includes fluoroscopic guidance.Coding Clinic for HCPCS 2008 1st qtr, states CPT® code 43752 is intended to be reported when the skill level necessitates the performance by a physician and also requires fluoroscopic guidance. Since a nurse is not a physician, it would be inappropriate for the hospital to report this code for the nurse's service.The placement of the nasogastric tube by the nurse in the emergency department would be captured in the appropriate evaluation and management (E/ M), HCPCS code assigned using the hospital's own internal guidelines. Please refer to the PARA Data Editor code description.

PARA Weekly Update: November 3, 2017

ICD-10 CM TUBAL/OVARIAN PREGNANCY

Qu est ion : What is the appropriate ICD-10 CM to report a tubal pregnancy when the physician identifies the left or right side? An sw er : Report ICD-10 CM code O00.112, Left Tubal pregnancy with intrauterine pregnancy or O00.102, left tubal pregnancy without intrauterine pregnancy.The codes for tubal pregnancy and ovarian pregnancy have been revised to include laterality effective October 1st 2017.As indicated in Coding Clinic for ICD-10 CM, capturing laterality is important for management of a patient during subsequent pregnancies and efficacy of treatment protocols.Please refer to the PARA Data code descriptions for ovarian and tubal pregnancies.

PARA Weekly Update: November 3, 2017

2018 CODING UPDATE DOCUMENTS

New!

In preparation for the year-end CPTÂŽ / HCPCS update, PARA is preparing a number of short, one to two- page ?coding update? documents listing deleted codes and added codes within a particular clinical area or procedure group.The coding topics addressed are those which are most likely to be ?hard-coded? to a line item in a facility chargemaster.Users are advised that topics are divided into immediately related areas, and more than one paper may contain information useful to a service line manager. Due to CPTÂŽ licensing restrictions, these documents cannot be published within the PARA Weekly Update, however, PARA Data Editor users may access the information on the Advisor tab; search ?Coding Update? in the type field, and 2018 in the subject field, as illustrated below:

Following the release of the OPPS Final Rule in November, coding update papers may be revised to indicate whether Medicare will accept/ cover new HCPCS.PARA Data Editor Users can identify updated papers by the word ?Revised? in the title and the date issued will be updated. Download these FREE papers from the PDE

PARA Weekly Update: November 3, 2017

PARA YEAR-END HCPCS UPDATE PROCESS

In keeping our commitment to outstanding customer service, PARA clients will be fully supported with information and assistance on the annual CPTÂŽ HCPCS coding updates. The PARA Data Editor (PDE) contains a copy of each client chargemaster; we use the powerful features of the PDE to identify any line item in the chargemaster which has a HCPCS code assigned that will be deleted as of January 1, 2018. For this reason, it is important that clients check to ensure that a recent copy of the chargemaster has been supplied to PARA for use in the year-end update. PARA will produce excel spreadsheets of each CDM line item, as well as our recommendation for alternate codes, in three waves as information is released from the following sources: 1. The American Medical Association?s publication of new, changed, and deleted CPTÂŽ codes; this information is released in September of each year.PARA will produce the first spreadsheet of CPT updates for client review in October, 2017. 2. Medicare?s 2018 OPPS Final Rule, typically published the first week of November; PARA will perform analysis and produce the second spreadsheet to include both the CPT information previously supplied, as well as alpha-numeric HCPCS updates (J-codes, G-codes, C-codes, etc.) from the Final Rule. 3. Medicare?s 2018 Clinical Lab Fee Schedule (CLFS) ? typically published in late November, the CLFS will reveal whether Medicare will accept new CPT?s generated by the AMA, or whether Medicare will require another reporting method (i.e. G0480 ? G0483 for definitive drug testing in 2016 and 2017.)

Clients will be notified by email as spreadsheets are produced and recorded on the PARA Data Editor ?Admin? tab, under the ?Docs? subtab.

In addition, PARA consultants will publish concise papers on coding update topics in order to ensure that topical information is available in a manner that is organized and easy to understand. PARA clients may rest assured that they will have full support for year-end HCPCS coding updates to the chargemaster.

PARA Weekly Update: November 3, 2017

Reprinted

JANUARY 1, 2018 CMS UPDATES

The following Transmittals have been published for the January 1 update. This list will continue to expand in the coming weeks, and links to all documents can be found in the PDE Advisor tab. Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2018

January 2018 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing

Files and Revisions to Prior Quarterly Pricing Files

Quarterly Influenza Virus Vaccine Code Update - January 2018

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 24.0, Effective January 1, 2018

To go to the full Transmittal document simply click on the screen shot.

PARA Weekly Update: November 3, 2017

JANUARY 1,2018 CMS UPDATES

Instructions for Downloading the Medicare ZIP Code File for January 2018

Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - January 2018

Affordable Care Act Bundled Payments for Care Improvement Initiative - Recurring File Updates Models 2 and 4 January 2018 Updates

Health Insurance Portability and Accountability Act (HIPAA) Electronic Data Interchange (EDI) Front End Updates for January 2018 This link leads to a ZIP file containing several files with several documents.

To go to the full Transmittal document simply click on the screen shot.

PARA Weekly Update: November 3, 2017

Reprinted

JANUARY 1, 2018 CMS UPDATES

The COMPLETE List! Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3872CP.pdf January 2018 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3878CP.pdf Quarterly Influenza Virus Vaccine Code Update - January 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3827CP.pdf Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 24.0, Effective January 1, 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3869CP.pdf Instructions for Downloading the Medicare ZIP Code File for January 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3860CP.pdf Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - January 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3861CP.pdf Fiscal Year (FY) 2018 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3885CP.pdf Clinical Laboratory Fee Schedule Not Otherwise Classified, Not Otherwise Specified, or Unlisted Service or Procedure Code Data Collection https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3881CP.pdf Payment for Services Furnished by Qualified Nonphysician Anesthetists https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3883CP.pdf Place of Service Codes https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3873CP.pdf 2018 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3870CP.pdf Accepting Hospice Notices of Election via Electronic Data Interchange https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3866CP.pdf Instructions for Retrieving the 2018 Pricing and HCPCS Data Files through CMS' Mainframe Telecommunications Systems https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3865CP.pdf Medicare Payment Rates for routine SNF-type services by swing-bed hospitals during calendar year 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R475PR1.pdf

PARA Weekly Update: November 3, 2017

JANUARY 1,2018 CMS UPDATES

More of The COMPLETE List! Annual Clotting Factor Furnishing Fee Update 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3862CP.pdf Updated Editing of Always Therapy Services ? MCS https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3863CP.pdf Correcting Payment of Inpatient Prospective Payment System (IPPS) Transfer Claims Assigned to Medicare Severity-Diagnosis Related Group (MS DRG) 385 and Allowing Part A Deductible on Medicare Secondary Payer (MSP) Same Day Transfer Inpatient Claims Https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1918OTN.pdf 2018 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3857CP.pdf Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3849CP.pdf Healthcare Provider Taxonomy Codes (HPTCs) October 2017 Code Set Update https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3842CP.pdf Influenza Vaccine Payment Allowances - Annual Update for 2017-2018 Season https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3837CP.pdf Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index and Hospice Pricer for FY 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3828CP.pdf Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Fiscal Year (FY) 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3826CP.pdf Implementation of the Transitional Drug Add-On Payment Adjustment https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1889OTN.pdf ICD-10 Coding Revisions to National Coverage Determinations (NCDs) https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1875OTN.pdf Common Working File (CWF) to Modify CWF Provider Queries to Only Accept National Provider Identifier (NPI) as valid Provider Number https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1877OTN.pdf New Specialty Code for Pharmacy https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R290FM.pdf Screening for Hepatitis B Virus (HBV) Infection https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R198NCD.pdf Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3796CP.pdf 2017-2018 Influenza (Flu) Resources for Health Care Professionals https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/SE17026.pdf 17

PARA Weekly Update: November 3, 2017

There was ONE new or revised Med Learn (MLN Matters) articles released this week. All new and previous Med Learn articles can be viewed under the type ?Med Learn? in the Advisor tab of the PARA Data Editor (see example below.) To go to the full Med Learn document simply click on the screen shot or the link.

PARA Weekly Update: November 3, 2017

The link to this Med Learn: MM10276

PARA Weekly Update: November 3, 2017

There were SIXTEEN new or revised Transmittals released this week. All new and previous Transmittals can be viewed under the type Transmittals in the Advisor tab of the PARA Data Editor. To go to the full Transmittal document simply click on the screen shot or the link.

PARA Weekly Update: November 3, 2017

The link to this Transmittal #R1956OTN

The link to this Transmittal #R1965OTN

PARA Weekly Update: November 3, 2017

The link to this Transmittal #R1966OTN

The link to this Transmittal #R3907CP

PARA Weekly Update: November 3, 2017

The link to this Transmittal #R3908CP

The link to this Transmittal #R1964OTN

PARA Weekly Update: November 3, 2017

The link to this Transmittal #R185DEMO

The link to this Transmittal #R108GI

PARA Weekly Update: November 3, 2017

The link to this Transmittal #R1962OTN

The link to this Transmittal #R3903CP

PARA Weekly Update: November 3, 2017

The link to this Transmittal #R1958OTN

The link to this Transmittal #R237BP

PARA Weekly Update: November 3, 2017

The link to this Transmittal #R1959OTN

The link to this Transmittal #R1960OTN

PARA Weekly Update: November 3, 2017

The link to this Transmittal #R3902CP

The link to this Transmittal #R3901CP

PARA Weekly Update: November 3, 2017

The PDE Editor Bulletin Board Tablet lists all articles added to the Bulletin Board

PARA Weekly Update: November 3, 2017