Coding Changes Effect Billing Practices October 1, 2005
Be sure and review all current coding changes which effect billing guidleines and protocols October 1, 2005. ICD-9 Coding changes go to the boxes marked "effective Oct. 1, 2005" to find the new codes and the new invalid codes. http://www.cms.hhs.gov/medlearn/icd9code.asp

Some new changes to diagnosis codes relevant to oncology effective October 1, 2005 are:

V58.1 no longer valid

effective October 1, 2005 new codes:
V58.11* Encounter for antineoplastic chemotherapy
V58.12* Encounter for immunotherapy for neoplastic condition

276.5 is no longer valid

585 is no longer valid ........staging of kidney disease with the deletion of 585

effective October 1, 2005 new codes:
585.1 Chronic kidney disease, Stage I
585.2 Chronic kidney disease, Stage II (mild)
585.3 Chronic kidney disease, Stage III (moderate)
585.4 Chronic kidney disease, Stage IV (severe)
585.5 Chronic kidney disease, Stage V
585.6 End stage renal disease

Announcements

• In November 2005, the 2006 Medicare Participation Enrollment Agreement and Fee Schedule information will be sent in CD format. No internet access is required to access the CD information.

What's New (visit http://www.medicarenhic.com/whats_new/whats_new.shtml)

• CMS has posted a comprehensive article on the National Provider Identifier (NPI) . (SE 0555).
• Beginning January 1, 2006, Medicare prescription drug coverage will be available to people with Medicare. Health care professionals can find information about this new coverage at www.cms.hhs.gov/medlearn/drugcoverage.asp , on the CMS website. (JSM 05541)
• Public Service Announcements for Health Care Professionals : What Do You Say When Asked About the New Medicare Prescription Drug Coverage?  (JSM 05541).
• A national modifier and condition code will be used to identify disaster related claims (CR 4106).

CA Updates (visit http://www.medicarenhic.com/cal_prov/updates.shtml)

• We now are offering Education Online. Visit our new page, and take our online courses on the CMS-1500 Form and Preventive Services.
• The October allowance limits for Medicare Part B Drugs has been posted. The files for April and July have been revised .
• The October update for DMEPOS Fee Schedule has been posted.
• Questions and Answers from the Advance Beneficiary Notice and Open Forum ACTs have been posted.
• Registration is being accepted for the October 12 Webinar: Influenza and Pneumococcal Pneumonia Immunization .

MM3627 - Requirements for Voided, Canceled, and Deleted Claims
http://www.cms.hhs.gov/medlearn/matters/mmarticles/2005/MM3627.pdf 

SE0555 - Medicare’s Implementation of the National Provider Identifier (NPI): The Second in the Series of Special Edition Medlearn Matters Articles on NPI-Related Activities  Revised: 9/28/2005 http://www.cms.hhs.gov/medlearn/matters/mmarticles/2005/SE0555.pdf 

MM4044 - Redesigned Skilled Nursing Facility (SNF) Consolidated Billing (CB) Annual Update File and Discontinuation of the SNF Healthcare Common Procedure Coding System (HCPCS) Help File http://www.cms.hhs.gov/medlearn/matters/mmarticles/2005/MM4044.pdf



CMS Ends HIPAA Contingency Plan; Noncompliant Electronic Claims Will Be Rejected Effective Oct. 1
The Centers for Medicare & Medicaid Services (CMS) have announced that effective October 1, Medicare carriers will reject electronic claims that don’t meet the HIPAA transaction and code sets standards.

Although HIPAA transaction and code sets regulations took effect on October 16, 2003, CMS implemented a “contingency plan” that allowed more time for physicians and other health care providers to make the transition to HIPAA-compliant billing systems.

The decision to end the contingency plan was made because most physicians are now submitting compliant claims. In June 2005, 96 percent of physicians were in compliance, compared to only 80-85 percent in 2004.

MOASC Comments of the 2006 Fee Schedule
MOASC continues to work for for it's members by submitting comments to CMS regarding issues that will effect the oncology community. Read the MOASC 2006 Physician Fee Schedule Comments here>>



MOASC Comments on Drug CAP Program
Although the CAP program has been stalled, MOASC submitted it's comments to CMS for official recognition of our position on the matter.
Read the MOASC CAP Comments here >>



HR 261
MOASC supports the efforts of collegial associations such as ASCO and COA in supporting Representative Ralph Hall (R-TX) and other Congresssional supporters to advance House Resolution 261, which urges CMS to continue the oncology demonstration project in 2006. We will continue to provide updates on timing and legislative action.

Contact the MOASC office for further details or ASCO's Cancer Policy & Clinical Affairs Department at 703-299-1050, or email publicpolicy@asco.org with any questions.



The Governor has acted on two of interest to  MOASC
The Governor signed AB 929 Assemblymember Jenny Oropeza on radiologic technology and exposure.  He also signed SB 650 by Senator Oritz on the Improving Access, Counseling, and Treatment for Californians with Prostate Cancer (IMPACT) Program. 

SB 650 allocates $2.4 million to treat low-income, uninsured men suffering from prostate cancer. Approximately 366 patients will receive critical treatment under this program. In addition, the legislation requires 87 percent of the funding be spent on direct patient care.  The Governor included a signing message, which I have attached.

If you have any questions, please do not hesitate to contact Kris Rosa at Noteware Government Relations, MOASC's state lobbist, Kris@frednoteware.com, she'll be happy to discuss with you.