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MLN Connects Provider eNews for August 13, 2015
Medicare Learning Network, MLN Connects Weekly eNews logo

Thursday, August 13, 2015


Editor's Note:

Your responses to our eNews feedback tool help us improve our service. Each week, we offer an online version of the eNews, as well as a PDF version, located below the table of contents on the web page. If you are having trouble viewing the eNews, please let us know through our updated feedback tool. If you have a question about Medicare, please contact your Medicare Administrative Contractor.


Countdown to ICD-10


MLN Connects® National Provider Calls and Events




Medicare Learning Network® Educational Products

View this edition as a PDF [PDF, 92KB]


Countdown to ICD-10


MLN Connects National Provider Call: Countdown to ICD-10

Thursday, August 27; 2:30-4pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

Don’t miss the August 27 MLN Connects National Provider Call — five weeks before ICD-10 implementation on October 1, 2015. CMS Acting Administrator Andy Slavitt will open the call with a national implementation update. Then, Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) will join us with coding guidance and tips, along with updates from CMS.


  • National implementation update, CMS Acting Administrator Andy Slavitt
  • Coding guidance, AHA and AHIMA
  • How to get answers to coding questions
  • Claims that span the implementation date
  • Results from acknowledgement and end-to-end testing weeks
  • Provider resources

Target Audience: Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, skilled nursing facilities, home health agencies, and all Medicare providers.

Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.


Finding ICD-10 Information Online Just Got Easier

Check out the redesigned Medicare Fee-For-Service (FFS) Provider ICD-10 Resources page to learn 5 things you can do to get ready for ICD-10 and to browse Medicare Learning Network educational materials on these topics:

  • Claims processing and billing guidance
  • Coding
  • Unspecified ICD-10-CM codes
  • General Equivalence Mappings (GEMs)
  • Home health provider information
  • National Coverage Determinations (NCDs)
  • Local Coverage Determinations (LCDs)
  • Testing and results
  • Features and benefits


5 Ways to Check Your Claim Status

After the implementation of ICD-10, you can continue to check your claim status by:

  • Interactive Voice Response (IVR): IVR gives providers access to Medicare claims information through a toll-free telephone number. Visit your Medicare Administrative Contractor (MAC) website for information on the Provider Contact Center and IVR user guide.
  • Customer Service Representative (CSR): Visit your MAC website for information on the Provider Contact Center only if you are unable to access claims information via IVR.
  • MAC portal: Visit your MAC website for portal features and access.
  • Direct Data Entry (DDE): Providers that bill institutional claims are also permitted to submit claims electronically via DDE screens. Visit your MAC website for more information.
  • ASC X12: The ASC X12 Health Care Claim Status Request and Response (276/277) is a pair of electronic transactions you can use to request the status of claims (via the 276) and receive a response (via the 277). Visit your MAC website for more information.


Home Health Episodes that Span October 1, 2015

Since Home Health (HH) claims are submitted for a 60-day payment episode, there may be cases where an episode spans October 1. In these cases, the Requests for Anticipated Payment (RAPs) for an episode will be submitted using ICD-9 codes and the corresponding claim (which spans the October 1, 2015 implementation date) will be submitted using ICD-10 codes. This FAQ and MLN Matters article contain more information about coding HH episodes that span the ICD-10 implementation date.


New CMS Infographic: Get the Facts About ICD-10

The ICD-10 transition is less than 50 days away. Get ready now. CMS has released a new infographic with facts about ICD-10 coding, reimbursement, testing, and resources. Visit the CMS ICD-10 website and for the latest news and resources to help you prepare.  


MLN Connects® National Provider Calls and Events


National Partnership to Improve Dementia Care and QAPI Call — Register Now

Thursday, September 3; 1:30-3pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

During this MLN Connects National Provider Call, two nursing homes will share how they successfully implemented person-centered care approaches and overcame the barriers of cost and staff. Additionally, CMS subject matter experts will update you on the progress of the National Partnership and Quality Assurance and Performance Improvement (QAPI). A question and answer session will follow the presentations.

The National Partnership to Improve Dementia Care in Nursing Homes and QAPI are partnering on MLN Connects Calls to broaden discussions related to quality of life, quality of care, and safety issues. The National Partnership was developed to improve dementia care in nursing homes through the use of individualized, comprehensive care approaches to reduce the use of unnecessary antipsychotic medications. QAPI standards expand the level and scope of quality activities to ensure that facilities continuously identify and correct quality deficiencies and sustain performance improvement.

Discussion Topics:

  • Person-Centered Care Implementation Success - Hillcrest Health Services and Washington Rehabilitation & Nursing
  • QAPI
  • National Partnership

Target Audience: Consumer and advocacy groups, nursing home providers, surveyor community, prescribers, professional associations, and other interested stakeholders.

Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.


New MLN Connects National Provider Event Audio Recording and Transcript

The audio recording and transcript are now available for the July 29 call — ESRD QIP: Proposed Rule for Payment Year 2019. More information is available on the call detail web page. This call focused on the upcoming End-Stage Renal Disease (ESRD) Prospective Payment System proposed rule, which would operationalize the ESRD Quality Incentive Program (QIP) in PY 2019.




DMEPOS Competitive Bidding: Timeline for Round 1 2017

CMS has announced the bidding timeline for the Round 1 2017 competition of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. CMS has also launched a comprehensive bidder education program. Visit the Competitive Bidding Implementation Contractor (CBIC) Round I 2017 web page to view the timeline and helpful bidding resources, and to sign up for important announcements.

For More Information:


 Medicare Learning Network® Educational Products


Upgraded Learning Management and Product Ordering System — Now Live

The upgraded Medicare Learning Network Learning Management and Product Ordering System (LM/POS) is now live. Please see the LM/POS Announcement for the latest information about the upgrade.

The LM/POS is used to house and track Medicare Learning Network educational activities, post-assessments and certificates. It also provides access to downloadable Medicare Learning Network products and allows you to order products that are available in hardcopy.


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