Displaying Part A Inpatient Rehabilitation Facility Articles 1 to 25 of 26

Topic	Date	Description
Call Center Closing Times (Part A)	Friday, August 15, 2008	To better serve the provider community, the Centers for Medicare and Medicaid Services (CMS) is allowing Provider Contact Centers across the nation to conduct customer service training during normal business hours. The Medicare Program is very complex with continuous changes and this initiative will help prepare Provider Customer Service Representatives (CSR's) to give quality answers to substantive Medicare related questions or inquiries. Pinnacle Business Solutions, Inc. the Medicare Part A Intermediary for the State of Rhode Island, will be participating in this program. We have developed a comprehensive training plan that includes closing our Provider Contact Center for up to eight hours each month. Using Provider Contact Center call distribution data to determine the least possible impact for our customers, we have selected the following dates in August 2008 and September 2008.
Implementation of New Provider Authentication Requirements for Medicare Contractor Provider Telephone and Written Inquiries	Friday, August 15, 2008	CR 6139, from which this article is taken, addresses the necessary provider authentication requirements to complete IVR transactions and calls with a Customer Service Representative (CSR). Effective March 1, 2009, when you call either the IVR system, or a CSR, the Centers for Medicare & Medicaid Services (CMS) will require you to provide three data elements for authentication: 1) Your National Provider Identifier (NPI); 2) Your Provider Transaction Access Number (PTAN), and 3) The last 5-digits of your tax identification number (TIN). Make sure that your staffs are aware of this requirement for provider authentication.
Fiscal Year (FY) 2006 Supplemental Security Income (SSI) Data	Tuesday, August 12, 2008	This article is based on Change Request (CR) 6126, which states that, as of May 5, 2008, hospitals (this includes acute care hospitals paid under the inpatient prospective payment system and inpatient rehabilitation facilities (IRF)) may elect to use either its FY 2005 or FY 2006 SSI ratio from the files published on the Centers for Medicare & Medicaid Services (CMS) website to file its cost report that would otherwise be submitted with the FY 2006 SSI ratio.
Manual Revisions to Reflect Special Billing Instructions for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items as a Result of the DMEPOS Competitive Bidding Program	Tuesday, August 05, 2008	Note: This article is impacted by the Medicare Improvements for Patients and Providers Act of 2008, which was enacted on July 15, 2008. That legislation delays the implementation of the DMEPOS competitive bidding program until 2009 and makes other changes to the program. This article will be further revised and/or replaced as more details of the modified program are available. The Centers for Medicare & Medicaid Services (CMS) issued Change Request (CR) 6007 so suppliers are aware of the information provided in the new section 50 of chapter 36 of the Medicare Claims Processing Manual highlighted in the Key Points section of this CR and attached to CR6007.
Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC): THE FIRST IN A SERIES OF ARTICLES	Tuesday, August 05, 2008	Note: This article was revised on July 30, 2008, to reflect current processes and provide the Web address for the new IACS website which contains user reference guides. Please note that CMS will notify providers as internet applications become available, and provide clear instructions that specify which providers should register in IACS-PC. Do not register until you are notified by CMS or one of its contractors to do so and only if you meet the criteria in the notice. These articles will help providers to register for access to CMS online computer services when directed to do so by CMS. This article contains: 11 questions and answers to get you started and Overview of the registration process for IACS-PC defined provider/supplier organization users.
Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC): THE SECOND IN A SERIES OF ARTICLES ON THE IACS	Tuesday, August 05, 2008	Note: This article was revised on July 30, 2008, to reflect current processes and provide the Web address for the new IACS website which contains user reference guides. Please note that CMS will notify providers as internet applications become available, and provide clear instructions that specify which providers should register in IACS-PC. Do not register until you are notified by CMS or one of its contractors to do so and only if you meet the criteria in the notice. This article contains: 3 questions and answers about the registration process for provider organizations. (See NOTE below.) Links to the Quick Reference Guides for completing the registration process for provider organizations. (See NOTE below.) Note: For purposes of the IACS-PC, "Provider Organizations" include individual practitioners who will delegate IACS-PC work to staff as well as their staff using IACS-PC.
Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC): THE THIRD IN A SERIES OF ARTICLES ON THE IACS-PC	Tuesday, August 05, 2008	Note: This article was revised on July 30, 2008, to reflect current processes and provide the Web address for the new IACS website which contains user reference guides. Please note that CMS will notify providers as internet applications become available, and provide clear instructions that specify which providers should register in IACS-PC. Do not register until you are notified by CMS or one of its contractors to do so and only if you meet the criteria in the notice. This article describes the 3 steps providers must take to access a CMS Enterprise Provider Application including how to request a provider application role in IACS-PC (See step 2). CMS will notify providers as internet applications become available, and provide clear instructions that specify which providers should register in Individuals Authorized Access to CMS Computer Services – Provider/Supplier Community (IACS-PC). Do not register until you are notified by CMS or one of its contractors to do so and only if you meet the criteria in the notice.
Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)	Monday, August 04, 2008	This article is based on Change Request (CR) 6107 and reminds the Medicare contractors and providers that the annual ICD-9-CM update will be effective for dates of service on and after October 1, 2008 (for institutional providers, effective for discharges on or after October 1, 2008). You can see the new, revised, and discontinued ICD-9-CM diagnosis codes on the Centers for Medicare & Medicaid Services (CMS) website at http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/07_summarytables.asp#TopOfPage, or at the National Center for Health Statistics (NCHS) website at http://www.cdc.gov/nchs/icd9.htm in June of each year.
Clarification on the Correct Condition Code to Report on Provider Adjustment Requests to Indicate a Health Insurance Prospective Payment System (HIPPS) Code Change	Thursday, July 31, 2008	Note: This article was revised on July 28, 2008, to reflect that CR 6002 was revised on July 25, 2008. The CR release date, transmittal number, and the Web address for accessing CR 6002 have been changed in this article. All other information remains the same. CR 6002, from which this article is taken, announces that, as of January 1, 2009, you should no longer use the D4 condition code to report HIPPS code changes on SNF adjustment requests, but rather should begin to use Condition Code D2 – Change in Revenue Codes/HCPCS/HIPPS Rate Codes instead.
New Hemophilia Clotting Factor and HCPCS Code	Thursday, July 31, 2008	Note: This article was revised on July 28, 2008, to reflect changes made to CR 6006, which CMS revised on July 25, 2008. The CR release date, transmittal number, and the Web address for accessing CR 6006 were revised. All other information remains the same. This article is based on Change Request (CR) 6006 which announces that Healthcare Common Procedure Coding System (HCPCS) code Q4096 (INJECTION, VON WILLEBRAND FACTOR COMPLEX, HUMAN, RISTOCETIN COFACTOR (NOT OTHERWISE SPECIFIED), PER I.U. VWF:RCO VWF complex, NOS) will be payable for Medicare effective for claims with dates of service on or after April 1, 2008. Appropriate systems changes for editing hemophilia clotting factors on inpatient claims will not be made by Medicare’s Fiscal Intermediary Shared System (FISS) until January 5, 2009 release. This CR does not impact outpatient hospital claims or on any SNF claims as payment is made under different methodologies. Q4096 is payable in those settings effective April 1, 2008. Providers need to be aware of the instructions in the rest of this article in order to properly submit inpatient claims with Q4096 for discharges on or after April 1, 2008 through January 5, 2009.
Important Information on the New Medicare Law – The Medicare Improvements for Patients and Providers Act of 2008	Tuesday, July 22, 2008	This article contains a compilation of messages that were issued on July 16, 2008. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) was enacted on July 15, 2008. This legislation alters a number of Medicare policies, which have been the subject of a number of change requests (CRs) and MLN Matters articles published in recent months. The Centers for Medicare & Medicaid Services (CMS) is in the process of revising these previously issued CRs and MLN Matters articles as a result of this legislation. However, CMS feels it is important that physicians, providers and suppliers be aware of five critical issues immediately. These five issues are: New 2008 Medicare Physician Fee Schedule (MPFS) payment rates effective for dates of service July 1, 2008 through December 31, 2008; Extension of the exceptions process for the therapy caps; A delay in the Medicare durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) competitive bidding program; Reinstatement of the moratorium that allows independent laboratories to bill for the technical component (TC) of physician pathology services furnished to hospital patients; and Extension of the payment rule for Brachytherapy and Therapeutic Radiopharmaceuticals. Be sure your billing staff is aware of these changes.
Update-Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Rate Year 2009	Tuesday, July 01, 2008	Change Request (CR) 6077, from which this article is taken, identifies changes that are required as part of the annual inpatient psychiatric facilities prospective payment system (IPF PPS) update for RY 2009. These changes include the market basket update, Pricer updates for IPF PPS rate year (RY) 2009, (July 1, 2008 – June 30, 2009), the stop-loss provision, the electroconvulsive therapy (ECT) update, the payment rate, the national urban and rural cost to charge ratios (CCRs) for the IPF PPS RY 2008, the MS DRG update, and the cost-of-living adjustment (COLA) for Alaska and Hawaii. These changes are effective July 1, 2008, and are applicable to IPF discharges occurring during the rate year beginning on July 1, 2008, through June 30, 2009. In addition, CR 6077 corrects the IPF PPS Pricer to include diagnosis code 07070 (Viral Hepatitis C without Hepatic Coma) in calculating a comorbidity adjustment for claims with discharge dates on or after January 1, 2005 through June 30, 2006. Make sure that your billing staffs are aware of these IPF PPS changes.
Payment for Complex Rehabilitative Power Mobility Device (PMD) Services that Span the Implementation Date of DMEPOS Competitive Bidding Programs in Competitive Bidding Areas	Monday, June 23, 2008	CR 6112, from which this article is taken, provides instructions for payment of claims for the purchase of Group 3 single or multiple power option power mobility devices and accessories where the face-to-face examination by the treating physician occurred from April 1, 2008 through May 31, 2008 for beneficiaries who maintain their permanent residence in one of the geographic areas covered by Round 1 of the DMEPOS competitive bidding program. See the rest of this article for further details.
Instructions for Institutional Providers and Suppliers Billing Self-Referred Mammography Claims Regarding the Attending/Referring Physician National Provider Identifier (NPI)	Tuesday, June 10, 2008	This article is based on Change Request (CR) 6023 which provides National Provider Identifier (NPI) instructions for institutional providers and suppliers billing for self-referred mammography services. Do not use the surrogate unique physician identification number (UPIN) of "SLF000" on claims effective May 23, 2008. Providers of mammography services are instructed to report their own facility NPI in the attending physician NPI field in cases where the service is self-referred by the patient (beneficiary) and no attending/referring physician NPI is available. See the Background and Additional Information Sections of this article for further details regarding these changes.
July 2008 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files	Tuesday, June 10, 2008	CR 6049, from which this article is taken, instructs Medicare contractors to download and implement the July 2008 Average Sales Price (ASP) drug pricing file for Medicare Part B drugs; and if released by CMS, also the revised April 2008, January 2008, January 2007, April 2007, July 2007, and October 2007 files.
Pinnacle Business Solutions, Inc. Holiday	Monday, May 19, 2008	Pinnacle Business Solutions, Inc. will be closed on Monday, May 26, 2008 in observance of the Memorial Day holiday. EDI Technical Support and Customer Service Representatives will not be available. The EDI Gateway will be available for transmissions and report retrieval. No Medicare checks or Electronic Remits will be generated on these dates.
Assignment of Providers to Medicare Administrative Contractors	Friday, May 16, 2008	This "One Time Notice" CR describes the Centers for Medicare & Medicaid Services (CMS) approach for assigning providers to MACs and discusses the process of moving providers to MACs.
Provider Authentication by Medicare Provider Contact Centers	Monday, May 05, 2008	SE0814 covers the implementation of the National Provider Identifier (NPI) and the Provider Transaction Access Number (PTAN), effective May 23, 2008, as the provider authentication elements used when providers make telephone or written inquiries to the Medicare fee-for-service contractor provider contact centers. Note: For providers enrolled in Medicare before May 23, 2008, their PTAN initially will be their legacy provider number. New providers enrolling in Medicare on or after May 23, 2008, will be assigned a PTAN as part of the Medicare enrollment process.
New HCPCS Codes for the April 2008 Update	Tuesday, April 22, 2008	This article is based on Change Request (CR) 5981, which instructs Medicare Contractors to implement Healthcare Common Procedure Coding System (HCPCS) code changes effective April 1, 2008. Make sure that your billing staffs are aware of these changes.
Announcing the Release of the Revised CMS-855 Medicare Enrollment Applications	Thursday, April 03, 2008	The Centers for Medicare & Medicaid Services (CMS) issued revised CMS-855 Medicare enrollment applications in March 2008. With the exception of providers enrolling as a specialty hospital on the CMS-855A, Medicare contractors will continue to accept the 2006 version of the Medicare enrollment application through June 2008. Providers and suppliers should begin to use the new Medicare enrollment applications immediately. Initially, these applications will be available only from the CMS provider enrollment web site. The link for that CMS web site is listed in the Additional Information section of this article. Over the last year, CMS has received numerous comments and suggestions regarding the proposed revisions to the Medicare enrollment applications. CMS reviewed the comments and adopted many of the suggested revisions. Also, CMS incorporated a number of enhancements and changes (see Key Points below) to clarify the enrollment process and to reduce the burden imposed on the provider and supplier communities. This Special Edition outlines the significant revisions to the Medicare enrollment applications.
April Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB)	Tuesday, March 25, 2008	This article is based on Change Request (CR) 5980 which amends payment files previously issued to Medicare contractors based upon the 2008 Medicare Physician Fee Schedule Final Rule. CR 5980 also includes new/revised codes for the Physician Quality Reporting Initiative (PQRI).
April 2008 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) Pricer Changes	Monday, March 24, 2008	This article is based on CR 5965 which instructs Medicare contractors to install the April Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) Pricer. CR 5965 updates the Fiscal Year 2008 (FY08) standard payment conversion factor from $13,451 to $13,034, effective for discharges on or after April 1, 2008, and it adds the default Case Mix Group (CMG) of A9999 as a valid CMG to allow "informational only" claims for Medicare Advantage (MA) patients to be processed, effective for discharges on or after October 1, 2006. See the Background and Additional Information Sections of this article for further details regarding these changes.
Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update	Wednesday, March 12, 2008	CR 5942, from which this article is taken, announces the latest update of Remittance Advice Remark Codes (RARCs) and Claim Adjustment Reason Codes (CARCs), effective April 1, 2008. Be sure billing staff are aware of these changes.
Update to Audiology Policies	Wednesday, March 05, 2008	This article is based on Change Request (CR) 5717, which alerts affected providers that there are updates to language in the Medicare Benefit Policy Manual (MBPM) Chapter 15, sections 80.3 and 230.3 and the Medicare Claims Processing Manual (MCPM) Chapter 12, section 30.3. These manual changes highlight coding issues, including auditory implants as auditory prosthetic devices, differentiate the functions of speech-language pathologists and audiologists in aural rehabilitation, and discuss policy related to automated hearing testing.
Tips for Searching the Pinnacle Medicare Services Web Site	Thursday, January 31, 2008	The Pinnacle Medicare Services Web site search function offers several ways to search for information. The following is an overview of the search function to assist providers with searching our web site.
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