Updates from the Medicare Learning Network
§ “Sole Community Hospital” Fact Sheet (ICN 006399) Revised § “Medicare Dependent Hospital” Fact Sheet (ICN 901683) Revised § “Mass Immunizers and Roster Billing Fact Sheet Available - New § “Hospital-Acquired Conditions (HAC) in Acute Inpatient Prospective Payment System (IPPA) Hospitals” Fact Sheet Available § “Present on Admission (POA) Indicator Reporting by Acute Inpatient Prospective Payment System (IPPS) Hospitals” Fact Sheet Available § “Medicare Shared Savings Program: Notice of Proposed Rulemaking Fact Sheets” Booklet (ICN 907663) Available - New § “How to Use the Searchable Medicare Physician Fee Schedule” Booklet (ICN 901344) Available - New § “Additional HIPAA 837 5010 Transitional Changes and Further Modifications to COBA National Crossover Process” MLN Matters(r) Article Released >From the MLN: “Sole Community Hospital” Fact Sheet (ICN 006399) Revised The revised “Sole Community Hospital<http://www.cms.gov/MLNProducts/downloads/SoleCommHospfctsht508-09.pdf>” fact sheet (ICN 006399) includes the following information: Sole Community Hospital (SCH) classification criteria, SCH payments, and hospital reclassifications. >From the MLN: “Medicare Dependent Hospital” Fact Sheet (ICN 901683) Revised >[↑] The revised “Medicare Dependent Hospital<http://www.cms.gov/MLNProducts/downloads/MedDependHospfctsht508.pdf>” fact sheet (ICN 901683) includes the following information: Medicare Dependent Hospital (MDH) classification criteria and MDH payments. >From the MLN: “Mass Immunizers and Roster Billing Fact Sheet Available - New >[↑] The new “Mass Immunizers and Roster Billing<http://www.cms.gov/MLNProducts/downloads/Mass_Immunize_Roster_Bill_factsheet_ICN907275.pdf>” fact sheet (ICN 907275) is designed to provide education on mass immunizers and roster billing. It includes information on simplified billing procedures for the influenza and pneumococcal vaccinations. >From the MLN: “Hospital-Acquired Conditions (HAC) in Acute Inpatient >Prospective Payment System (IPPA) Hospitals” Fact Sheet Revised [↑] The revised “Hospital-Acquired Conditions (HAC) in Acute Inpatient Prospective Payment System (IPPA) Hospitals” fact sheet (ICN 901045) is designed to provide education on the Deficit Reduction Act of 2005 which requires a quality adjustment in Medicare Severity Diagnosis Related Group payment for certain Hospital Acquired Conditions (HAC). This Fact Sheet lists all 10 categories of HAC to help providers learn more about the HAC program. This fact sheet also provides an overview of DRA and types of affected and exempted hospitals and provides a table of HACs and codes. >From the MLN: “Present on Admission (POA) Indicator Reporting by Acute >Inpatient Prospective Payment System (IPPS) Hospitals” Fact Sheet Available [↑] The “Present on Admission (POA) Indicator Reporting by Acute Inpatient Prospective Payment System (IPPS) Hospitals” fact sheet (ICN 901046) is designed to provide clarity for providers on how to apply the Present on Admission(POA) indicator to the final set of diagnosis codes that have been assigned in accordance with sections I, II, and III of the official coding guidelines. Subsequent to the assignment of the ICD-9-CM codes, the POA indicator should then be assigned to those conditions that have been added. >From the MLN: “Medicare Shared Savings Program: Notice of Proposed >Rulemaking Fact Sheets” Booklet (ICN 907663) Available - New [↑] The new “Medicare Shared Savings Program: Notice of Proposed Rulemaking Fact Sheets<http://www.cms.gov/MLNProducts/downloads/MSSP_NPRM_Factsheets_ICN907663.pdf>” booklet (ICN 907663) is designed to provide education on the Medicare Shared Savings Program (MSSP) as proposed in the Notice of Proposed Rulemaking. It includes the following previously published fact sheets: Summary of Proposed Rule Provisions for Accountable Care Organizations Under the Medicare Shared Savings Program; What Providers Need to Know: Accountable Care Organizations; Improving Quality Of Care for Medicare Patients: Accountable Care Organizations; Medicare Shared Savings Program and Rural Providers; and Federal Agencies Address Legal Issues Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program. >From the MLN: “How to Use the Searchable Medicare Physician Fee Schedule” >Booklet (ICN 901344) Available - New [↑] The new “How to Use the Searchable Medicare Physician Fee Schedule<http://www.cms.gov/MLNProducts/downloads/How_to_MPFS_Booklet_ICN901344.pdf>” booklet (ICN 901344) is designed to provide education on how to use the Medicare Physician Fee Schedule (MPFS). It includes steps to search for payment information, pricing, Relative Value Units (RVUs), and payment policies. If you like this booklet, check out How to Use the Medicare Coverage Database<https://www.cms.gov/MLNProducts/downloads/MedicareCvrgeDatabase_ICN901346.pdf> and How to Use the National Correct Coding Initiative (NCCI) Tools<https://www.cms.gov/MLNProducts/downloads/How-To-Use-NCCI-Tools.pdf> from the Medicare Learning Network(r). >From the MLN: “Additional HIPAA 837 5010 Transitional Changes and Further >Modifications to COBA National Crossover Process” MLN Matters(r) Article >Released [↑] The new, “Additional Health Insurance Portability and Accountability Act (HIPAA) 837 5010 Transitional Changes and Further Modifications to the Coordination of Benefits Agreement (COBA) National Crossover Process<http://www.cms.gov/MLNMattersArticles/Downloads/SE1137.pdf>” MLN Matters(r) Special Edition Article (#SE1137) is designed to provide education on the HIPAA 5010 COBA National Crossover Process for supplemental payers. It includes important information and examples to assist providers with the transition. ------------------------------------------------- Each Office Visit is an Opportunity. Medicare patients give many reasons for not getting their annual flu vaccination, but the fact is that flu seasons are unpredictable and can be severe. Each year, it is estimated that 90 percent of seasonal flu-related deaths and more than 60 percent of seasonal flu-related hospitalizations occur in people 65 years and older. Please talk with your Medicare patients about the importance of getting their annual flu vaccination. And remember, vaccination is important for healthcare workers too, who may spread the flu to high risk patients. Don’t forget to immunize yourself and your staff. Protect your patients. Protect your family. Protect yourself. Get the Flu Vaccine-Not the Flu. Remember - The flu vaccine plus its administration are covered Part B benefits. CMS has posted the 2011-2012 seasonal flu vaccine payment limits at http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp. Note that the flu vaccine is NOT a Part D-covered drug. For more information on coverage and billing of the flu vaccine and its administration, as well as related educational provider resources, visit http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and http://www.cms.gov/immunizations. ------------------------------------------------------ Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. 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