CMS Updates Hospice Claims Processing Instructions

The Centers for Medicare & Medicaid Services (CMS) has upted Chapter 11 of the Medicare Claims Processing Manual (Pub 100-04), with the new Transmittal 10173/Change Request (CR) 11807. This CR makes updates to the manual language regarding submitting Notice of Termination/Revocation (NOTR), Processing Professional Claims for Hospice Beneficiaries, and section 30.3 about the Data Required on the…

CMS Issues New G-Codes and Other Claims Processing Instructions

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request (CR) 11721, two new G-codes to indicate on home health (HH) claims when maintenance therapy is provided by a therapy assistant. The CR also provides various clarifying changes to the Medicare Claims Processing Manual, chapter 10, in order to better reflect the policies…

Changes to Requirements for Billing Physician Home Visits

The Centers for Medicare & Medicaid Services (CMS) recently released Transmittal 439/Change Request (CR) 11273, Documentation of Medical Necessity of the Home Visit; and Physician Management Associated with Superficial Radiation Treatment. The new transmittal updates the Medicare Claims Processing Manual, Pub. 100-04, Chapter 12, Section 30.6.14.1 – Home Services to reflect the elimination of the…

CMS Releases Additional Instructions for Claims under PDGM

The Centers for Medicare & Medicaid Services (CMS) has released a second set of revisions to Chapter 10 of the Medicare Claims Processing Manual providing instructions to home health agencies for claims submission under PDGM. CMS Transmittal 4294/Change Request (CR) 11272, Home Health (HH) Patient-Driven Groupings Model (PDGM) – Additional Manual Instructions, provides some clarity…

CMS Updates Hospice Chapter of Medicare Claims Processing Manual

The Centers for Medicare & Medicaid Services (CMS) released Transmittal 4280/Change Request (CR) 11205, Update to Pub. 100-04, Chapter 11.    This CR updates the Hospice chapter of the Medicare Claims Processing Manual to reflect: Language regarding billing for physician assistants as attending physicians Clarification of hospice election periods and benefit periods (same meaning for claims…

CMS Updates Instructions for Claim Appeals

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 11042, which updates the Medicare Claims Processing Manual, Chapter 29- Appeals of Claim Decisions. The updates includes several policy revisions related to acceptable signatures, limiting the scope of redetermination review in certain instances, application of good cause for late filing,  as well as…