Jurisdiction M Home Health & Hospice News for Friday 8/18/17

Hospice Change of Ownership

A Change of Ownership (CHOW) in hospice does not constitute a change (transfer) from one hospice to another. Only the beneficiary can elect to change hospices. When a change of ownership takes place, and the Provider Transaction Access Number (PTAN) and/or the National Provider Identifier (NPI) number changes, there are certain steps that have to be followed in order for claims to process for dates of service on or after the effective date of the change.

Hospice Transfer Requirements

The admission process is one of the most important steps in Hospice Billing. Upon admission, providers are required to verify the beneficiary’s eligibility files to ensure the patient is entitled to Medicare and determine if prior hospice benefit periods exist. An individual may change, once in each election/benefit period the designation of the particular hospice from which he or she elects to receive hospice care. It is imperative that hospices work together when a patient chooses to change hospices.

Notice of Change of Ownership (TOB 8XE) Job Aid

The Notice of Change of Ownership (TOB 8XE) is submitted when the hospice has a change of ownership that results in either a change in the Provider Transaction Access Number (PTAN) or the National Provider Identifier (NPI). To complete the 8XE, select menu option ‘28’ from the claims entry menu in the Direct Data Entry (DDE) system and follow the steps in this article.


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This post applies to: JM HHH

Jurisdiction M Part B News for Friday 8/18/17

Local Coverage Determinations – Notice Period

The Non-Covered Category III CPT Codes L34555 A/B MAC LCD begins its notice period August 17, 2017. The notice period will end October 1, 2017. Please share with appropriate staff.

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

The Application of Skin Substitutes L36466 and Noncovered Services other than CPT® Category III Noncovered Services L36954 A/B MAC LCDs were revised. The Non-Coverage of Extracorporeal Shock Wave Lithotripsy for Musculoskeletal Conditions L35627 A/B MAC LCD was retired August 8, 2017. Please share with appropriate staff.


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Jurisdiction M Part A News for Friday 8/18/17

CMS Inpatient Rehabilitation Facilities (IRFs): Documentation Positively Impacts CERT Training Module

CMS makes available a web-based training module, Inpatient Rehabilitation Facilities (IRFs): Improving Documentation Positively Impacts CERT, to assist you in improving IRF documentation. In this module learn about the basic elements of the Comprehensive Error Rate Testing (CERT) Program and Inpatient Rehabilitation Facility (IRF) services, and documentation requirements for IRF services. Please share with appropriate staff.

Local Coverage Determinations – Notice Period

The Non-Covered Category III CPT Codes L34555 A/B MAC LCD begins its notice period August 17, 2017. The notice period will end October 1, 2017. Please share with appropriate staff.

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

The Application of Skin Substitutes L36466 and Noncovered Services other than CPT® Category III Noncovered Services L36954 A/B MAC LCDs were revised. The Non-Coverage of Extracorporeal Shock Wave Lithotripsy for Musculoskeletal Conditions L35627 A/B MAC LCD was retired August 8, 2017. Please share with appropriate staff.


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Jurisdiction M Home Health & Hospice News for Thursday 8/17/17

Responding to a Home Health Additional Documentation Request (ADR)

The article provides recommendations for what to include when responding to a Home Health Additional Documentation Request (ADR). Please share with appropriate staff.

Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index and Hospice Pricer for FY 2018

Change Request (CR) 10131 updates the hospice payment rates, hospice wage index, and Pricer for Fiscal Year (FY) 2018. The CR also updates the hospice cap amount for the cap year ending October 31, 2017. Make sure your billing staffs are aware of these changes.

Calling All Palmetto GBA Hospice Providers!

We are in the process of planning our 2018 provider outreach and education events and are exploring the possibility of holding a Hospice Conference. Before we decide to proceed, we need to determine provider interest so we are asking you to please take a short five-question survey. Please complete the survey. Please share this information with your staff and encourage them to take the survey.


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This post applies to: JM HHH

Jurisdiction M Home Health & Hospice News for Tuesday 8/15/17

Can I Appeal My Claim Denial? Module

If you are dissatisfied with an initial claim determination, you have the right to request an appeal. This tool allows you to answer questions to determine your appeal options. Please share with appropriate staff.

CMS National Provider Enrollment Conference: September 6 and 7, 2017

The Centers for Medicare & Medicaid Services (CMS) will hold a National Provider Enrollment Conference on Wednesday, September 6, 2017 from 8 a.m. to 5 p.m. EDT and Thursday, September 7, 2017 from 8 a.m. to 3 p.m. EDT. This session will be held at the Charleston Area Convention Center located at 5000 Coliseum Dr., North Charleston, SC 29418. Don’t miss this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts. Registration for this free conference ends August 29, 2017. Please plan to attend.

Provider Contact Center (PCC) To Close For Training On August 18

The Provider Contact Center (PCC) will be closed for training on August 18, 2017, from 8 a.m. to 12 p.m. ET. The PCC will reopen at 12 p.m. ET.


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Jurisdiction M Part B News for Tuesday 8/15/17

CMS National Provider Enrollment Conference: September 6 and 7, 2017

The Centers for Medicare & Medicaid Services (CMS) will hold a National Provider Enrollment Conference on Wednesday, September 6, 2017 from 8 a.m. to 5 p.m. EDT and Thursday, September 7, 2017 from 8 a.m. to 3 p.m. EDT. This session will be held at the Charleston Area Convention Center located at 5000 Coliseum Dr., North Charleston, SC 29418. Don’t miss this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts. Registration for this free conference ends August 29, 2017. Please plan to attend.

Provider Contact Center (PCC) To Close For Training On August 18

The Provider Contact Center (PCC) will be closed for training on August 18, 2017, from 8 a.m. to 12 p.m. ET. The PCC will reopen at 12 p.m. ET.

Mactoberfest Workshop Conference: Innovation Today for Success Tomorrow

Palmetto GBA, the JM A/B MAC, is presenting an informative workshop in Columbia, South Carolina that will provide information related to the most common errors identified through a variety of data analysis and tips to avoid them. This workshop is intended to keep providers apprised of Medicare guidelines as well as using technology for better results. The recommended participants are administrators, billers, nurses and other healthcare professionals that submit claims to Medicare. Topics include: Electronic Data Interchange (EDI), Medicare Updates, Appeals, Medical Affairs, Medical Review, eServices Online Secure Portal, and Provider Enrollment and Revalidations. This is a free event! Please plan to attend.

Part B August 17, 2017, Ask the Contractor Teleconference: PECOS Overview

Join Palmetto GBA on August 17, 2017, at 10 a.m. ET for the next Part B Ask the Contractor Teleconference. The general question and answer session will follow a brief overview of the Provider Enrollment, Chain and Ownership System (PECOS). Please share this information with your staff.

Quality Payment Program Webcast for South Carolina Providers: August 24

Join us for a webinar on the Quality Payment Program presented just for our South Carolina providers on August 24, 2017 from 10 – 11 a.m. ET. This webinar is cosponsored by The Carolinas Center for Medical Excellence (CCME), The South Carolina Office of Rural Health, and Palmetto GBA. By the end of this webcast you should have an understanding of your options for the 2017 reporting year, be aware of the proposed updates for the second year of the Quality Payment Program, and be better prepared to plan your approach for participation in 2017 and 2018. Be sure to tune in and gain insight into what the first year of the new Quality Payment Program means, where the program is headed and resources available to assist you!

Did you know you can view your latest electronic Comparative Billing Report (eCBR) in eServices?

Did you know you can view your latest electronic Comparative Billing Report (eCBR) in eServices? Be sure to check them out today!

eServices makes it easy to monitor the use of your NPI!

eUtilization reports provide rendering providers and ordering and referring providers access to their personal data. Check them out today.


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Jurisdiction M Part A News for Tuesday 8/15/17

CMS National Provider Enrollment Conference: September 6 and 7, 2017

The Centers for Medicare & Medicaid Services (CMS) will hold a National Provider Enrollment Conference on Wednesday, September 6, 2017 from 8 a.m. to 5 p.m. EDT and Thursday, September 7, 2017 from 8 a.m. to 3 p.m. EDT. This session will be held at the Charleston Area Convention Center located at 5000 Coliseum Dr., North Charleston, SC 29418. Don’t miss this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts. Registration for this free conference ends August 29, 2017. Please plan to attend.

Provider Contact Center (PCC) To Close For Training On August 18

The Provider Contact Center (PCC) will be closed for training on August 18, 2017, from 8 a.m. to 12 p.m. ET. The PCC will reopen at 12 p.m. ET.

Can I Appeal My Claim Denial? Module

If you are dissatisfied with an initial claim determination, you have the right to request an appeal. This tool allows you to answer questions to determine your appeal options. Please share with appropriate staff.

Fiscal Year (FY) 2017 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) PPS Changes

This article is based on CR 9723 which implements policy changes for FY 2017 IPPS and LTCH PPS and covers services effective for hospital discharges occurring on or after October 1, 2016, through September 30, 2017, unless otherwise noted. Failure to adhere to these new policies could affect payment of Medicare claims. Make sure that your billing staff is aware of these IPPS and LTCH PPS changes for FY 2017.

Mactoberfest Workshop Conference: Innovation Today for Success Tomorrow

Palmetto GBA JM A/B MAC is presenting an informative workshop in Columbia, South Carolina that will provide information related to the most common errors identified through a variety of data analysis and tips to avoid them. This workshop is intended to keep providers apprised of Medicare guidelines as well as using technology for better results. The recommended participants are administrators, billers, nurses and other healthcare professionals that submit claims to Medicare. Topics include: Electronic Data Interchange (EDI), Medicare Updates, Appeals, Medical Affairs, Medical Review, eServices Online Secure Portal, and Provider Enrollment and Revalidations. This is a free event! Please plan to attend.

Quarterly Updates Webcast: September 13

Palmetto GBA will host the JM Part A Quarterly Updates Webcast on September 13, 2017, at 10 am. ET. This webcast is intended for Part A providers billing for services rendered in Virginia, West Virginia, North Carolina and South Carolina. This 60-minute Webcast is designed to provider pertinent updates, changes and reminders to assist the provider community in staying compliant with Medicare rules and regulations. Please plan to attend.

Critical Access Hospital (CAH) Fundamentals Webcast: August 16, 2017

Please join Palmetto GBA for an informative Part A Critical Access Hospital (CAH) Fundamentals Webcast on August 16, 2017, at 10 a.m. ET! This 60 minute webcast is designed to provide an overview of CAH services, documentation and medical necessity requirements, CERT and valuable tips to prevent errors. Please plan to attend.


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Railroad Medicare Provider News for Monday 8/14/17

What are the minimum system requirements for Palmetto GBA’s eServices?

In an effort to maintain the security of the information available through eServices and adhere to CMS security requirements, users must now access eServices with one of the current supported internet browsers. To optimize usability of eServices, we recommend that users verify their system adheres to all items in the most current version of eServices minimum system requirements. Please read this article to learn more.

ICD-10 Coding Revisions to National Coverage Determinations (NCDs)

Change Request (CR) 10184 outlines edits to International Classification of Diseases, 10th Revision (ICD-10) and other coding updates specific to National Coverage Determinations (NCDs) that will be included in subsequent, quarterly releases as needed. No policy-related changes are included with these updates. Any policy-related changes to NCDs continue to be implemented via the current, long-standing NCD process. Make sure your staff is aware.


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Jurisdiction M Home Health & Hospice News for Monday 8/14/17

What are the minimum system requirements for Palmetto GBA’s eServices?

In an effort to maintain the security of the information available through eServices and adhere to CMS security requirements, users must now access eServices with one of the current supported internet browsers. To optimize usability of eServices, we recommend that users verify their system adheres to all items in the most current version of eServices minimum system requirements. Please read this article to learn more.


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This post applies to: JM HHH

Jurisdiction M Part B News for Monday 8/14/17

What are the minimum system requirements for Palmetto GBA’s eServices?

In an effort to maintain the security of the information available through eServices and adhere to CMS security requirements, users must now access eServices with one of the current supported internet browsers. To optimize usability of eServices, we recommend that users verify their system adheres to all items in the most current version of eServices minimum system requirements. Please read this article to learn more.

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

The Echocardiography L37379, Infliximab (Remicade) L35677, and White Cell Colony Stimulating Factors L37176 A/B MAC LCDs were revised. Please share with appropriate staff.

Local Coverage Determinations – Notice Period

The Chiropractic Services L37387 Part B LCD began its notice period August 10, 2017. The notice period will end September 24, 2017. Any revisions made will become effective September 25, 2017. Please share with appropriate staff.

ICD-10 Coding Revisions to National Coverage Determinations (NCDs)

Change Request (CR) 10184 outlines edits to International Classification of Diseases, 10th Revision (ICD-10) and other coding updates specific to National Coverage Determinations (NCDs) that will be included in subsequent, quarterly releases as needed. No policy-related changes are included with these updates. Any policy-related changes to NCDs continue to be implemented via the current, long-standing NCD process. Make sure your staff is aware.


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