CMS Regulatory News: MM10098, MM10145, MM10198

MM10098 – Common Working File (CWF) to Modify CWF Provider Queries to Only Accept National Provider Identifier (NPI) as Valid Provider Number

This article is based on Change Request (CR) 10098, which informs the MACs about modifications to the CWF Provider Queries, ELGA, ELGH, HIQA, HIQH, and HUQA, to only accept the National Provider Identifier (NPI) as a valid Provider Number. Make sure that your billing staffs are aware of these changes. Download or view a copy of this article.

NEW: MM10145 – Correcting Payment of Inpatient Prospective Payment System (IPPS) Transfer Claims Assigned to Medicare Severity-Diagnosis Related Group (MS DRG) 385

This article, based on Change Request (CR) 10145, informs the MACs about a correction to Medicare’s Fiscal Intermediary Shared System (FISS) assignment of review code for Inpatient Prospective Payment System (IPPS) transfer claims assigned Medicare Severity Diagnosis Related Group (MS-DRG) 385, so that the IPPS Pricer will calculate the per diem transfer payment. Another correction allows Part A deductible, identified by a value code, on MSP same day transfer claims. Please be sure your billing staffs are aware of these corrections. Download or view a copy of this article.

MM10198 – New Waived Tests

Change Request (CR) 10198 informs MACs of new Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived tests approved by the Food and Drug Administration (FDA). Since these tests are marketed immediately following approval, the Centers for Medicare & Medicaid Services (CMS) must notify the MACs of the new tests so that they can accurately process claims. CR10198 lists 17 newly added waived complexity tests. Download or view a copy of this article.

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