Part A Headlines

Part A PIP & pass-through payments scheduled for July 2, 2008, will be temporarily delayed.

This document is maintained on our Web site. The LCDs are maintained on the CMS Web site.

The exceptions to outpatient therapy caps expired on June 30, 2008. Outpatient therapy service providers should not submit claims with the KX modifier for services furnished on or after July 1, 2008. [JSM 08387, PERL 200807-03]

Questions and answers pertaining to the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) Competitive Bidding Program.

This article provides clarification on the correct billing of VIDAZA (J9025) and chemotherapy administration code 96401 (Chemotherapy administration, subcutaneous or intramuscular; non-hormonal).

Questions and answers pertaining to rehabiliation services.

Questions and answers pertaining to SNF consolidated billing (SNF CB) and the SNF Prospective Payment System (SNF PPS).

CMS is clarifying the term "common carrier" in its mail order definition published in chapter 36 of the Medicare Claims Processing Manual. [PERL 200806-25]

In order for providers to properly claim a bad debt and be reimbursed under the Medicare program, providers must follow all of the criteria to be an allowable bad debt. [SE0824]

Under the DMEPOS Competitive Bidding Program, beneficiaries who permanently reside in or travel to a designated CBA are required to obtain competitive bid items from a contract supplier, unless an exception applies. [PERL 200806-23]

Claims for Computed Tomographic Angiography (CTA) used to diagnose coronary artery disease (CAD) will continue to be determined by local Medicare contractor discretion and the Medicare NCD Manual remains unchanged. [MM6098]

Change request (CR) 6077 identifies changes that are required as part of the annual inpatient psychiatric facilities prospective payment system (IPF PPS) update for rate year (RY) 2009. [MM6077]

Part A Local Coverage Determination (LCD) statuses and indicators.

CMS has extended the implementation to submit services under HCPCS code Q4096 until the implementation of the January 2009 system release. Providers can submit claim adjustments for HCPCS code Q4096 at that time. [JSM 08357]

Changes to, and billing instructions for, various payment policies implemented in the July 2008 outpatient prospective payment system update. [MM6094]

CMS has revised chapter 18 of the Medicare Claims Processing Manual to clarify the elements needed during a screening pelvic examination. [MM6085]