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Date
2018-05-24
Subject
MLN Connects for May 24, 2018

MLN Connects logo

Thursday, May 24, 2018

News & Announcements

Provider Compliance

Claims, Pricers & Codes

Upcoming Events

Medicare Learning Network® Publications & Multimedia

View this edition as a PDF [PDF, 298KB]  

 

 

News & Announcements

 

MIPS Promoting Interoperability Performance Category

Recently, CMS announced that we changed the name of the Merit-based Incentive Payment System (MIPS) Advancing Care Information performance category to the Promoting Interoperability performance category:

  • This is not a new performance category.
  • 2018 requirements are the same as what was finalized for the Advancing Care Information performance category. Review the fact sheet for an overview and participation requirements. We are in the process of updating the 2018 measure specifications to reflect the name change.
  • CMS also changed the name of the Electronic Health Record Incentive Programs to the Promoting Interoperability Programs.

For More Information:

 

Provider Documentation Manual on Home Use of Oxygen: Submit Comments on Draft by May 31

CMS will create a new Internet Only Manual – the Provider Documentation Manual, which will list all required documentation for Medicare payment. We welcome feedback on the first draft section: Home Oxygen Therapy:

 

Proposals for New Measures for Promoting Interoperability Program: Deadline June 29

CMS encourages you to submit a measure proposal for the Annual Call for Measures for eligible hospitals and critical access hospitals participating in the Medicare Promoting Interoperability Program. Measure proposals will be accepted until June 29 and will be considered for inclusion in rulemaking in CY 2019. To propose a measure, send your application to CMSCallforMeasuresEHR@Ketchum.com.

CMS is interested in adding measures that:

  • Build on the advanced use of certified electronic health record technology using 2015 Edition Standards and Certification Criteria
  • Increase health information exchange and interoperability
  • Continue improving program efficiency, effectiveness, and flexibility
  • Measure patient outcomes
  • Emphasize patient safety

 

Targeted Probe and Educate Video

The CMS Targeted Probe and Educate (TPE) program helps providers and suppliers reduce claim denials and appeals through one-on-one help. Check out a five-minute video that explains the TPE process in more detail, and visit the TPE webpage.

 

Hospice Compare Quarterly Refresh

The May 2018 quarterly Hospice Compare refresh of quality data is available. This refresh is based on Hospice Item Set quality measure results and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey results for the third quarter of 2016 through the second quarter of 2017. Visit the Hospice Compare website to view the data. For more information, see the Hospice Quality Public Reporting website.

 

CQM Annual Update

CMS posted the electronic Clinical Quality Measure (eCQM) annual update for:

For More Information:

 

Break Free from Osteoporosis

May is National Osteoporosis Month. The chance of having osteoporosis increases with age, but making lifestyle changes can build strong bones. Talk to your Medicare patients about their risk factors and recommend Bone Mass Measurement if appropriate.

For More Information:

Visit the Preventive Services website to learn more about Medicare-covered services.

 

Provider Compliance

 

Medicare Hospital Claims: Avoid Coding Errors — Reminder

In two recent reports, the Office of Inspector General (OIG) cited significant issues leading to coding errors on Medicare hospital claims:

Use the following resources to bill correctly and avoid overpayment recoveries:

 

Claims, Pricers & Codes

 

FY 2019 ICD-10-PCS Procedure Codes

FY 2019 ICD-10-PCS procedure code updates including a complete list of code titles are posted on the 2019 ICD-10-PCS webpage. FY 2019 ICD-10-CM diagnosis code updates will be posted in June.

 

Upcoming Events

 

Hospice Quality Reporting Program Data Submission and Reporting Webinar — May 30

Wednesday, May 30 from 2 to 3:30 pm ET

Register for this webinar.

Hospice providers: Learn about reports available through the Hospice Quality Reporting Program and how to access the information. The webinar focuses on how to navigate the Certification and Survey Provider Enhanced Reports (CASPER) system, including a live demonstration, an introduction of the Hospice Item Set and CAHPS® Provider Preview Reports, and a brief review of information available in previously released reports.

 

DMEPOS Dietary Related Items, Templates and CDEs Special Open Door Forum — May 31

Thursday, May 31 from 2 to 3 pm ET

This Special Open Door Forum allows physicians, provider and supplier professional associations, and other interested parties to provide feedback on the Durable Medical Equipment, Orthotics and Supplies (DMEPOS) Dietary Related Clinical Templates and Clinical Data Elements (CDEs). See the announcement for more information on the call and the templates.

 

Qualified Medicare Beneficiary Program Billing Requirements Call — June 6

Wednesday, June 6 from 1:30 to 3 pm ET

Register for Medicare Learning Network events.

During this call, CMS experts discuss the Qualified Medicare Beneficiary (QMB) billing requirements and their implications. Find out about the July 2018 re-launch of changes to the remittance advice and November 2017 changes to the HIPAA Eligibility Transaction System (HETS) to identify the QMB status of your patients and exemption from cost-sharing. Also, learn key steps to promote compliance.

Medicare providers may not bill people in the QMB program for Medicare deductibles, coinsurance, or copays. Visit the QMB Program webpage for more information.

Target Audience: Medicare Part A and B providers, medical billing specialists, practice administrators, IT vendors, health care industry professionals, and other interested stakeholders.

 

MIPS Promoting Interoperability Performance Category Webinar — June 12

Tuesday, June 12 from 1 to 2 pm ET

Register for this webinar.

This webinar provides information about the Promoting Interoperability performance category of the Merit-based Incentive Payment System (MIPS):

  • Brief overview of MIPS requirements in 2018
  • Renaming of Advancing Care Information to Promoting Interoperability
  • Promoting Interoperability performance category requirements for 2018
  • Scoring for the Promoting Interoperability performance category

 

Medicare Learning Network® Publications & Multimedia

 

RARC, CARC, MREP, and PC Print Update MLN Matters Article — New

A new MLN Matters Article on Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update is available. Learn about code update notifications when updates to CARC and RARC lists are available.

 

Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of CARC, RARC and CAGC Rule - Update from CAQH CORE MLN Matters Article — New

A new MLN Matters Article on Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE is available. Learn about the next version of the Code Combination List to be published on or about June 4, 2018.

 

Removal of KH Modifier from Capped Rental Items MLN Matters Article — Revised

A revised MLN Matters Article on Removal of KH Modifier from Capped Rental Items is available. Learn about this change on purchased capped rental durable medical equipment or parenteral/enteral items and services.

 

Changes to the ESRD Claim to Accommodate Dialysis Furnished to Beneficiaries with AKI MLN Matters Article — Revised

A revised MLN Matters Article on Changes to the End-Stage Renal Disease (ESRD) Facility Claim (Type of Bill 72X) to Accommodate Dialysis Furnished to Beneficiaries with Acute Kidney Injury (AKI) is available. Learn how to submit ESRD claims for items and services furnished to beneficiaries with AKI.

 

World of Medicare Web-Based Training Course — Revised

With Continuing Education Credit

A revised World of Medicare Web-Based Training course is available through the Learning Management System. Learn about:

  • Fundamentals of the program
  • Parts A, B, C, and D
  • Beneficiary health insurance options

 

Your Office in the World of Medicare Web-Based Training Course — Revised

With Continuing Education Credit

A revised Your Office in the World of Medicare Web-Based Training course is available through the Learning Management System. Learn about:

  • Impact of regulations, Medicare policies, and Federal law on office practices
  • How to locate forms and resources related to different provider types

 

Your Institution in the World of Medicare Web-Based Training Course — Revised

With Continuing Education Credit

A revised Your Institution in the World of Medicare Web-Based Training course is available through the Learning Management System. Learn about:

  • Beneficiary health insurance options
  • Eligibility and enrollment
  • How Medigap and Medicaid work with the Medicare Program

 

 


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