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NPI News for Medicare FFS Providers: May 23rd is Days Away - Are you Prepared? Reference: CMS List-Serv Message 051408 May 23rd is Days Away – Are you Prepared? As of May 23, Medicare FFS will require and send NPI-Only in ALL provider identifier fields for all HIPAA and paper transactions where a provider identifier is required. If you send Medicare a transaction with a Medicare legacy identifier in any of the provider fields, your claim will be rejected. These transactions include all electronic and paper claims (837I, 837P, NCPDP, DDE and paper CMS-1500 and UB-04), the 276/277 claims status transaction, the 270/271 eligibility transaction, 835 remittance advice and SPR paper remittance. If your billing software is set up to continue to send both the NPI and the legacy identifier, and your clearinghouse or billing service will not be stripping the legacy identifier from your claim as of May 23rd, the responsibility falls to the provider to send in the Medicare claim with NPI-only, i.e., NO legacy identifiers. Published Online: Friday, May 16, 2008

Medicare Shared Systems Modifications Necessary to Capture and Crossover Medicaid Drug Rebate Data Submitted on Form UB 04 Paper Claims and Direct Data Entry (DDE) Claims Reference: Trans. 1496, CR #5950, Pub. 100-04, MLN: MM5950 The Centers for Medicare & Medicaid Service (CMS) issued Change Request (CR) 5950 so that Medicaid drug rebate information submitted to Medicare on the UB 04 or via DDE will crossover to Medicaid. This change request is to notify providers that modifications to Medicare systems will be implemented that will allow CMS to capture and crossover the National Drug Codes (NDCs). Corresponding quantities are then recorded on claims by Medicare providers. In order to capture the information needed to fulfill the rebate requirements, providers billing for dual eligible patients will be required to submit the NDCs for physician-administered drugs in the Revenue Description Field (Form Locator 43) on the UB-04 in order that this data can be crossed over to Medicaid for the billing of Medicaid rebates. It is important billing staffs note three items in this change request that impact provider billing, effective October 1, 2008. Published Online: Friday, May 16, 2008

July Quarterly Update to 2008 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement Reference: Trans. 1501, CR #6009, Pub. 100-04, MLN: MM6009 This notification provides updates to the lists of Healthcare Common Procedure Coding System (HCPCS) codes that are subject to the consolidated billing provision of the SNF Prospective Payment System (PPS). CR 6009 adds HCPCS code J9303 (Injection, Panitumumab, 10MG) to the Major Category III.A. Chemotherapy services FI/A/B MAC Exclusion List retroactive to January 1, 2008. Published Online: Friday, May 16, 2008

Assignment of Providers to Medicare Administrative Contractors Reference: Trans. 333, CR #5979, Pub. 100-20, MLN: MM5979 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. Published Online: Friday, May 16, 2008

CMS to Host Second National Provider Education Call on the DMEPOS Competitive Bidding Program - May 27, 2008 Reference: CMS List-Serv Message 051508 The Centers for Medicare & Medicaid Services (CMS) will host the second national education conference call to address the implementation of the new Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding program scheduled to begin on July 1, 2008. This call is being conducted for Medicare fee-for-service DMEPOS suppliers, physicians, and other providers – all of which may be affected by the program. CMS Subject Matter Experts will be available to answer questions and address some of the exceptions and situations you may encounter as the program is implemented. To view a PowerPoint presentation that was used in the first national call, please click here: http://www.cms.hhs.gov/DMEPOSCompetitiveBid/Downloads/policy_teleconference_final.pdf. In order to receive the call-in information, you must register for the call. Registration will close at 1:00 p.m. EDT on May 26, 2008, or when available space has been filled. Published Online: Friday, May 16, 2008

Updated IVR Instructions Some of the information available to you through our IVR is claims status, eligibility records, and reimbursement checks information. Additionally the IVR is available in English and Spanish. When you call into our IVR you will be greeted by a pleasant automated voice which will instruct you on what information to speak to obtain data from our IVR. The below information will provide you with an overview of the new IVR options and provide you with additional facts that will help you to expedite your call. Published Online: Thursday, May 15, 2008

Part A Local Coverage Determination Updates The following Part A LCDs have been revised: Anti-Cancer Drugs ARA-01-024, Chronic Wound Care ARA-02-025. Published Online: Wednesday, May 14, 2008

Part B Local Coverage Determination Updates The following Part B LCDs have been revised: Anti-Cancer Drugs AC-01-024, Audiology Services AC-02-027, Chronic Wound Care AC-02-025, Clinical Pathology Consultation AC-03-017, Office Injectables AC-01-023, Outpatient Sleep Studies AC-03-030, Percutaneous Thrombectomy of Arteriovenous Fistula/Graft AC-03-032. Published Online: Wednesday, May 14, 2008

ALERT: Food and Drug Administration (FDA) Heparin Recall for All Provider Types Reference: CMS List-Serv Message 050908 Please help FDA spread the word about recalls of injectable heparin products and heparin flush solutions that may be contaminated with oversulfated chondroitin sulfate (OSCS). Affected heparin products have been found in medical care facilities in one state since the recall announcement. Although product recall instructions were widely distributed, they may not have been fully acted upon at all sites where heparin is used. There have been many reports of deaths associated with allergic or hypotensive symptoms after heparin administration (see FDA link at http://www.fda.gov/cder/drug/infopage/heparin/adverse_events.htm ). We ask that health professionals and facilities please review and examine all drug/device storage areas, including emergency kits, dialysis units and automated drug storage cabinets to ensure that all of the recalled heparin products have been removed and are no longer available for patient use. Published Online: Wednesday, May 14, 2008

2008 Physician Quality Reporting Initiative (PQRI) - National Provider Call Announcement Reference: CMS List-Serv Message 051408 The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the third in a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 3:30 p.m. – 5:00 p.m., EDT, on Wednesday, May 28, 2008. This call will provide an overview of the alternative reporting periods and alternative criteria for satisfactorily reporting quality measures for the 2008 PQRI as authorized by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) (P.L. 110-173) which was enacted on December 29, 2007. Published Online: Wednesday, May 14, 2008

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