Railroad Medicare Provider News for Friday 6/23/17

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2017

This article is based on Change Request (CR) 10156 which announces the changes that will be included in the October 2017 quarterly release of the edit module for clinical diagnostic laboratory services. Make sure your billing staffs are aware of these changes to ensure proper billing to Medicare.

Understanding the Railroad Medicare Medical Review Program: Recorded Presentation

Have questions about the Railroad Medicare Medical Review program? We have answers! Register here for the on-demand recorded presentation of our June 13, 2017, Understanding the Railroad Medicare Medical Review Program webcast on which we cover the basics of the Medical Review program. In this updated webcast we discuss why we conduct reviews, the different types of reviews we conduct, and your role in the medical review process. We also share helpful resources and answer frequently asked questions.


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Jurisdiction M Home Health & Hospice News for Friday 6/23/17

Understanding Claim Denials with Reason Code 37253

Medicare regulations require that the Outcome and Assessment Information Set (OASIS) be transmitted to the state repository, known as the Quality Improvement Evaluation System (QIES), within 30 days of the date the OASIS is completed. Home health claims with dates of service on or after April 1, 2017, that are submitted for payment will deny with Reason Code 37253 when either no OASIS is found or a corresponding OASIS cannot be found in the state in the state repository and the claim receipt date is more than 40 days from the OASIS completion date reported on the claim. Please share with appropriate staff.


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This post applies to: JM HHH

Jurisdiction M Part B News for Friday 6/23/17

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2017

This article is based on Change Request (CR) 10156 which announces the changes that will be included in the October 2017 quarterly release of the edit module for clinical diagnostic laboratory services. Make sure your billing staffs are aware of these changes to ensure proper billing to Medicare.


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Jurisdiction M Part A News for Friday 6/23/17

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2017

This article is based on Change Request (CR) 10156 which announces the changes that will be included in the October 2017 quarterly release of the edit module for clinical diagnostic laboratory services. Make sure your billing staffs are aware of these changes to ensure proper billing to Medicare.


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Railroad Medicare Provider News for Thursday 6/22/17

Expanded Systems Maintenance Scheduled Sunday, June 25, 2017

Palmetto GBA will be performing expanded system maintenance between 8 a.m. and 10 p.m. on Sunday, June 25, 2017. Connectivity to the Medicare and NCPDP Secure File Transfer protocol (SFTP), as well as Web applications on eServices and CSSC Web portals, will not be accessible during this time. All systems should be available on Monday, June 26, 2017. We apologize for any inconvenience.


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Jurisdiction M Home Health & Hospice News for Thursday 6/22/17

Expanded Systems Maintenance Scheduled Sunday, June 25, 2017

Palmetto GBA will be performing expanded system maintenance between 8 a.m. and 10 p.m. on Sunday, June 25, 2017. Connectivity to the Medicare and NCPDP Secure File Transfer protocol (SFTP), as well as Web applications on eServices and CSSC Web portals, will not be accessible during this time. All systems should be available on Monday, June 26, 2017. We apologize for any inconvenience.


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This post applies to: JM HHH

Jurisdiction M Part B News for Thursday 6/22/17

Expanded Systems Maintenance Scheduled Sunday, June 25, 2017

Palmetto GBA will be performing expanded system maintenance between 8 a.m. and 10 p.m. on Sunday, June 25, 2017. Connectivity to the Medicare and NCPDP Secure File Transfer protocol (SFTP), as well as Web applications on eServices and CSSC Web portals, will not be accessible during this time. All systems should be available on Monday, June 26, 2017. We apologize for any inconvenience.

Local Coverage Determination (LCD) Updates Part B

The Chemodenervation L33458 JM Part B LCD was revised. Please share with appropriate staff.

West Virginia Part B Clinicians: Merit-based Incentive Payment System (MIPS) Tips Webcast: July 18

West Virginia Part B providers, Palmetto GBA is pleased to partner with Quality Insights for a free CMS-Funded Quality Payment Program (QPP) and MIPS webcast on July 18, 2017 at 1 p.m., ET. Registration is required and this session is only for WV Part B providers. Providers in other states should watch the Palmetto GBA website for announcements about QPP partnering webcasts for your specific state. Please plan to attend.

Local Coverage Determination (LCD) Update: Part A and Part B

The Retroperitoneal Ultrasound L34577, Rituximab (Rituxan) L35026, and Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) L34431 A/B MAC LCDs were revised. Please share with appropriate staff.


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Jurisdiction M Part A News for Thursday 6/22/17

Expanded Systems Maintenance Scheduled Sunday, June 25, 2017

Palmetto GBA will be performing expanded system maintenance between 8 a.m. and 10 p.m. on Sunday, June 25, 2017. Connectivity to the Medicare and NCPDP Secure File Transfer protocol (SFTP), as well as Web applications on eServices and CSSC Web portals, will not be accessible during this time. All systems should be available on Monday, June 26, 2017. We apologize for any inconvenience.

Local Coverage Determination (LCD) Update: Part A and Part B

The Retroperitoneal Ultrasound L34577, Rituximab (Rituxan) L35026, and Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) L34431 A/B MAC LCDs were revised. Please share with appropriate staff.


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Railroad Medicare Provider News for Wednesday 6/21/17

Influenza and Pneumococcal Roster Billing Packet and Forms

Roster billing is a simplified process used by mass immunizers. Palmetto GBA has prepared a packet for health care providers who mass immunize their patients against influenza and pneumonia. The packet contains instructions on how to submit claims using the roster billing method. Please share this information with appropriate members of your staff.


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Jurisdiction M Home Health & Hospice News for Wednesday 6/21/17

June 2017 Home Health and Hospice Quarterly Updates Webcast: June 22

Palmetto GBA will host the June 2017 Home Health and Hospice Quarterly Updates webcast on June 22, 2017, at 10 a.m. ET. The Quarterly Update Webcasts are intended to provide ongoing, scheduled opportunities for providers to stay up to date on Medicare requirements. Please plan to attend.


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This post applies to: JM HHH