03/20/2018

CMS-Medicare

Recent Oncology Related Articles

Quarterly HCPCS Drug/Biological Code Changes MLN Matters Article — Revised

A revised MLN Matters Article on Quarterly Healthcare Common Procedure Coding System (HCPCS)
Drug/Biological Code Changes - April 2018 Update is available. Learn about updates of biosimilar biological product HCPCS codes, modifiers, and autologous cellular immunotherapy treatment.

Medicare Pharmaceutical and Technology Ombudsman

James Bailey is serving as the Medicare Pharmaceutical and Technology Ombudsman. He will receive and review questions and concerns from pharmaceutical, biotechnology, medical device, diagnostic product manufacturers, and other stakeholders regarding Medicare coverage, coding, and payment. Visit the Medicare Pharmaceutical and Technology Ombudsman webpage for more information.

New Medicare Card Transition Begins In Less Than a Month

CMS will begin mailing new Medicare cards with the Medicare Beneficiary Identifier (MBI) on April 1. Start using the MBI as soon as your patients get their new cards. The MBI on the new card is effective immediately unless the patient is new to Medicare, in which case refer to the “coverage starts” date on the card. People new to Medicare will only have a Medicare card with an MBI.

How can I get the MBI?

• From your patient’s new Medicare card: From April 2018 through December 31, 2019, if you submit a HICN on the 270 eligibility transaction request, we will tell you in the message field of the 271 response when we mailed a new Medicare card to each individual with Fee-For-Service Medicare. (Mailing schedule)
• From your Medicare Administrative Contractor’s (MAC) portal if your patient can’t provide the card: Starting in June 2018, use the look-up tool on your MAC’s portal. If you don’t have access, sign up.
• From the Remittance Advice (RA): From October 2018 through December 31, 2019, we will include the MBI on the RA if you submit a HICN on the claim. (Examples)

People with Medicare enrolled in Medicare Advantage and/or Part D plans will continue to use the cards from those plans when they get health care and/or prescriptions.

Questions? Attend the next Open Door Forum devoted to answering provider questions. . Details will be provided in a future MLN Connects.

For More Information:

• Fact Sheet
• Overview webpage
• Provider webpage

New Medicare Card Project Special Open Door Forum — March 20 

Tuesday, March 20 from 2 to 3 pm ET - TRANSCRIPT AVAILABLE - See Below...

CMS will host a Special Open Door Forum to give providers an opportunity to ask questions about the New Medicare Card Project. Use this call to get answers to your questions, so you are ready to accept the new Medicare Beneficiary Identifier starting April 1, 2018.

For more information, visit the New Medicare Card website. Send feedback and questions to
NewMedicareCardSSNRemoval@cms.hhs.gov.

A transcript and audio recording will be posted to the Podcasts and Transcripts webpage.

April 2018 Update of the Hospital OPPS MLN Matters Article — New

A new MLN Matters Article on April 2018 Update of the Hospital Outpatient Prospective Payment System (OPPS) is available. Learn about changes to the OPPS.

Provider Compliance Tips for Laboratory Tests: Other Fact Sheet – Revised

A revised Provider Compliance Tips for Laboratory Tests – Other (Non-Medicare Fee Schedule) Fact Sheet is available. Learn about:

• Reasons for denial
• How to prevent claim denials
• Acceptable forms for submitting orders

Provider Compliance Tips for Ordering Hospital Outpatient Services Fact Sheet — Revised

A revised Provider Compliance Tips for Ordering Hospital Outpatient Services Fact Sheet is available.
Learn about:

• Reasons for claim denials
• How to prevent claim denials
• Required documentation

Recent LearnResource & MedLearn Matters Articles

• Billing Requirements for OPPS Providers with Multiple Service Locations (SE 18002)
• Internet Only Manual Updates to Pub. 100-01, 100-02 and 100-04 to Correct Errors and Omissions (SNF) (2018) (MM 10512)
• Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - April 2018 Update (Revised MM 10454)