Medicare Part A News-Jurisdiction H for April 1st, 2014

The following news is brought to you by Novitas Solutions.

Medicare News

2014 Medicare Symposiums
Dates and locations for upcoming 2014 Medicare Symposiums are now available! Register today for an event near you! Additional event locations and handout materials will be added when they become available. Stay tuned for updates!


2014 Open Meeting Dates and New Meeting Format Information is Now Posted

Dates for the remainder of the 2014 Open Meetings are now posted here.

Please note that starting in May of 2014 the Novitas Solutions Open Meeting will be a combined meeting for both Medicare Administrative Contractor (MAC) Jurisdiction H (JH) and MAC Jurisdiction L (JL) contract areas.

Open Meetings are for the purpose of discussing draft Local Coverage Determinations (LCDs). Anyone is welcome to present information related to the policies that are in the 45-day draft comment period. Interested participants may request to present scientific, evidence-based information; professional consensus opinions; or any other information that is relevant to any of the LCDs that are in draft. These in-person presentations are made to the Novitas Solutions’ Contractor Medical Directors. Interested parties may also request to attend as an observer.

NOTE: The Open Meeting is not a forum for discussing specific claims; or for the submission of new drugs, indications, or marketing of forthcoming drugs or medical devices. Information regarding new drugs, indications, or marketing information should be submitted according to Novitas guidelines. Specific claim questions, including billing, pricing and coding, should be directed to our Customer Service Center at 1-877-235-8073.


Medicare Learning Network (MLN) Matters Articles from CMS

New:

• MM8651 – Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) Rule - Update from CAQH CORE - February 1, 2014 version 3.0.4
• MM8695 – Calendar Year (CY) 2014 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment - REVISION

Revised:

• MM8566 – Rescind/Replace Reclassification of Certain Durable Medical Equipment from the Inexpensive and Routinely Purchased Payment Category to the Capped Rental Payment Category

Medicare Part A News-Jurisdiction H for March 31st, 2014

The following news is brought to you by Novitas Solutions.

Medicare News

Protocol for Submission of Information relative to New Drugs, New or Revised Indications, or Marketing Information of Forthcoming Drugs or Devices is Now Available!

Please review Novitas Solutions’ protocol regarding Submission of Information relative to New Drugs, New or Revised Indications, or Marketing Information of Forthcoming Drugs or Devices. This information can be also be located by clicking Medical Policy Center, from the left menu. Look for it under the section “Need Help?”


JH Part A Webinar Handout: "Update - New Novitas Website" 

April 2, 2014 (1:00pm-2:30pm CT, 2:00pm-3:30pm ET)

Join us for our webinar "Update - New Novitas Website" on April 2, 2014 (1:00pm CT/2:00pm ET).

We will demonstrate the improved Novitas Solutions website, how to navigate the site, inform you of the new available search tools, and provide tips to enhance your search results.

Register today for this informative event!


Novitas Educational Tips and Tools - NETTs: Timely Filing

How long do I have to submit a claim? Are there exceptions if I miss the deadline to file a claim? Find answers to these questions and more when you visit the Novitas Educational Tips and Tools - NETTs page and review the document titled "Timely Filing Requirements". Additional documents are available for your viewing pleasure. Visit this page often to see what has been added or join the Listserv and receive immediate notification when something is added or updated.

Medicare Part A News-Jurisdiction H for March 28th, 2014

The following announcements are brought to you by Novitas Solutions.

Medical Policy Updates

The following JH MAC Local Coverage Determinations (LCDs) which were posted for notice on February 6, 2014 are now effective:

• Bariatric Surgical Management of Morbid Obesity (L32619)
• Frequency of Dialysis (L32755)
• Glaucoma Treatment with Aqueous Drainage Device (L32733)
• Hemophilia Factor Products (L32735)
• Infrared Photocoagulation (IRC) of Hemorrhoids (L34350)
• Intraoperative Neurophysiological Testing (L32605)
• Lacrimal Punctum Plugs (L32607)
• Outpatient Sleep Studies (L32711)
• Qualitative Drug Testing (L34352)
• Surgery: Blepharoplasty (L32715)
• Vascular Access for Hemodialysis (L32708)
• Wireless Capsule Endoscopy (L32686)

The JH MAC draft LCD L32687 Wound Care and Cellular and/or Tissue-Based Products for Wounds scheduled to become effective on 3/27/2014 has been placed on hold. Therefore, the LCD has been reverted back to the version effective prior to the 3/27/2014 revisions and has been revised for dates of service on and after 01/01/2014 to reflect the annual CPT/HCPCS code updates.

• Wound Care (L32687)

The following JH MAC Local Coverage Determination (LCD) which was posted for notice on February 6, 2014 is now effective. This LCD has also been revised:

• Cataract Extraction (including Complex Cataract Surgery) (L32690)

The following JH MAC LCD has been retired effective March 26, 2014 for dates of service on and after March 27, 2014:

• Qualitative Drug Screening (L32666)

Enhanced Provider Enrollment Status Inquiry Tool

We have updated our online status tool to include the status of Phase 3 revalidation applications (i.e., requests issued after September 20, 2013). We apologize for the inconvenience and appreciate your patience as we worked through this issue. We request that you utilize the online tool as your source of information for application status so our Customer Service Representatives can be utilized for more complex inquiries.

JH Part A Top Inquiries (December 2013 - February 2014)

The JH Part A Top Inquiries Frequently Asked Questions (FAQs) have been updated. Please visit our FAQs for the answers to your questions.

Medicare Part B News-Jurisdiction H for April 1st, 2014

The following updates are brought to you by Novitas Solutions.

Medicare News

2014 Medicare Symposiums

Dates and locations for upcoming 2014 Medicare Symposiums are now available! Register today for an event near you! Additional event locations and handout materials will be added when they become available. Stay tuned for updates! Information can be found here.


2014 Open Meeting Dates and New Meeting Format Information is Now Posted

Dates for the remainder of the 2014 Open Meetings are now posted here.

Please note that starting in May of 2014 the Novitas Solutions Open Meeting will be a combined meeting for both Medicare Administrative Contractor (MAC) Jurisdiction H (JH) and MAC Jurisdiction L (JL) contract areas.

Open Meetings are for the purpose of discussing draft Local Coverage Determinations (LCDs). Anyone is welcome to present information related to the policies that are in the 45-day draft comment period. Interested participants may request to present scientific, evidence-based information; professional consensus opinions; or any other information that is relevant to any of the LCDs that are in draft. These in-person presentations are made to the Novitas Solutions’ Contractor Medical Directors. Interested parties may also request to attend as an observer.

NOTE: The Open Meeting is not a forum for discussing specific claims; or for the submission of new drugs, indications, or marketing of forthcoming drugs or medical devices. Information regarding new drugs, indications, or marketing information should be submitted according to Novitas guidelines. Specific claim questions, including billing, pricing and coding, should be directed to our Customer Service Center at 1-877-235-8073.


Medicare Learning Network (MLN) Matters Articles from CMS

New:

• MM8651 – Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) Rule - Update from CAQH CORE - February 1, 2014 version 3.0.4
• MM8695 – Calendar Year (CY) 2014 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment - REVISION

Revised:

• MM8566 – Rescind/Replace Reclassification of Certain Durable Medical Equipment from the Inexpensive and Routinely Purchased Payment Category to the Capped Rental Payment Category

Medicare Part B News-Jurisdiction H for March 31st, 2014

The following announcements are brought to you by Novitas Solutions.

Medicare News 

Protocol for Submission of Information relative to New Drugs, New or Revised Indications, or Marketing Information of Forthcoming Drugs or Devices is Now Available!

Please review Novitas Solutions’ protocol regarding Submission of Information relative to New Drugs, New or Revised Indications, or Marketing Information of Forthcoming Drugs or Devices. This information can be also be located by clicking Medical Policy Center, from the left menu. Look for it under the section “Need Help?”


Part B Webinar Handout: "Part B Evaluation and Management Score Sheet: Part One- Understanding the Key Components of Evaluation and Management Services"

April 2, 2014 (11:00am-12:00pm ET, 10:00am-11:00am CT)

Join us for the four part series on Evaluation and Management Services. This week will be "Part One- Understanding the Key Components." This four part series was developed to increase your understanding of evaluation and management services. The complete series will be presented every month with one part each week. It is recommended to take the entire series in order to maximize your understanding. However, if you miss any part of the series, it will be presented again the following month in the same order.

The series will consist of the following:

• Week One-Part One- Understanding the Key components of Evaluation and Management. 
• Week Two-Part Two- Introduction to the Score Sheet, 
• Week Three- Part Three- Using the Score Sheet 
• Week Four- Part Four- Scoring Medical Records Using the Score Sheet 

If you are new to documenting and/or scoring evaluation and management services, this webinar event is for you. You must attend this event. Information and registration can be found here.

Medicare Part B News-Jurisdiction H for March 28th, 2014

The following announcements are brought to you by Novitas Solutions.

Medical Policy Updates

The following JH MAC Local Coverage Determinations (LCDs) which were posted for notice on February 6, 2014 are now effective:

• Bariatric Surgical Management of Morbid Obesity (L32619)
• Frequency of Dialysis (L32755)
• Glaucoma Treatment with Aqueous Drainage Device (L32733)
• Hemophilia Factor Products (L32735)
• Infrared Photocoagulation (IRC) of Hemorrhoids (L34350)
• Intraoperative Neurophysiological Testing (L32605)
• Lacrimal Punctum Plugs (L32607)
• Outpatient Sleep Studies (L32711)
• Qualitative Drug Testing (L34352)
• Surgery: Blepharoplasty (L32715)
• Vascular Access for Hemodialysis (L32708)
• Wireless Capsule Endoscopy (L32686)

The JH MAC draft LCD L32687 Wound Care and Cellular and/or Tissue-Based Products for Wounds scheduled to become effective on 3/27/2014 has been placed on hold. Therefore, the LCD has been reverted back to the version effective prior to the 3/27/2014 revisions and has been revised for dates of service on and after 01/01/2014 to reflect the annual CPT/HCPCS code updates.

• Wound Care (L32687)

The following JH MAC Local Coverage Determination (LCD) which was posted for notice on February 6, 2014 is now effective. This LCD has also been revised:

• Cataract Extraction (including Complex Cataract Surgery) (L32690)

The following JH MAC LCD has been retired effective March 26, 2014 for dates of service on and after March 27, 2014:

• Qualitative Drug Screening (L32666)

Enhanced Provider Enrollment Status Inquiry Tool

We have updated our online status tool to include the status of Phase 3 revalidation applications (i.e., requests issued after September 20, 2013). We apologize for the inconvenience and appreciate your patience as we worked through this issue. We request that you utilize the online tool as your source of information for application status so our Customer Service Representatives can be utilized for more complex inquiries.

Senate to Delay Scheduled Cuts in Physician Payments under Medicare

The Senate voted Monday evening to delay scheduled cuts in physician payments under Medicare.

The legislation also delays a requirement for hospitals to comply with the "two-midnight" rule for inpatient reimbursement, and pushes back recovery audits of allegedly unnecessary claims until March 2015.