April 1, 2010, Home Health & Hospice Medicare A Newsline - CGS

CR 6851 continues and completes this process by announcing that, effective January 1, 2011, CMS isexpanding the number of ICD-9 diagnosis and procedure codes it will accept and process on institutionalclaims.This expansion is being done to allow for: 1) Adding additional ICD-9 other (secondary) diagnosis codes(from 8 codes to 24 codes) as well as additional associated present on admission (POA) codes; and 2)Adding additional ICD-9 other (secondary) procedure codes (from 5 codes to 24 codes).Note: CMS will be able to accept and process additional ICD-9/POA codes effective January 1, 2011.Additional InformationYou can find the official instruction, CR 6851, issued to your FI, RHHI, or A/B MAC by visitinghttp://www.cms.hhs.gov/Transmittals/downloads/R648OTN.pdf on the CMS Web site.If you have questions regarding this issue, refer to the “Contact Us” page of our Web site and select “PhoneUs” to call the Provider Contact Center.DisclaimerThis article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article maycontain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be ageneral summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review thespecific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.July 2010 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Filesand Revisions to Prior Quarterly Pricing FilesThe Centers for Medicare & Medicaid Services (CMS) has provided the following Medicare LearningNetwork (MLN) Matters article. This MLN Matters article and other CMS articles can be found on theCMS Web site at: http://www.cms.hhs.gov/MLNMattersArticlesMLN Matters ® Number: MM6805 Related Change Request (CR) #: 6805Related CR Release Date: February 19, 2010 Effective Date: July 1, 2010Related CR Transmittal #: R1922CP Implementation Date: July 6, 2010Provider Types AffectedAll physicians, providers and suppliers who submit claims to Medicare contractors (Medicare administrativecontractors (MACs), fiscal intermediaries (FIs), carriers, durable medical equipment Medicareadministrative contractors (DME MACs) or regional home health intermediaries (RHHIs)) are affected bythis issue.What You Need to KnowThis article is based on CR 6805 which instructs Medicare contractors to download and implement the July2010 ASP drug pricing file for Medicare Part B drugs; and if released by CMS, also the revised April 2010,January 2010, October 2009, and July 2009 files. Medicare will use the July 2010 ASP and not otherwiseHome Health & Hospice April 1, 2010 5Medicare A Newsline Vol. 17, No. 7