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2019 Transmittals

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Transmittal # Issue Date Subject Implementation Date CR # MM Article # MM Article Release Date
R2218OTN 2019-01-03 ViPS Medicare System (VMS) Prepayment Review File 2019-04-01 10461
R853PI 2019-01-04 Updates to the Appeals Prioritization Process 2019-02-05 10641
R854PI 2019-01-11 Local Coverage Determinations (LCDs) 2019-01-08 10901 MM10901 2019-01-11
R4193CP 2019-01-11 Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.1 Effective April 1, 2019 2019-04-01 11126 MM11126 2019-01-11
R4192CP 2019-01-11 Quarterly Update for the Temporary Gap Period of the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - April 2019 2019-04-01 11097 MM11097 2019-01-11
SE19002 Total Knee Arthroplasty (TKA) Removal from the Medicare Inpatient-Only (IPO) List and Application of the 2-Midnight Rule SE19002 2019-01-08
R4195CP 2019-01-11 New Waived Tests 2019-04-01 11080 MM11080 2019-01-11
R4194CP 2019-01-11 Update to Publication (Pub.) 100-04 Chapter 25 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-12 11091
R4197CP 2019-01-11 Chapter 30 Revisions in Publication (Pub.) 100-04, Medicare Claims Processing Manual 2019-04-15 10848 MM10848 2019-01-11
R2219OTN 2019-01-11 Shared System Enhancement 2018: Enhance Common Working File (CWF) Internal Testing Facility (ITF) Response Records 2019-04-01 10974
R4198CP 2019-01-11 Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) 2018-04-30 10567 MM10567 2019-01-11
R4200CP 2019-01-11 2019 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List 2019-02-12 11085 MM11085 2019-01-11
R2220OTN 2019-01-11 Direct Mailing Notification to MACs Regarding Addressing the Opioid Crisis 2019-02-15 11069
R4199CP 2019-01-11 Clinical Laboratory Fee Schedule – Medicare Travel Allowance Fees for Collection of Specimens 2019-02-12 11146 MM11146 2019-01-11
R310FM 2019-01-11 Notice of New Interest Rate for Medicare Overpayments and Underpayments -2nd Qtr Notification for FY 2019 2019-01-17 11157
R4201CP 2019-01-18 Update to Pub. 100-04 Chapter 1 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 10916
R212NCD 2019-01-18 Update to Pub. 100-03 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 11118
R4202CP 2019-01-18 Update to Pub. 100-04 Chapters 8, 20, and 24 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 10964
R4203CP 2019-01-18 Update to Pub. 100-04 Chapter 32 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 11079
R4205CP 2019-01-18 Update to Pub. 100-04 Chapter 15 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 11078
R4204CP 2019-01-17 January 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2019-01-07 11099 MM11099 2019-01-18
SE19003 Proof of Delivery Documentation Requirements SE19003 2019-01-17
R2221OTN 2019-01-18 Fiscal Intermediary Standard System (FISS) Prepayment Review Report 2019-01-01 10414
R2222OTN.zip 2019-01-18 Update to the Medicare Fee-For-Service (FFS) Companion Guides 2019-03-01 11131
R4208CP 2019-01-17 Calendar Year (CY) 2019 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment 2019-01-07 11076 MM11076 2019-01-18
R2223OTN 2019-01-18 Multi-Carrier System (MCS) Prepayment Review File 2019-04-01 10460
R4209CP 2019-01-18 Calendar Year (CY) 2019 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2019-01-07 11064 MM11064
SE19004 New Electronic System for Provider Reimbursement Review Board Appeals SE19004 2019-01-18
R2224OTN 2019-01-22 ViPS Medicare System (VMS) Prepayment Review File 2019-04-01 10461
R4210CP 2019-01-25 Update to Pub. 100-04 Chapter 10 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-26 11077
R2239OTN 2019-01-24 Targeted Probe and Educate 2017-10-01 10249
R2226OTN 2019-01-25 Synchronize the Common Working File (CWF) and Enrollment Data Base (EDB) Entitlement Data N/A 11052
R2227OTN 2019-01-25 New State Code for CA, FL, LA, MI, MS, OH, PA, TN and TX 2019-07-01 11065
R2228OTN 2019-01-25 Fiscal Intermediary Shared System (FISS) Enhancement of PC Print Billing Software N/A 11070
R2229OTN 2019-01-25 Lock the Claim Term Date on File 41 - Analysis Only 2019-09-01 11107
R2230OTN 2019-01-25 Removal of Quality Programs from the Medicare Physician Fee Schedule (MPFS) Disclosure Report 2019-07-01 11119
R4214CP 2019-01-25 Updates to Reflect Removal of Functional Reporting Requirements and Therapy Provisions of the Bipartisan Budget Act of 2018 2019-02-26 11120 MM11120 2019-01-28
R4213CP 2019-01-25 April 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files 2019-04-01 11151 MM11151 2019-01-28
R4211CP 2019-01-25 Update to Publication (Pub.) 100-04 Chapter 11 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-26 11090
R255BP 2019-01-25 Updates to Reflect Removal of Functional Reporting Requirements and Therapy Provisions of the Bipartisan Budget Act of 2018 2019-02-26 11120 MM11120 2019-01-28
R2240OTN 2019-01-25 User CR: MCS - Print Report Edit/Audit and PJ/PL/PM Set-Up PJ/PL or PL/PM Segments 2019-07-01 10659
R4219CP 2019-01-25 Update to Pub. 100-04 Chapter 34 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-26 11115
R4220CP 2019-01-25 Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process 2019-07-01 11092
R2232OTN 2019-01-25 Revising the Remittance Advice Messaging for the 20-Hour Weekly Minimum for Partial Hospitalization Program (PHP) Services 2019-07-01 11066 MM11087 2019-01-28
R2231OTN 2019-01-25 Processing Veterans Administration (VA) Inpatient Claims Exempt from Present on Admission (POA) Reporting 2019-07-01 11053 MM11053 2019-01-28
R2233OTN 2019-01-25 Shared System Enhancement 2018: Automate Health Insurance Master Record (HIMR) Lookup Within Common Working File (CWF) 2019-07-01 11095
R2235OTN 2019-01-25 Ensuring Organ Acquisition Charges Are Not Included in the Inpatient Prospective Payment System (IPPS) Payment Calculation 2019-07-01 11087 MM11087 2019-01-28
R2234OTN 2019-01-25 Utilizing Data from the USPS Secure Destruction Program to Suppress Mailing Medicare Summary Notices (MSNs) to Undeliverable Addresses 2019-04-01 11075
R2237OTN 2019-01-25 Viable Information Processing Systems (ViPS) Medicare Systems (VMS) Changes to Accommodate National Provider Identifier Associations Analysis and Development 2019-07-01 11096
R2238OTN 2019-01-25 Reduce/Eliminate Screen-Scraping for Shared Systems by Creating Transaction-based Access to Common Working File (CWF) Beneficiary Data - Analysis and Design 2019-07-01 11133
R4222CP 2019-02-01 Update to Intensive Cardiac Rehabilitation (ICR) Programs 2019-03-19 11117 MM11117 2019-02-06
R256BP 2019-02-01 Update to Intensive Cardiac Rehabilitation (ICR) Programs 2019-03-19 11117 MM11117 2019-02-06
R2241OTN 2019-01-29 Enhancing the Verification Process of Common Working File (CWF) Part A Provider Inquiries 2019-04-01 10983 MM10983 2019-01-30
R2243OTN 2019-02-01 International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) N/A 11134 MM11134 2019-02-06
R4229CP 2019-02-01 Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)—Clarification of Payment Rules and Expansion of International Classification of Diseases Tenth Edition (ICD-10) Diagnosis Codes N/A 11022 MM11022 2019-02-06
R4228CP 2019-02-01 Home Health (HH) Patient-Driven Groupings Model (PDGM) - Split Implementation N/A 11081
R4230CP 2019-02-01 Implementation of the Medicare Performance Adjustment (MPA) for the Maryland Total Cost of Care (MD TCOC) Model 2019-07-01 10971
R4227CP 2019-02-01 Independent Laboratory Billing of Laboratory Tests for End-Stage Renal Disease (ESRD) Beneficiaries and the Sunset of the CB Modifier 2019-07-02 11061 MM11061 2019-02-04
R4225CP 2019-02-01 Update to Mammography Editing 2019-07-01 11132
R2247OTN 2019-02-01 Analysis Call to Discuss Multi-Carrier System (MCS) Limitation When Quantity Allowed is Greater Than Quantity Billed 2019-07-01 11149
R2248OTN 2019-02-01 Implementation to Exchange the list of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System 2019-07-01 11003 MM11003 2019-02-04
R2249OTN 2019-02-01 Analysis on Systems to use Documentation Code References in Additional Documentation Request (ADR) Letters and to Include Non-Medical ADRs for Electronic Medical Documentation Requests (eMDRs) via the Electronic Submission of Medical Documentation (esMD) System 2019-07-01 11139
R2250OTN 2019-02-01 User CR: ViPS Medicare System (VMS) changes to the IC4301 - RAC Reopenings and Appeals Tracking Report to Display the Current Appeal Level 2019-07-01 10646
R2244OTN 2019-02-01 Multi-Carrier System (MCS) Analysis Change Request (CR) to create Application Program Interfaces (APIs) for Letter Writing 2019-07-01 11154
R2245OTN 2019-02-01 Processing Instructions to Update the Standard Paper Remit (SPR) 2019-07-01 11112 MM11112 2019-02-04
R2246OTN 2019-02-01 Expand Narrative File Message Number Range Implementation N/A 11156
R4223CP 2019-02-01 File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions 2019-04-01 11138
R2253OTN 2019-02-08 Implementation of Additional Contact with Providers in the Event of a Rejected Cost Report Filing 2019-03-12 10919
R2252OTN 2019-02-08 Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-07-01 11152 MM11152 2019-02-08
R2251OTN 2019-02-08 Utilizing the Blank Page on Odd-Numbered Medicare Summary Notices to Promote CMS Priorities 2019-07-01 11140
R4232CP 2019-02-08 Update to Publication (Pub.) 100-04 Chapter 26 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12 11129
R41COM 2019-02-08 Update to Publication (Pub.) 100-09 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12 11059
R4236CP 2019-02-08 Update to Publication (Pub.) 100-04 Chapter 3 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12 11083
R4233CP 2019-02-08 Update to Publication (Pub.) 100-04 Chapters 4 and 17 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12 11084
R2255OTN 2019-02-07 Shared System Enhancement 2018: Rewrite Fiscal Intermediary Shared System (FISS) module FSSB6001, Common Working File (CWF) Unsolicited Response Function 2019-10-07 11010
R4234CP 2019-02-08 Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2019 Update 2019-04-01 11163 MM11163 2019-02-08
R4237CP 2019-02-08 Update to the Internet-Only-Manual (IOM) Publication (Pub.) 100-04, Chapter 32, Section 12.1 2019-03-12 11127
R863PI 2019-02-12 Local Coverage Determinations (LCDs) 2019-02-11 10901 MM10901 2019-02-14
R4239CP 2019-02-15 Healthcare Provider Taxonomy Codes (HPTCs) April 2019 Code Set Update N/A 11121 MM11121 2019-02-19
R4238CP 2019-02-15 Combined Common Edits/Enhancements Modules (CCEM) Code Set Update 2019-07-01 11147
R2257OTN 2019-02-15 User CR: MCS - Health Professional Shortage Area (HPSA) No Pay Remittances Should Not Be Sent for Do Not Forward (DNF) Provider 2019-07-01 10656
R2261OTN 2019-02-13 Direct Mailing Notification to MACs Regarding Addressing the Opioid Crisis 2019-02-28 11069
R2260OTN 2019-02-15 User CR: MCS - Add MSP Confirmed Flag and Cost Avoid to History Screen, IDR, and other Files 2019-07-01 10669
R4241CP 2019-02-15 Instructions for Downloading the Medicare ZIP Code Files for July 2019 2019-07-01 11150
R2259OTN 2019-02-15 Modification of the MCS Claims Processing System Logic for Modifier 59, XE, XS, XP, and XU Involving the National Correct Coding Initiative (NCCI) Procedure to Procedure (PTP) Column One and Column Two Codes 2019-07-01 11168 MM11168 2019-02-19
R2258OTN 2019-02-15 User CR: MCS - Display Region on Select MCS Screens 2019-07-01 10657
R4242CP 2019-02-15 April Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2019-04-01 11179 MM11179 2019-02-19
R4243CP 2019-02-14 Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process 2019-04-01 10961
R213NCD 2019-02-14 National Coverage Determination (NCD) 20.4 Implantable Cardiac Defibrillators (ICDs) 2019-03-26 10865 MM10865
SE19005 What New Home Health Agencies (HHAs) Need to Know About Being Placed in a Provisional Period of Enhanced Oversight SE19005 2019-02-15
R4244CP 2019-02-15 Home Health (HH) Patient-Driven Groupings Model (PDGM) - Split Implementation N/A 11081 MM11081 2019-02-19
R2263OTN 2019-02-22 Implementation of the Award for the Jurisdiction 8 (J-8) Part A and Part B Medicare Administrative Contractor (J8 A/B MAC) N/A 11153
R4246CP 2019-02-22 Evaluation and Management (E/M) when Performed with Superficial Radiation Treatment 2019-03-25 11137 MM11137 2019-02-25
R866PI 2019-02-22 Update to Chapter 4, Section 4.11 in Publication (Pub.) 100-08 2019-03-25 11058
R867PI 2019-02-22 Update to Exhibit 16 - Model Payment Suspension Letters in Publication (Pub.) 100-08 2019-03-25 11088
R868PI 2019-02-22 Update to Chapter 4, Section 4.7 in Publication (Pub.) 100-08 2019-03-25 11136
R2262OTN 2019-02-21 Ensuring Organ Acquisition Charges Are Not Included in the Inpatient Prospective Payment System (IPPS) Payment Calculation 2019-07-01 11087 MM11087 2019-02-22
R865PI 2019-02-21 Update to Chapter 15 of Publication (Pub.) 100-08 2019-03-12 10954
R4245CP 2019-02-22 Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits 2019-04-01 11135 MM11135 2019-02-25
R2264OTN 2019-02-21 Implementation to Exchange the list of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System 2019-07-01 11003 MM11003 2019-02-22
R311FM 2019-02-22 Updating Chapter 3, Section 200, Limitation on Recoupment; Medicare Overpayments Manual, 2 of 4 CRs. 2019-10-07 10336
R2265OTN 2019-02-25 Revising the Remittance Advice Messaging for the 20-Hour Weekly Minimum for Partial Hospitalization Program (PHP) Services. 2019-07-01 11066 MM11066 2019-02-25
R257BP 2019-03-01 Update to Publication 100-02 Provide Language-Only Changes for the New Medicare Card Project 2019-04-01 11170
R4247CP 2019-03-01 Update to Publication 100-04 Chapters 2, 6, and 18 to Provide Language-Only Changes for the New Medicare Card Project 2019-04-01 11155
SE19006 Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting and Reporting Data for the Private Payor Rate-Based Payment System SE19006 2019-02-27
R2266OTN 2019-02-28 Revising the Remittance Advice Messaging for the 20-Hour Weekly Minimum for Partial Hospitalization Program (PHP) Services 2019-07-01 11066 MM11066 2019-03-01
R186SOMA 2019-03-04 Revisions to State Operations Manual (SOM) Appendix Z, Emergency Preparedness for All Provider and Certified Supplier Types 2019-03-04 N/A
R187SOMA 2019-03-06 Revision to the State Operations Manual (SOM 100-07) Appendix Q 2019-03-06 N/A
R2267OTN 2019-03-06 New State Code for CA, FL, LA, MI, MS, OH, PA, TN and TX N/A 11065
R214NCD 2019-03-06 National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) 2019-04-08 10878 MM10878 2019-03-06
R4250CP 2019-03-08 Update to Chapter 30 in Publication (Pub.) 100-04 to Provide Language-Only Changes for the New Medicare Card Project 2019-04-08 11165
R2268OTN 2019-03-08 Instructions Relating to the Self-Disallowance Requirement for Determining Jurisdiction over Appeals 2019-04-08 10912
R2269OTN 2019-03-07 User CR: MCS - Health Professional Shortage Area (HPSA) No Pay Remittances Should Not Be Sent for Do Not Forward (DNF) Provider 2019-03-07 10656
R5pr242 2019-03-08 Medicare Provider Reimbursement Manual Part 2, Provider Cost Reporting Forms and Instructions, Chapter 42, Form CMS-265-11 2019-03-08 N/A
R4254CP 2019-03-13 Ensuring Only the Active Billing Hospice Can Submit a Revocation 2019-07-01 11049 MM11049 2018-12-28
R2270OTN 2019-03-13 Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-10-01 11152
R4257CP 2019-03-14 Implementation of the Medicare Performance Adjustment (MPA) for the Maryland Total Cost of Care (MD TCOC) Model 2019-07-01 10971
R4256CP 2019-03-15 April 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.1 2019-04-01 11192 MM11192 2019-03-15
R4255CP 2019-03-15 April 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2019-04-01 11216 MM11216 2019-03-19
R4253CP 2019-03-15 Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update 2019-07-01 11204 MM11204 2019-03-15
R4258CP 2019-03-18 Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2019 Update 2019-04-01 11163 MM11163
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