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Centers for Medicare & Medicaid Services Issues New Resources on ESRD Conditions for Coverage Reference: CMS List-Serv Message 100208 Thank you to all of our colleagues in the renal care community who submitted questions to the Centers for Medicare & Medicaid Services (CMS) about our recently released ESRD Conditions for Coverage final rule. In response to these inquiries, we have already provided many of you with individual responses to your questions; however, to share the benefit of these questions with the entire community, CMS has developed a "Frequently Asked Questions" document that condenses many of the questions we received from you. The FAQs are available online at http://www.cms.hhs.gov/center/esrd.asp on the CMS website. To view them, click on the second Spotlight. As another tool to help you understand the new Conditions for Coverage, CMS has developed a crosswalk that compares the former conditions to the final revised conditions, which were issued in the Federal Register on April 15, 2008. The crosswalk will help you navigate the new organization structure of the condition as well as some revised provisions of the conditions themselves. The crosswalk is available online at http://www.cms.hhs.gov/center/esrd.asp on the CMS website. To view the Crosswalk, click on the third Spotlight. Published Online: Friday, October 10, 2008

CMS Conference on DMEPOS Quality Standards Reference: CMS List-Serv Message 100608 On October 14, the Centers for Medicare & Medicaid Services will conduct an on-site conference that will provide guidance to the DMEPOS suppliers on how to comply with the DMEPOS quality standards. The goal of this conference is to provide non-accredited DMEPOS suppliers with technical guidance on the new DMEPOS quality standards. Published Online: Friday, October 10, 2008

Medicare Hosts National Conference to Promote Electronic Prescribing Reference: CMS List-Serv Message 100708 Widespread Use of E-prescribing Would Eliminate Thousands of Annual Medication Errors Boston, MA – October 7, 2008 – More than 1,400 health care professionals and industry leaders convened in Boston today at the National E-prescribing Conference hosted by the Centers for Medicare & Medicaid Services (CMS) and 34 co-sponsoring organizations. Featuring U.S. Department of Health and Human Services Secretary (HHS) Mike Leavitt, CMS Acting Administrator Kerry Weems, Senator John Kerry (D-MA), Former House Speaker Newt Gingrich, Massachusetts Governor Deval Patrick, Rhode Island Governor Donald Carcieri, and Health Evolution Partners Chairman David Brailer, M.D., Ph.D., the conference addressed the potential of electronic prescribing (e-prescribing) to improve health care in the United States. Topics of discussion included a newly enacted federal e-prescribing incentive payment program; strategies and tools for integrating e-prescribing with current health care delivery practices; and privacy, security, and risk management implications. Published Online: Friday, October 10, 2008

Medical Review Documentation Request System Error Led To the Delay of Records Being Received By the MR Department Reference: AR – HDM100908 Documentation requested by Medical Review (MR) and received via mail for services in Rhode Island, encountered a system error which led to the delay of these records being received by the MR department. When the time allotted for receipt of these records expired, they were denied as "no response to request for records" and an EOB to that effect was sent to these providers. These records are now appearing in MR. If your records were already denied as "no response to request for records" and MR does have those records, a letter will be sent to you within the next two weeks explaining that MR will reopen those claims and review the records. If you receive a letter, please do not submit these claims for appeal until you receive a new EOB message for that beneficiary and date of service. If you are not notified by letter that MR is reopening your claim(s), denied for "no response to request for records," please wait until after 10/23/08 before requesting a reopening. If your 120 day appeal rights expire on claims denied for "no response to request for records" during 10/9/08 – 10/23/08, MR will extend this 120 day limit to 11/30/08. We apologize for problems caused by this error. Published Online: Friday, October 10, 2008

Part A Local Coverage Determination Updates The following Part A LCDs were retired effective September 30, 2008: Anoscopy/ Proctoscopy/Sigmoidoscopy (Diagnostic, Therapeutic, Screening) Fecal Occult Blood, Atriobiventricular Pacemakers, Electrophysiologic Studies, Intracardiac, Endovascular Repair of Descending Thoracic Aneurysm, Insertable Loop Recorder, Monitored Anesthesia Care, Percutaneous Renal Artery Angioplasty With or Without Stenting, Percutaneous Transluminal Angioplasty With or Without Stenting For Abdominal Aortic Stenosis Or Chronic Total Occlusion And Lower Extremity Claudication, and Routine Foot Care, ARA-02-043. Published Online: Thursday, October 09, 2008

Part B Local Coverage Determination Updates The following policies have been retired effective for services performed starting October 1, 2008: Ablation of Hepatic Tumors, Allergy Patch Test(s), Anoscopy/Proctoscopy/Sigmoidoscopy (Diagnostic, Therapeutic, and Screening)/Fecal Occult Blood, Atriobiventricular Pacemakers, Biofeedback Therapy, Bladder Scan, Deep Brain Stimulation, Electrophysiologic Studies, Intracardiac, Endovascular Repair for Descending Thoracic Aneurysm, FEESS/FEESST, Indocyanine Green Angiography, Insertable Loop Recorder (ILR), Intracoronary Brachytherapy, Monitored Anesthesia Care (MAC), Motion Analysis Studies, Oprelvekin (Neumega), Pachymetry, Percutaneous Renal Artery Angioplasty with or w/o Stenting, Percutaneous Transluminal Angioplasty with or Without Stenting for Abdominal Aortic Stenosis or Chronic Total Occlusion and Lower Extremity Claudication, Recombinant Human Thyrotropin for Radionucleotide Scanning, Routine Foot Care, Sacral Nerve Stimulation, and Vitamin B-12. Published Online: Thursday, October 09, 2008

Part B Local Coverage Determination Updates The following Part B LCD has been revised: EPO/Darbepoetin Alfa for Treatment Of Anemia Associated With Chronic Renal Failure, AC-05-007. Published Online: Thursday, October 09, 2008

Upcoming Claim Submission Error Webinar Do Medicare Part A denials confuse you? Would you like us to help you through the process? Attend our free 2 hour webinar session to learn how to stay on track when it comes to processing your Medicare claims.  During this session you will gain a better understanding on how to eliminate the Top 10 Claim Submission Errors. We will also be reviewing the top Comprehensive Error Rate Testing (CERT) program errors and how to avoid them. Detailed descriptions and recommendations will be addressed. We will cover our most common denials; medical necessity, bundling, and duplicates. We will also review current hot topics and helpful hints for monitoring your claims. This course should be attended by compliance officers, billing staff, and other facility staff who oversee or file Medicare Part A claims. Published Online: Wednesday, October 08, 2008

Reminder - The ICD-10-CM/PCS National Provider Conference Call for Hospital Staff will be conducted on October 14, 2008 from 12:30 p.m. – 2:30 p.m. EDT. Reference: CMS List-Serv Message 100808 The Centers for Medicare & Medicaid Services (CMS) will host a series of national provider calls that will provide an overview of ICD-10 and how it differs from ICD-9-CM. The presentations will include the major impacts providers should consider when planning to update any systems with ICD-10 codes. Issues such as differences in code length, alpha-numeric characters, and increased details captured by the codes will be explained. For the provider, payer, vendor, and publishing community, this overview will help them think about future reporting, system updates, and training, considering that ICD-10 may be implemented in the future. The presenters will include members of the Cooperating Parties for ICD-9-CM, a formal coalition that has been working together on ICD-10 issues. The role of each will be explained, along with a similar role they will play should ICD-10 be implemented. The Cooperating Parties include CMS, Centers for Disease Control and Prevention (CDC), American Health Information Management Association (AHIMA), and American Hospital Association (AHA). Published Online: Wednesday, October 08, 2008

Fiscal Year (FY) 2009 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, and Inpatient Psychiatric Facility (IPF) PPS Changes Reference: Trans. 1610, CR #6189, Pub. 100-04, MLN: MM6189 This article is based on Change Request (CR) 6189 which outlines changes for IPPS hospitals for FY 2009. The policy changes for FY 2009 appeared in the Federal Register on August 19, 2008, and the final IPPS rates will be available on the Centers for Medicare & Medicaid Services (CMS) website prior to October 1, 2008. CR 6189 also addresses changes to Medicare Severity Diagnosis Related Groups (MS-DRGs) and ICD-9-CM coding that affects LTCH PPS, and IPF PPS. The LTCH PPS rate changes occurred on July 1, 2008. Published Online: Wednesday, October 08, 2008

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