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Medicare Learning Network Matters Articles

MLN (Medicare Learning Network) Matters Articles are a series of national articles designed to inform the physician, provider and supplier community about the latest changes to the Medicare Program. Please use the links below to review the articles released by CMS (Centers for Medicare & Medicaid Services) in 2019. The following MLN Matters articles issued in 2019 are relevant to our regions only. Visit the CMS MLN Matters page for a complete listing of all MLNs issued nationwide.

Listed here are the following archived MLN Matters articles for 2018, 2017, 2016, 2015, 2014, 2013, 2012, 2011, 2010, 20092008

All MLN links below will open in new browser windows.

A/B

Date

Subject

MM#

Part A

1/23/2019

January 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) (Revised)

MM11099

Part APart B

1/23/2019

Calendar Year (CY) 2019 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule (Revised)

MM11064

Part A

1/18/2019

New Electronic System for Provider Reimbursement Review Board Appeals

SE19004

Part APart B

1/18/2019

Calendar Year (CY) 2019 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment (Revised)

MM11076

Part APart B

1/18/2019

Proof of Delivery Documentation Requirements

SE19003

Part B

1/16/2019

January 2019 Update of the Ambulatory Surgical Center (ASC) Payment System

MM11108

Part A

1/9/2019

Total Knee Arthroplasty (TKA) Removal from the Medicare Inpatient-Only (IPO) List and Application of the 2-Midnight Rule (Rescinded)

SE19002

Part B

1/11/2019

2019 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List

MM11085

Part B

1/11/2019

New Waived Tests

MM11080

Part B

1/11/2019

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.1 Effective April 1, 2019

MM11126

Part APart B

1/11/2019

Medicare Claims Processing Manual, Chapter 30 Revisions

MM10848

Part APart B

1/11/2019

Clinical Laboratory Fee Schedule – Medicare Travel Allowance Fees for Collection of Specimens

MM11146

Part APart B

1/11/2019

Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) (Revised)

MM10567

Part APart B

1/11/2019

Local Coverage Determinations (LCDs) (Revised)

MM10901

Part APart B

1/8/2019

International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) (Revised)

MM11005

Part A

1/4/2019

January 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS)

MM11099

Part B

1/4/2019

January 2019 Update of the Ambulatory Surgical Center (ASC) Payment System

MM11108

Part APart B

1/3/2019

Updates to Immunosuppressive Guidance

MM11072

Part A

1/3/2019

Home Health Rural Add-on Payments Based on County of Residence (Revised)

MM10782

Part A

12/26/2018

New Search Features Added to Fiscal Intermediary Shared System (FISS)/Direct Data Entry (DDE)

SE18028

Part A

12/26/2018

January 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.0

MM11068

Part APart B

12/26/2018

Claim Status Category and Claim Status Codes Update

MM11073

Part A

12/26/2018

Guidance for Medicare Administrative Contractors (MACs) Processing Beneficiary and Family Centered Care (BFCC) Quality Improvement Organizations (QIO) Two-Midnight (2MN) Short Stay Review (SSR) Determinations

MM10600

Part A

12/20/2018

Inpatient Rehabilitation Facility (IRF) Medical Review Changes

SE17036

Part APart B

12/20/2018

New Physician Specialty code for Undersea and Hyperbaric Medicine

MM10666

Part B

12/20/2018

Overview of the Repetitive, Scheduled Non-emergent Ambulance Prior Authorization Model

SE1514

Part APart B

12/19/2018

What Suppliers Need to Know About Orders for DMEPOS Items

SE18009

Part APart B

12/18/2018

Calendar Year (CY) 2019 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

MM11076

Part APart B

12/18/2018

NCD 20.4 Implantable Cardiac Defibrillators (ICDs) (Revised)

MM10865

Part APart B

12/17/2018

Calendar Year (CY) 2019 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule

MM11064

Part A

12/17/2018

Updates to the Inpatient Psychiatric Facility Benefit Policy Manual

MM11062

Part APart B

12/17/2018

Next Generation Accountable Care Organization (ACO) Model 2019 Benefit Enhancement (Revised)

MM10824

Part APart B

12/17/2018

Quarterly Influenza Virus Vaccine Code Update - January 2019 (Revised)

MM10871

Part A

12/17/2018

Implementation of Changes in the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Dialysis Furnished for Acute Kidney Injury (AKI) in ESRD Facilities for Calendar Year (CY) 2019 (Revised)

MM11021

Part APart B

12/13/2018

Hurricane Florence and Medicare Disaster Related North Carolina, South Carolina, and the Commonwealth of Virginia Claims (Revised)

SE18014

Part APart B

12/13/2018

Hurricane Michael and Medicare Disaster Related Florida and Georgia Claims (Revised)

SE18021

Part A

12/11/2018

Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Medicare Benefit Policy Manual Chapter 13 Update

MM11019

Part APart B

12/11/2018

Revision of Definition of the Physician Supervision of Diagnostic Procedures, Clarification of DSMT Telehealth Services, and Establishing a Modifier for Expanding the Use of Telehealth for Individuals with Stroke

MM11043

Part APart B

12/11/2018

National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS)

MM10878

Part APart B

12/11/2018

New Medicare Beneficiary Identifier (MBI) Get It, Use It (Revised)

SE18006

Part APart B

12/6/2018

Medicare Fee-for-Service (FFS) Response to the 2018 Alaska Earthquake

SE18027

Part APart B

12/4/2018

Annual Update to the Per-Beneficiary Therapy Amounts

MM11055

Part APart B

12/4/2018

Summary of Policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List

MM11063

Part B

11/30/2018

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.0, Effective January 1, 2019

MM11044

Part APart B

11/30/2018

Ambulance Inflation Factor for Calendar Year 2019 and Productivity Adjustment

MM11031

Part APart B

11/30/2018

Next Generation Accountable Care Organization (NGACO) Model Post Discharge Home Visit HCPCS (Revised)

MM10907

Part A

11/29/2018

New Medicare Webpage on Patient Driven Payment Model

SE18026

Part APart B

11/27/2018

New Modifier for Expanding the Use of Telehealth for Individuals with Stroke

MM10883

Part A

11/23/2018

Update to the Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) for Calendar Year (CY) 2019 - Recurring File Update

MM10990

Part APart B

11/19/2018

Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update

MM11038

Part APart B

11/19/2018

Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE

MM11039

Part APart B

11/19/2018

Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement

MM11040

Part A

11/16/2018

Update to Rural Health Clinic (RHC) All Inclusive Rate (AIR) Payment Limit for Calendar Year (CY) 2019

MM10989

Part A

11/16/2018

Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2019

MM10992

Part B

11/16/2018

New Waived Tests (Revised)

MM10958

Part APart B

11/16/2018

Medicare Fee-for-Service (FFS) Response to the 2018 California Wildfires

SE18025

Part A

11/14/2018

User CR: Fiscal Intermediary Shared System (FISS) - Implementation of the Molecular Diagnostic Services (MolDX)

MM10760

Part A

11/14/2018

Common Working File (CWF) Provider Queries National Provider Identifier (NPI) and Submitter Identification (ID) Verification

MM10983

Part APart B

11/9/2018

International Classification of Diseases, Tenth Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)

MM10859

Part APart B

11/7/2018

Update to Medicare Deductible, Coinsurance and Premium Rates for 2019

MM11025

Part B

11/7/2018

Certifying Patients for the Medicare Home Health Benefit (Revised)

SE1436

Part A

11/7/2018

Medicare Cost Report E-Filing (MCReF) (Revised)

MM10611

Part A

11/7/2018

Implementation of Healthcare Common Procedure Coding System (HCPCS) Code J3591 and Additional Changes for End Stage Renal Disease (ESRD) Claims

MM10851

Part A

11/5/2018

Hospital and Critical Access Hospital (CAH) Swing-Bed Manual Revisions

MM10962

Part APart B

11/5/2018

Internet Only Manual Updates to Pub. 100-01, 100-02 and 100-04 to Correct Errors and Omissions (SNF) (2018 Q4)

MM11004

Part APart B

11/5/2018

Revision of SNF CB Edits for Ambulance Services Rendered to Beneficiaries in a Part A Skilled Nursing Facility Stay

MM10955

Part APart B

11/2/2018

A Prescriber’s Guide to the New Medicare Part D Opioid Overutilization Policies for 2019

SE18016

Part APart B

11/1/2018

Typhoon Yutu and Medicare Disaster Related Commonwealth of the Northern Mariana Islands Claims

SE18024

Part A

10/26/2018

Correction to Common Working File (CWF) Informational Unsolicited Response (IUR) 7272 for Intervening Stay

MM10960

Part A

10/26/2018

Update to Common Working File (CWF) Edit of Medicare Advantage (MA) Enrollees' Inpatient Claims from Approved Teaching Hospitals Billed for Indirect Medical Education

MM10959

Part A

10/26/2018

Incomplete Colonoscopies Billed with Modifier 53 for Critical Access Hospital (CAH) Method II Providers

MM10937

Part APart B

10/26/2018

January 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files

MM11016

Part APart B

10/23/2018

Magnetic Resonance Imaging (MRI)

MM10877

Part B

10/17/2018

Updating Calendar Year (CY) 2019 Medicare Diabetes Prevention Program (MDPP) Payment Rates

MM10970

Part A

10/12/2018

Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations

SE18023

Part APart B

10/12/2018

Hurricane Michael and Medicare Disaster Related Florida Claims (Revised)

SE18021

Part A

10/11/2018

Fiscal Year (FY) 2019 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) PPS Changes

MM10869

Part APart B

10/11/2018

Hurricane Florence and Medicare Disaster Related North Carolina, South Carolina, and the Commonwealth of Virginia Claims (Revised)

SE18014

Part A

10/5/2018

Ensuring Occurrence Code 22 is Billed Correctly on Skilled Nursing Facility Inpatient Claims

MM10922

Part APart B

10/5/2018

2019 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update

MM10981

Part APart B

10/4/2018

Local Coverage Determinations (LCDs)

MM10901

Part APart B

10/1/2018

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2019

MM10941

Part APart B

10/1/2018

2019 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments

MM10968

Part B

9/25/2018

2018-2019 Influenza (Flu) Resources for Health Care Professionals

SE18015

Part B

9/24/2018

New Waived Tests

MM10958

Part APart B

9/21/2018

Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – October 2018 Update (Revised)

MM10834

Part APart B

9/13/2018

International Classification of Diseases, Tenth Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) (Revised)

MM10859

Part APart B

9/13/2018

Hurricane Maria and Medicare Disaster Related United States Virgin Islands and Commonwealth of Puerto Rico Claims (Revised)

SE17028

Part APart B

9/12/2018

Intensity-Modulated Radiation Therapy (IMRT) Planning Services Editing

SE18013

Part APart B

9/10/2018

Annual Clotting Factor Furnishing Fee Update 2019

MM10918

Part A

9/6/2018

Revisions to the Telehealth Billing Requirements for Distant Site Services (Revised)

MM10583

Part APart B

9/6/2018

Update to Chapter 15, Pub. 100-08, Certification Statement Policies (Revised)

MM10845

Part APart B

9/5/2018

Influenza Vaccine Payment Allowances - Annual Update for 2018-2019 Season

MM10914

Part A

9/5/2018

Reminder on Billing Requirements Implemented for non-OPPS Providers

SE18012

Part B

9/5/2018

October 2018 Update of the Ambulatory Surgical Center (ASC) Payment System

MM10932

Part B

8/30/2018

Review of Opioid Use during the Initial Preventive Physical Examination (IPPE) and Annual Wellness Visit (AWV)

SE18004

Part A

8/29/2018

October 2018 Update of the Hospital Outpatient Prospective Payment System (OPPS)

MM10923 

Part A

8/24/2018

October 2018 Integrated Outpatient Code Editor (I/OCE) Specifications Version 19.3

MM10900

Part APart B

8/24/2018

Healthcare Provider Taxonomy Codes (HPTCs) October 2018 Code Set Update

MM10857

Part APart B

8/24/2018

Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE

MM10904

Part APart B

8/24/2018

Claim Status Category and Claim Status Codes Update

MM10925

Part APart B

8/21/2018

Recent and Upcoming Improvements in Hospice Billing and Claims Processing (Revised)

SE18007

Part A

8/20/2018

Updating Language to Clarify for Providers Chapter 3, Section 20 and Chapter 5, Section 70 of the Medicare Secondary Payer Manual

MM10863

Part APart B

8/17/2018

Current Medicare Coverage of Diabetes Supplies

SE18011

Part APart B

8/15/2018

International Classification of Diseases, Tenth Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)

MM10859

Part A

8/15/2018

User CR: FISS to Add Additional Search Features to Provider Direct Data Entry (DDE) Screen

MM10542

Part APart B

8/13/2018

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - October 2018 Update

MM10898

Part APart B

8/10/2018

Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – October 2018 Update

MM10834

Part APart B

8/10/2018

October Quarterly Update for 2018 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule

MM10881

Part APart B

8/6/2018

Provider Enrollment Requirements for Writing Prescriptions for Medicare Part D Drugs (Rescinded)

SE1434

Part APart B

8/3/2018

Update to Medicare Claims Processing Manual, Chapter 24, Section 90

MM10559

Part A

8/3/2018

Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2019

MM10826

Part A

8/3/2018

System Changes to Implement Epoetin Alfa Biosimilar, Retacrit for End Stage Renal Disease (ESRD) and Acute Kidney Injury (AKI) Claims

MM10839

Part APart B

8/3/2018

Updates to the Medicare Claims Processing Manual, Chapter 24, ASCA Waiver Review Form of Letters, Exhibits A-H

MM10858

Part A

8/3/2018

Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Updates for Fiscal Year (FY) 2019

MM10880

Part APart B

8/3/2018

October 2018 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files

MM10899

Part APart B

7/26/2018

Hurricane Maria and Medicare Disaster Related United States Virgin Islands and Commonwealth of Puerto Rico Claims (Revised)

SE17028

Part A

7/23/2018

Internet Only Manual (IOM) Update to Publication 100-02, Chapter 11 - End Stage Renal Disease (ESRD), Section 100

MM10809

Part B

7/23/2018

New Waived Tests

MM10819

Part APart B

7/23/2018

Quarterly Update to 2018 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement

MM10852

Part APart B

7/23/2018

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2018

MM10873

Part APart B

7/23/2018

Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

MM10875

Part APart B

7/17/2018

Medical Review of Evaluation and Management (E/M) Documentation

MM10627

Part APart B

7/17/2018

New Physician Specialty Code for Undersea and Hyperbaric Medicine

MM10666

Part A

7/11/2018

Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update

MM10825

Part APart B

7/9/2018

Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – July 2018 Update (Revised)

MM10624

Part B

7/2/2018

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 24.3 Effective October 1, 2018

MM10827


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Last modified:  01/23/2019