Transmittals

Medicare Claims Processing Pub. 100-04 Chapter 24 Update for HIPAA 5010 and EDI Enhancements

Insurance Purchased From a Limited Purpose Insurance Company

Reflects further clarification to existing instructions and incorporates select Federal Register provisions.

Effective Date of Certified Provider or Supplier Agreement or Approval

Manual Clarifications for Skilled Nursing Facility (SNF) Part A Billing

April 2011 Update of the Ambulatory Surgical Center (ASC) Payment System

July 2011 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files

July Quarterly Update to 2011 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement

New Waived Tests

Waiver of Coinsurance and Deductible for Preventive Services in Rural Health Clinics (RHCs), Section 4104 of Affordable Care Act (ACA).

Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process Stemming Principally From the Affordable Care Act (ACA)

Advanced Diagnostic Imaging Accreditation Enrollment Procedures

Implementation of New Reasonable Useful Lifetime (RUL) Policy for Stationary and Portable Oxygen Equipment

Notice of New Interest Rate for Medicare Overpayments and Underpayments-3rd Notification for FY 2011.

New Specialty Code for Advanced Diagnostic Imaging Accreditation

Flat File Update for Institutional Claim Transaction 837I, Professional Claim Transaction 837P, and Claim Payment/Advice Transaction 835

Home Health Therapy Services

Implementation of the PWK (paperwork) segment for X12N Version 5010

ViPS Medicare System (VMS) ICD-10 Remove any Obsolete Quarterly Medical Review(QMR) Processes and Reports that Include ICD-9 codes

Upgrade of Optical Character Recognition (OCR) and Intelligent Character Recognition (ICR) Systems in Preparation for HIPAA Version 5010 (Analysis Only)