Transmittals

Enhancements to the Recovery Audit Mass Adjustment/Reporting Process in the Fiscal Intermediary Shared System (FISS)

Modify the Interchange Control Number (ICN) for Medicare Advantage Encounters

Revisions to Common Working File (CWF) Edits that Deny Claims for Prosthetics, Orthotics, and Supplies (POS) Furnished to Beneficiaries in a Skilled Nursing Facility (SNF) Stay

Inpatient Rehabilitation Facility (IRF) and Inpatient Psychiatric Facility (IPF) Cost-to-Charge Ratios (CCRs)

Health Insurance Portability and Accountability Act (HIPAA) 5010 837 Institutional (837I) Edits and 5010 837 Professional (837P) Edits-April 2012 Version

Instructions for the Fiscal Intermediary Shared System (FISS) to modify the Workers Compensation Set Aside (WCSA) Claims Process to Capture the Amount Medicare would have paid when the Claim is returned by CWF. This change request also updates the MSP Savings Report to add Special Project Savings Total on the Savings Report to include totals from all Special Projects

Annual Type of Service (TOS) Update

VMS Modifications to Oxygen CMN Editing

New Waived Tests

Quarterly Update to the Correct Coding Initiative (CCI) Edits, Version 18.0, Effective January 1, 2012

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2012

Calendar Year (CY) 2012 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures

Update to Notifications Sent to State Medicaid Agencies and Child Health Plans of Medicare Terminations for Certified Providers and Suppliers and Medicare Revocations for Providers and Suppliers. This CR rescinds and fully replaces CR 7017, 7074 and 7334.

Updates to the Internet Only Manual Pub.100-04, Chapter 15-Ambulance to include The Medicare and Medicaid Extenders Act of 2010 (MMEA) Provisions

Updates to the Internet Only Manual Pub.100-04, Chapter 15-Ambulance to include The Medicare and Medicaid Extenders Act of 2010 (MMEA) Provisions

Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement

Hospice Claims Processing Procedures When Required Face-to-Face Encounters Do Not Occur Timely

Proof of Delivery and Delivery Methods

Updates to the Internet Only Manual, Pub. 100-04, Chapter 15-Ambulance, to include the Medicare and Medicaid Extenders Act of 2010 (MMEA) Provisions

Claim Status Category and Claim Status Codes Update