Medicare Compliance & Reimbursement

The 2004 update to the Healthcare Common Procedure Coding System will reach Medicare contractors Oct. 15, the Centers for Medicare & Medicaid Services says in a Sept. 12 program memorandum (AB-03-140; http://cms.hhs.gov/manuals/pm_trans/AB03140.pdf). CMS points out that the American Medical Association has established some new category II codes (ending with the letter "F") that will be used to track performance measurement. In other recent program memoranda, CMS: updates contractor instructions on appeals quality improvement and data analysis activities (AB-03-139; http://cms.hhs.gov/manuals/pm_trans/AB03139.pdf), and changes policies on end stage renal disease reimbursement for automated multi-channel chemistry tests (A-03-080; http://cms.hhs.gov/manuals/pm_trans/A03080.pdf). Heads up: CMS will soon be phasing out program memoranda (see story, "GET READY FOR A NEW WAY TO LEARN ABOUT MEDICARE CHANGES"). Program updates will be released, among other ways, via "one time notifications." This week's notifications include an explanation of payment policies for tositumomab and Iodine I-131 (Trans. 1; http://cms.hhs.gov/manuals/pm_trans/R1OTSN.pdf) and an outline of payment allowances for the influenza vaccine (Trans. 3; http://cms.hhs.gov/manuals/pm_trans/R3OTN .pdf).