PARA Weekly Update For Users October 20, 2017

Date

PARA WEEKLY

UPDATE For Users

Improving T he Businessof HealthCare Since 1985 October 20, 2017 NEWS FOR HEALTHCARE DECISION MAKERS THE

EDITION QUESTION AND ANSWER -

Dieulafoy Lesions Diabetes With Cellulitis Pulse Oximetry Resolving MUE Edits Billing For Contracted Pathology Services Analgesic Nerve Blocks -- Post-Op Pain Management Patient Transport Between Facilities

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AND AN UPDATED AND EXPANDED LIST OF CMS UPDATES FOR 2018

PARA COMPANY NEWS ABOUT PARA SERVICES CONTACT US

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The number of new or revised Med Learn (MLN Matters) articles released this week. All new and previous Med Learn articles can be viewed under the type "Med Learn", in the Advisor tab of the PARA Dat a Edit or . Click here.

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The number of new or revised Transmittals released this week. All new and previous Transmittals can be viewed under the type "Transmittals" in the Advisor tab of the PARA Dat a Edit or . Click here.

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FAST LINKS: Click on the link for special areas of interest: Page

Administration: Pages 1-25 HIM/Coding Staff: Pages 2-25 Patient Financial Services: 6,9,11.13 Providers: Pages 2,3,4,10,

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Pathology: Pages 9 PDE Users: Pages 12-17 Pharmacy: Pages 10, 19 Finance Depts: Pages 9,11,12,13,14

© PARA Healt h Car e Fin an cial Ser vices CPT® is a r egist er ed t r adem ar k of t h e Am er ican M edical Associat ion

PARA Weekly Update: October 20, 2017

DIEULAFOY LESIONS

Question:What is the appropriate ICD-10 CM code for Dieulafoy lesion of the intestine with gastrointestinal bleeding?

Answer: Report ICD-10 CM codes K63.81 for Dieulafoy lesion of the intestine. Dieulafoy lesions are a rare cause of major gastrointestinal bleeding. When gastrointestinal bleeding is present with Dieulafoy lesions, a separate code for the gastrointestinal bleeding is not assigned.The bleeding is an integral part of the disease. Codes for Dieulafoy lesions are based on the anatomic site.

Please refer to the PARA Data Editor list of ICD-10 CM code descriptions for Dieulafoy lesions.

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PARA Weekly Update: October 20, 2017

DIABETES WITH CELLULITIS

Question: What is the appropriate ICD-10 CM code for cellulitis of upper back in a patient Type 2 diabetes?

Answer: Report ICD-10 CM codes L03.312, Cellulitis of back and E11.9, Diabetes Type 2 Unspecified.The code description for ICD-10 CM L03.312 includes any part of the back except the buttock.Therefore, ICD-10 CM code L03.312 supports upper back.

As indicated in Coding Clinic fourth Quarter, 2017, the provider would need to document cellulitis as a diabetic skin complication in order to code the Diabetes as a complication. Diabetes with skin complication Not Elsewhere Classified (NEC) can be indexed in the ICD-10 CM code book, however, diabetes with cellulitis is not specifically indexed. The "with" guideline does not apply to NEC index entries that cover broad categories of conditions.

Please refer to the PARA Data Editor code descriptions provided.

Diabetes and Cellulitis Coding Clinic for ICD-10-CM/PCS, Fourth Quarter 2017: Page 100 "Diabetes with skin complication NEC," is indexed, but "diabetes with cellulitis" is not specifically indexed.The "with" guideline does not apply to "not elsewhere classified (NEC)" index entries that cover broad categories of conditions. Specific conditions must be linked by the terms "with," "due to" or "associated with".

Coding professionals should not assume a causal relationship when the diabetic complication is "NEC." The ICD-10-CM classification presumes a cause and effect relationship with certain specific conditions when the Alphabetic Index links the conditions by the terms "with", "due to" or "associated with".

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PARA Weekly Update: October 20, 2017

PULSE OXIMETRY

Question: We have a patient who is on continuous pulse oximetry all day (we are using CPTÂŽ 94762). That night the patient had a two channel sleep study. We are getting a MUE edit for 94762 that we cannot have two units in one day. Is 94762 the correct CPTÂŽ to be using for a two channel sleep study?

Is there a different way to bill this scenario or does the 94762 capture both the continuous pulse ox and the two channel sleep study?

In a different situation, if a patient is in observation with continuous pulse ox from 7 am. to 7 pm, can we still use the 94762 even though that code states "by continuous OVERNIGHT monitoring".

Answer: HCPCS 94762 requires overnight testing; therefore, if the hours of the testing do not cross the midnight hour, we cannot endorse the use of this code.

The sleep study and polysomnography codes all require more than two channels. If the device is a two-channel oximetrymonitor, then the appropriate HCPCS is 94762 if the test is performed overnight, as the HCPCS requires. Obviously, two overnight studies cannot be performed in the same night.

If the documentation of the daytime oximetry testing justifies a ?separate and distinct? service from the overnight two-channel test, you may bill a different oximetry code, such as 94760 for a single determination or 94761 for multiple determinations, with a modifier XU (unusual overlapping service) or modifier 59. Unfortunately, the NCCI edit manual does not illuminate when two oximetry codes are sufficiently ?separate and distinct? to justify a modifier 59 or XU.

It is correct that there is an MUE that prevents billing more than one unit of 94762. This MUE is assigned an adjudication indicator of 2, which means that it cannot be overridden by a modifier and MACs are not permitted to allow multiple units on the same day for any reason:

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PARA Weekly Update: October 20, 2017

PULSE OXIMETRY

The following pages contain PARA?s paper on MUE Edits, which provides further explanation of the adjudication indicators.

Oxygen saturation (oximetry) is considered a component of any sleep study or polysomnography, and therefore cannot be reported for the same date of service, as illustrated by the following CCI edit report:

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PARA Weekly Update: October 20, 2017

RESOLVING MUE EDITS

Question: When can we resolve an MUE edit by simply splitting the number of units up onto more than one line on the claim?

Answer: Not all Medically Unlikely Edits (MUEs) are the same. MUEs are discussed in Chapter 1 of Medicare?s NCCI Edit Manual, which is available on the PARA Data Editor Calculator tab:

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Some MUEs may be resolved by splitting the units on two different lines and adding a modifier 59 or X{EPSU} to the second line HCPCS, but this may not satisfy other MUE requirements.

Medicare?s Outpatient Code Editor claims processing system is capable of summing all of the units on all lines with the same HCPCS for the same DOS, therefore simply splitting units among different lines may not resolve the edit.

There are three general types of MUE identified by an MUE Adjudication Indicator (MAI); in the MUE table published by CMS, the MAI is assigned to each HCPCS MUE and a brief ?rationale? is provided.

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PARA Weekly Update: October 20, 2017

RESOLVING MUE EDITS

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MAI 1 ? Line item ? Claim line MUE ? these MUEs may be bypassed by splitting the units among different claim lines. For instance, 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour) has an MUE of 1 because in most cases, only one primary IV code should be billed per encounter. However, it is appropriate to bill a second unit in the unusual circumstance that a second line is established on another site, and a 59 modifier appended. By billing the second 96365 on a second line, the MUE will be satisfied.

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MAI 2 ? Date of Service Edit: Policy ? these are absolute ?per day edits based on policy?.

MACs are not allowed to bypass these edits under any circumstances.

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MAI 3 ? Date of Service Edit: Clinical ? These edits are ?per day edits based on clinical benchmarks?; MACs may allow units in excess of the MUE ?3? if the MAC has evidence that UOS in excess of the MUE value were actually provided, were correctly coded and were medically necessary.

To provide the information necessary for the MAC to allow an exception to an MUE with an adjudication indicator of 3, providers should append modifier GD (Units of service exceeds medically unlikely edit value and represents reasonable and necessary services) to the HCPCS and provide additional information in the remarks field on the claim. If the MUE remains denied, the provider may have to appeal the denial to obtain appropriate payment.

The MUE Adjudication Indicators can be downloaded from the CMS website; there are separate files for practitioner vs. facility MUEs: https://www.cms.gov/medicare/coding/nationalcorrectcodinited/mue.html

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PARA Weekly Update: October 20, 2017

RESOLVING MUE EDITS

Pertinent excerpts from CMS 2016 NCCI Edit Manual, Chapter 1, are provided below: ?The MUE files on the CMS NCCI website display an ?MUE Adjudication Indicator? (MAI) for each HCPCS/CPT® code. An MAI of ?1? indicates that the edit is a claim line MUE. An MAI of ?2? or ?3? indicates that the edit is a DOS MUE. ?If a HCPCS/CPT® code has an MUE that is adjudicated as a claim line edit, appropriate use of CPT® modifiers (e.g., 59, 76, 77, 91, anatomic) may be used to report the same HCPCS/CPT® code on separate lines of a claim. Each line of the claim with that HCPCS/CPT® code will be separately adjudicated against the MUE value for that HCPCS/CPT® code. Claims processing contractors have rules limiting use of these modifiers with some HCPCS/CPT® codes. ?MUEs for HCPCS codes with an MAI of ?2? are absolute date of service edits. These are ?per day edits based on policy?. HCPCS codes with an MAI of ?2? have been rigorously reviewed and vetted within CMS and obtain this MAI designation because UOS on the same date of service (DOS) in excess of the MUE value would be considered impossible because it was contrary to NCCI Edit Manual Excerpts statute, regulation or subregulatory guidance.

This subregulatory guidance includes clear correct coding policy that is binding on both providers and CMS claims processing contractors. ?Limitations created by anatomical or coding limitations are incorporated in correct coding policy, both in the HIPAA mandated coding descriptors and CMS approved coding guidance as well as specific guidance in CMS and NCCI manuals.

For example, it would be contrary to correct coding policy to report more than one unit of service for CPT® 94002 "ventilation assist and management . . . initial day" because such usage could not accurately describe two initial days of management occurring on the same date of service as would be required by the code descriptor. As a result, claims processing contractors are instructed that an MAI of ?2? denotes a claims processing restriction for which override during processing, reopening, or redetermination would be contrary to CMS policy. ?MUEs for HCPCS codes with an MAI of ?3? are ?per day edits based on clinical benchmarks?.

MUEs assigned an MAI of ?3? are based on criteria (e.g., nature of service, prescribing information) combined with data such that it would be possible but medically highly unlikely that higher values would represent correctly reported medically necessary services. If contractors have evidence (e.g., medical review) that UOS in excess of the MUE value were actually provided, were correctly coded and were medically necessary, the contractor may bypass the MUE for a HCPCS code with an MAI of ?3? during claim processing, reopening or redetermination, or in response to effectuation instructions from a reconsideration or higher level appeal.?

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PARA Weekly Update: October 20, 2017

BILLING FOR CONTRACTED PATHOLOGY SERVICES

Question: In discussing our process for billing for Pathology Lab Services that are sent offsite, the offsite provider wants us to bill both components, tech and professional. Are we, as a Critical Access Hospital, able to bill for both components?

Answer: A Critical Access Hospital (CAH) may bill on behalf of an employed or contracted physician, including a pathologist, if that physician is performing services for CAH patients and the physician is enrolled under the CAH?s NPI. This would be true of all contracted payors, including Medicare, Medicaid, and commercial payors.

Here?s an excerpt from the Medicare Claims Processing Manual: https:/ / www.cms.gov/ Regulations-and-Guidance/ Guidance / Manuals/ Downloads/ clm104c04.pdf

?The Medicare Prescription Drugs, Improvement, and Modernization Act (MMA) of 2003, changed the requirement that each practitioner rendering a service at a CAH that has elected the optional method, reassign their billing rights to that CAH. This provision allows each practitioner to choose whether to reassign billing rights to the CAH or file claims for professional services through their A/B MAC (B). The reassignment will remain in effect for that entire cost reporting period. ?The individual practitioner must certify, using the Form CMS-855R, if he/she wishes to reassign their billing rights. The CAH must then forward a copy of Form CMS-855R to the A/B MAC (A), and the A/B MACs (B) must have the practitioner sign an attestation that clearly states that the practitioner will not bill the A/B MAC (A) or A/B MAC (B) for any services rendered at the CAH once the reassignment has been given to the CAH. This ?attestation? will remain at the CAH.?

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PARA Weekly Update: October 20, 2017

ANALGESIC NERVE BLOCKS - POST-OP PAIN MANAGEMENT

Question: Our anesthesiologists charge a professional fee for performing analgesic nerve blocks prior to surgery, in addition to the anesthesia for the surgical procedure itself. Can the hospital bill the facility fee for this service, or is it considered ?integral to? the surgical procedure?

Analysis: PARA?s paper on ?Integral To? concepts suggests two questions to test whether a service or supply should be considered integral to a billed procedure: - Can a procedure, as described in its HCPCS or ICD-9 code, be properly performed without supplying the item in question or performing the service in question?If the answer is no, then likely the item or service is considered ?integral.?

Answer: Yes, the procedure can be properly performed without a nerve block.The nerve block does not serve to provide anesthesia for the procedure itself, but only to reduce postoperative pain.The safety and efficacy of the procedure is not affected by the nerve block procedure.

- Is the item always supplied or service always performed in the course of providing another billable item or service? If the answer is yes, the item or service is likely ?integral.?

Answer: No, not all patients undergoing the same procedure receive nerve blocks, and not all anesthesiologists offer nerve blocks to all patients undergoing a given procedure.

The 2014 National Correct Coding Initiative Policy Manual discusses this question in Chapter Ii -Anesthesia Services, CPT Codes 00000-09999.An excerpt follows: ?64400-64530 (Peripheral nerve blocks ? bolus injection or continuous infusion) CPT codes 64400-64530 (Peripheral nerve blocks ? bolus injection or continuous infusion) may be reported on the date of surgery if performed for postoperative pain management only if the operative anesthesia is general anesthesia, subarachnoid injection, or epidural injection and the adequacy of the intraoperative anesthesia is not dependent on the peripheral nerve block.Peripheral nerve block codes should not be reported separately on the same date of service as a surgical procedure if used as the primary anesthetic technique or as a supplement to the primary anesthetic technique. Modifier 59 may be utilized to indicate that a peripheral nerve blockinjection was performed for postoperative pain management, rather than intraoperative anesthesia, and a procedure note should be included in the medical record.?

Answer: Nerve blocks which are performed for postoperative pain management only are separately billable if the physician documentation clearly establishes that the anesthesia required for the procedure is not dependent upon the peripheral nerve block. Append modifier -59 to the nerve block procedure code.

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PARA Weekly Update: October 20, 2017

PATIENT TRANSPORT BETWEEN FACILITIES

Question: How should billing and codeing for an inpatient transport betwen facilities be handled?

Answer: The facility for which the patient is an inpatient is responsible for the costs of the ambulance transportation to and from the second facility. It is PARA's recommendation that a contract be executed with the ambulance firm to pay Medicare fee schedule for the service.

The Medicare Claims Processing Manual section that addresses this requirement is below: https:/ / www.cms.gov/ Regulations-and-Guidance/ Guidance / Manuals/ Downloads/ clm104c03.pdf

10.4 - Payment of Nonphysician Services for Inpatients (Rev. 3030, Issued: 08-22-14, Effective: ASC X12: January 1, 2012, ICD-10: Upon Implementation of ICD-10, Implementation: ICD-10: Upon Implementation of ICD-10, ASC X12: September, 23 2014) All items and nonphysician services furnished to inpatients must be furnished directly by the hospital or billed through the hospital under arrangements. This provision applies to all hospitals, regardless of whether they are subject to PPS. A. - Other Medical Items, Supplies, and Services The following medical items, supplies, and services furnished to inpatients are covered under Part A. Consequently, they are covered by the prospective payment rate or reimbursed as reasonable costs under Part A to hospitals excluded from PPS. - Laboratory services (excluding anatomic pathology services and certain clinical pathology services); - Pacemakers and other prosthetic devices including lenses, and artificial limbs, knees, and hips; - Radiology services including computed tomography (CT) scans furnished to inpatients by a physician's office, other hospital, or radiology clinic; - Total parenteral nutrition (TPN) services; and - Transportation, including transportation by ambulance, to and from another hospital or freestanding facility to receive specialized diagnostic or therapeutic services not available at the facility where the patient is an inpatient.

The hospital must include the cost of these services in the appropriate ancillary service cost center, i.e., in the cost of the diagnostic or therapeutic service. It must not show them separately under revenue code 0540.

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PARA Weekly Update: October 20, 2017

PARA PRESENTATIONS FOR CLIENTS AND ASSOCIATIONS

PARA clients are invited to request PARA to present educational programs at group meetings within their organization or with affiliated groups, such as hospital or professional associations.

PARA staff routinely prepare presentations for facilities and professionals interested in keeping up to date on recent Medicare changes, or to provide education on the basics related to pricing, coding, and billing.

PARA staff are available to develop a presentation on a specific topic at client request, or present a ready-made program.PARA Data Editor Users may review programs which have been developed on the Advisor tab, filtering the document type to ?Presentations?:

For example, PARA staff have made recent presentations on the following topics: - Hospital Chargemaster Pricing Strategies in a Transparent Healthcare Marketplace - CMS Quarterly HCPCS Update - Medicare?s Appropriate Use Program - Billing for Supplies Interested clients are invited to reach out to your Account Executive for further information and assistance.

Download these FREE presentations from the PARA Data Editor.

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PARA Weekly Update: October 20, 2017

PARA YEAR-END HCPCS UPDATE PROCESS

In keeping our commitment to outstanding customer service, PARA clients will be fully supported with information and assistance on the annual CPTÂŽ HCPCS coding updates.

The PARA Data Editor (PDE) contains a copy of each client chargemaster; we use the powerful features of the PDE to identify any line item in the chargemaster which has a HCPCS code assigned that will be deleted as of January 1, 2018.

For this reason, it is important that clients check to ensure that a recent copy of the chargemaster has been supplied to PARA for use in the year-end update.

PARA will produce excel spreadsheets of each CDM line item, as well as our recommendation for alternate codes, in three waves as information is released from the following sources: 1. The American Medical Association?s publication of new, changed, and deleted CPTÂŽ codes; this information is released in September of each year.PARA will produce the first spreadsheet of CPT updates for client review in October, 2017.

2. Medicare?s 2018 OPPS Final Rule, typically published the first week of November; PARA will perform analysis and produce the second spreadsheet to include both the CPT information previously supplied, as well as alpha-numeric HCPCS updates (J-codes, G-codes, C-codes, etc.) from the Final Rule.

3. Medicare?s 2018 Clinical Lab Fee Schedule (CLFS) ? typically published in late November, the CLFS will reveal whether Medicare will accept new CPT?s generated by the AMA, or whether Medicare will require another reporting method (i.e. G0480 ?

G0483 for definitive drug testing in 2016 and 2017.)

Clients will be notified by email as spreadsheets are produced and recorded on the PARA Data Editor ?Admin? tab, under the ?Docs? subtab.

In addition, PARA consultants will publish concise papers on coding update topics in order to ensure that topical information is available in a manner that is organized and easy to understand. PARA clients may rest assured that they will have full support for year-end HCPCS coding updates to the chargemaster.

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PARA Weekly Update: October 20, 2017

Reprinted

JANUARY 1, 2018 CMS UPDATES

The following Transmittals have been published for the January 1 update.

This list will continue to expand in the coming weeks, and links to all documents can be found in the PDE Advisor tab.

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2018

January 2018 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing

Files and Revisions to Prior Quarterly Pricing Files

Quarterly Influenza Virus Vaccine Code Update - January 2018

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 24.0, Effective January 1, 2018

To go to the full Transmittal document simply click on the screen shot.

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PARA Weekly Update: October 20, 2017

JANUARY 1,2018 CMS UPDATES

Instructions for Downloading the Medicare ZIP Code File for January 2018

Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - January 2018

Affordable Care Act Bundled Payments for Care Improvement Initiative - Recurring File Updates Models 2 and 4 January 2018 Updates

Health Insurance Portability and Accountability Act (HIPAA) Electronic Data Interchange (EDI) Front End Updates for January 2018 This link leads to a ZIP file containing several files with several documents.

To go to the full Transmittal document simply click on the screen shot.

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PARA Weekly Update: October 20, 2017

JANUARY 1, 2018 CMS UPDATES

The COMPLETE List!

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3872CP.pdf January 2018 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3878CP.pdf Quarterly Influenza Virus Vaccine Code Update - January 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3827CP.pdf Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 24.0, Effective January 1, 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3869CP.pdf Instructions for Downloading the Medicare ZIP Code File for January 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3860CP.pdf Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - January 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3861CP.pdf Fiscal Year (FY) 2018 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3885CP.pdf Clinical Laboratory Fee Schedule Not Otherwise Classified, Not Otherwise Specified, or Unlisted Service or Procedure Code Data Collection https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3881CP.pdf Payment for Services Furnished by Qualified Nonphysician Anesthetists https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3883CP.pdf Place of Service Codes https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3873CP.pdf 2018 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3870CP.pdf Accepting Hospice Notices of Election via Electronic Data Interchange https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3866CP.pdf Instructions for Retrieving the 2018 Pricing and HCPCS Data Files through CMS' Mainframe Telecommunications Systems https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3865CP.pdf Medicare Payment Rates for routine SNF-type services by swing-bed hospitals during calendar year 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R475PR1.pdf

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PARA Weekly Update: October 20, 2017

JANUARY 1,2018 CMS UPDATES

More of The COMPLETE List!

Annual Clotting Factor Furnishing Fee Update 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3862CP.pdf Updated Editing of Always Therapy Services ? MCS https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3863CP.pdf Correcting Payment of Inpatient Prospective Payment System (IPPS) Transfer Claims Assigned to Medicare Severity-Diagnosis Related Group (MS DRG) 385 and Allowing Part A Deductible on Medicare Secondary Payer (MSP) Same Day Transfer Inpatient Claims Https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1918OTN.pdf 2018 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3857CP.pdf Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3849CP.pdf Healthcare Provider Taxonomy Codes (HPTCs) October 2017 Code Set Update https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3842CP.pdf Influenza Vaccine Payment Allowances - Annual Update for 2017-2018 Season https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3837CP.pdf Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index and Hospice Pricer for FY 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3828CP.pdf Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Fiscal Year (FY) 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3826CP.pdf Implementation of the Transitional Drug Add-On Payment Adjustment https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1889OTN.pdf ICD-10 Coding Revisions to National Coverage Determinations (NCDs) https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1875OTN.pdf Common Working File (CWF) to Modify CWF Provider Queries to Only Accept National Provider Identifier (NPI) as valid Provider Number https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1877OTN.pdf New Specialty Code for Pharmacy https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R290FM.pdf Screening for Hepatitis B Virus (HBV) Infection https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R198NCD.pdf Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2018 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3796CP.pdf 2017-2018 Influenza (Flu) Resources for Health Care Professionals https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/SE17026.pdf 17

PARA Weekly Update: October 20, 2017

There were TWO new or revised Med Learn (MLN Matters) articles released this week. All new and previous Med Learn articles can be viewed under the type ?Med Learn? in the Advisor tab of the PARA Data Editor (see example below.) To go to the full Med Learn document simply click on the screen shot or the link.

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PARA Weekly Update: October 20, 2017

The link to this Med Learn: SE17032

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PARA Weekly Update: October 20, 2017

The link to this Med Learn: SE17035

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PARA Weekly Update: October 20, 2017

There were FIVE new or revised Transmittals released this week. All new and previous Transmittals can be viewed under the type Transmittals in the Advisor tab of the PARA Data Editor. To go to the full Transmittal document simply click on the screen shot or the link.

The link to this Transmittal #R3885CP

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PARA Weekly Update: October 20, 2017

The link to this Transmittal #R1935OTN

The link to this Transmittal #R1936OTN

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PARA Weekly Update: October 20, 2017

The link to this Transmittal #R751PI

The link to this Transmittal #R750PI

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PARA Weekly Update: October 20, 2017

The PDE Editor Bulletin Board Tablet lists all articles added to the Bulletin Board

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PARA Weekly Update: October 20, 2017

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