Customer News: CMS

Medicare fee-for-service (FFS) has amended the not otherwise classified (NOC) code set listing effective Monday, January 16, 2012. Various pathology and laboratory codes identified in procedure code section 8800 and a variety of other NOC codes have been removed. These codes do not meet the criteria of a non-specified procedure code and do not require a description to be supplied in the SV101-7/SV202-7 data elements.

The majority of procedure codes impacted and removed from the NOC code list are anesthesia codes, laboratory/pathology codes, and physicians quality reporting system codes.

As 2012 begins, CMS wants to remind eligible professionals (EPs) participating in the Medicare Electronic Health Record (EHR) Incentive Program of important deadlines approaching and what can still be completed in 2012 in order to receive an incentive payment for CY2011.

A new version of the Medicare Remit Easy Print (MREP) is now available on the CMS website to download. This upgrade will correct the printing issues experienced with MREP version 3.2.

CMS presents the Medicare Remit Easy Print (MREP) software to view and print HIPAA compliant 835 for professional providers and suppliers. This software, which is available for free to Medicare providers and suppliers, can be used to access and print remittance advice information, including special reports, from the HIPAA 835.

To date we have converted 76% of our payor and trading partner connections to 5010. These represent over 90% of the claims volume; those who have yet to be converted are some Medicaids and other smaller payors who have opted to extend their 5010 transition, due in part to the CMS extension. To ensure that your claims are processing, XIFIN continues to work diligently with these payors to complete testing and convert over to 5010 as soon as they are ready. To see a current status and to access a payor-by-payor list, please visit the 5010 page on the customer portal.

The Version 5010 deadline was on January 1, 2012; however, because of the 90-day enforcement discretion period for all HIPAA-covered entities upgrading to Version 5010, CMS will not initiate enforcement action until April 1, 2012. CMS made this decision based on industry feedback that many organizations and their trading partners were not yet ready to finalize system upgrades to be compliant.

CMS is amending Remittance Advice Remark Code (RARC) N103 to include language that further explains the newly modified RARC N103—denying claims for services to federally incarcerated beneficiaries; it reads as follows: "Social Security records indicate that this patient was a prisoner when the service was rendered.

Registration for the March 5, 2012 ICD-9-CM Coordination and Maintenance Committee Meeting will open on Friday, February 3, 2012. Proposals for the diagnosis codes will be discussed from approximately 1:30 pm-5:00 pm by the Centers for Disease Control (CDC).

A tentative Diagnosis agenda will also be posted in February. Please visit CDCs website for the Diagnosis agenda that is located at the following address: www.cdc.gov/nchs/icd/icd9cm_maintenance.htm

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has begun the process of notifying covered entities that they are among the unlucky few who have been selected for the first HIPAA privacy and security audits under the Health Information Technology for Economic and Clinical Health (HITECH) Act. The selected entities represent a cross sample of the health care industry from billion-dollar health care systems to small physician practices.

In last-minute maneuverings, Congressional lawmakers Dec. 23 approved an amended version of payroll tax legislation that also would defer for two months a Medicare pay cut for physicians due to be implemented Jan. 1. House and Senate leaders reached an agreement on the measure Thursday, narrowly averting a 27.5 percent reduction in Medicare reimbursement for physicians, including pathologists.