Example: bachelor of science

CMS Manual System Department of Health & Human Services

CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 2121 Date: December 17, 2010 Change Request 7247 SUBJECT: Reporting of Service Units With HCPCS I. SUMMARY OF CHANGES: This change request reinserts a table of therapy CPT codes indicating maximum unit limitations that was inadvertently deleted. EFFECTIVE DATE: March 21, 2011 IMPLEMENTATION March 21, 2011 Disclaimer for Manual changes only: The revision date and transmittal number apply only to red italicized material.

Aug 06, 2008 · 20.2 - Reporting of Service Units With HCPCS (Rev., 2121, Issued: 12-17-10, Effective: 03-21-11, Implementation: 03-21-11) A. General Effective with claims submitted on or after April 1, 1998, providers billing on Form CMS-1450

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of CMS Manual System Department of Health & Human Services

1 CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 2121 Date: December 17, 2010 Change Request 7247 SUBJECT: Reporting of Service Units With HCPCS I. SUMMARY OF CHANGES: This change request reinserts a table of therapy CPT codes indicating maximum unit limitations that was inadvertently deleted. EFFECTIVE DATE: March 21, 2011 IMPLEMENTATION March 21, 2011 Disclaimer for Manual changes only: The revision date and transmittal number apply only to red italicized material.

2 Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. II. CHANGES IN Manual INSTRUCTIONS: (N/A if Manual is not updated) R=REVISED, N=NEW, D=DELETED R/N/D CHAPTER / SECTION / SUBSECTION / TITLE R 5 of Service Units With HCPCS III. FUNDING: For Fiscal Intermediaries (FIs), Regional Home Health Intermediaries (RHHIs) and/or Carriers: No additional funding will be provided by CMS; contractor activities are to be carried out within their operating budgets.

3 For Medicare Administrative Contractors (MACs): The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract. CMS does not construe this as a change to the MAC Statement of Work. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by the contracting officer. If the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in question and immediately notify the contracting officer, in writing or by e-mail, and request formal directions regarding continued performance requirements.

4 IV. ATTACHMENTS: Business Requirements Manual Instruction *Unless otherwise specified, the effective date is the date of service. CMS / CMM / MCMG / DCOM Change Request Form: Last updated 06 August 2008 Page 1 Attachment - Business Requirements Pub. 100-04 Transmittal: 2121 Date: December 17, 2010 Change Request: 7247 SUBJECT: Reporting of Service Units With HCPCS EFFECTIVE DATE: March 21, 2011 IMPLEMENTATION DATE: March 21, 2011 I. GENERAL INFORMATION A. Background: This instruction reinserts a table of therapy CPT codes indicating maximum unit limitations that was inadvertently deleted from Pub.

5 100-04, Medicare Claims Processing Manual , chapter 5, section B. Policy: No changes are being made to the current policy. II. BUSINESS REQUIREMENTS TABLE Use Shall" to denote a mandatory requirement Number Requirement Responsibility (place an X in each applicable column) A/B MAC DME MAC FI CARRIER RHHI Shared- System Maintainers OTHER FISS MCS VMS CWF Contractors shall be aware of the revisions to Pub. 100-04, Medicare Claims Processing Manual , chapter 5, section X X X III. PROVIDER EDUCATION TABLE Number Requirement Responsibility (place an X in each applicable column) A/B MAC DME MAC FI CARRIER RHHI Shared- System Maintainers OTHER FISS MCS VMS CWF A provider education article related to this instruction will be available at shortly after the CR is released.

6 You will receive notification of the article release via the established "MLN Matters" listserv. Contractors shall post this article, or a direct link to this article, on their Web site and include information about it in a listserv message within one week of the availability of the provider education article. In addition, the provider X X X CMS / CMM / MCMG / DCOM Change Request Form: Last updated 06 August 2008 Page 2 Number Requirement Responsibility (place an X in each applicable column) A/B MAC DME MAC FI CARRIER RHHI Shared- System Maintainers OTHER FISS MCS VMS CWF education article shall be included in your next regularly scheduled bulletin.

7 Contractors are free to supplement MLN Matters articles with localized information that would benefit their provider community in billing and administering the Medicare program correctly. IV. SUPPORTING INFORMATION Section A: For any recommendations and supporting information associated with listed requirements, use the box below: N/A Use "Should" to denote a recommendation. X-Ref Requirement Number Recommendations or other supporting information: Section B: For all other recommendations and supporting information, use this space: N/A V.

8 CONTACTS Pre-Implementation Contact(s): Shauntari Cheely, Yvonne Young, Post-Implementation Contact(s): Regional office VI. FUNDING Section A: For Fiscal Intermediaries (FIs), Regional Home Health Intermediaries (RHHIs), and/or Carriers, use only one of the following statements: No additional funding will be provided by CMS; contractor activities are to be carried out within their operating budgets. Section B: For Medicare Administrative Contractors (MACs), include the following statement: The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract.

9 CMS does not construe this as a change to the MAC Statement of Work. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by the contracting officer. If the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in question and immediately notify the contracting officer, in writing or by e-mail, and request formal directions regarding continued performance requirements.

10 - Reporting of Service Units With HCPCS (Rev., 2121, Issued: 12-17-10, Effective: 03-21-11, Implementation: 03-21-11) A. General Effective with claims submitted on or after April 1, 1998, providers billing on Form CMS-1450 were required to report the number of units for outpatient rehabilitation Services based on the procedure or service, , based on the HCPCS code reported instead of the revenue code. This was already in effect for billing on the Form CMS-1500, and CORFs were required to report their full range of CORF Services on the Form CMS-1450.


Related search queries