This week in Medicare updates–12/16/2015
Revisions to ICD-10 conversion/coding infrastructure revisions to NCDs-Third maintenance change request
On December 3, CMS rescinded Transmittal 1547, dated October 5, and replaced it with Transmittal 1580 to: 1) remove invalid TOB 52X from NCD250.5, 2) remove invalid TOB 25X from and add TOB 85X to NCD80.11, and, 3) include complete history in NCD160.18. All other information remains the same.
Effective date: October 1, 2015
Implementation date: January 4, 2016-Exceptions: FISS will implement the following NCDs April 4, 2016: 260.1, 80.11, 20.16, 270.6, 160.18, 110.10, 110.21, 250.5, 100.1, and 160.24. CWF will deactivate edits 33XA and 33#A (NCD150.3) prior to the January 2016 implementation date
View Transmittal R1580OTN.
View MLN Matters article MM9252.
Modification of OIG Advisory Opinion 07-11
On December 7, the OIG posted a modification to a past advisory opinion relating to independent charity patient assistance programs.
View modified Advisory Opinion 07-11.
Revisions to NCD for single chamber and dual chamber permanent cardiac pacemakers
On December 10, CMS rescinded Transmittal 186 and Transmittal 3384, dated October 26, and replaced them with Transmittal 187 and Transmittal 3421, respectively. The NCD for cardiac pacemakers: single chamber and dual chamber permanent cardiac pacemakers (NCD20.8.3) was effective on August 13, 2013, and remains in effect. In order to address claims processing issues that were brought to the attention of CMS, it has instructed MACs to implement this NCD at the local level until CMS is able to revise the formal claims processing instructions. All aspects of the NCD policy in Publication 100-03, NCD Manual, section 20.8.3, remain in effect.
Effective date: August 13, 2013
Implementation date: January 13, 2016
View Transmittal R187NCD.
View Transmittal R3421CP.
FY 2016 results for the CMS Hospital-Acquired Conditions (HAC) Reduction Program
On December 10, CMS posted a fact sheet detailing an overview and results of the HAC Reduction Program.
View the fact sheet.
Public reporting of 2014 quality measures on the Physician Compare and Hospital Compare websites
On December 10, CMS posted a fact sheet and press release detailing the information sought and collected on the Physician Compare and Hospital Compare websites and new measures added.
View the fact sheet.
View the press release.