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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 2018. The following MLN Matters articles issued in 2018 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 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 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 APart B

10/30/2018

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

MM10907

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 APart B

9/10/2018

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

MM10871

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 APart B

8/30/2018

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

MM10824

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 APart B

7/12/2018

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

SE18006

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

Part APart B

6/28/2018

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

MM10788

Part APart B

6/28/2018

Comprehensive ESRD Care (CEC) Model Telehealth - Implementation (Revised)

MM10314

Part APart B

6/27/2018

Prohibition Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) Program (Revised)

SE1128

Part A

6/26/2018

Global Surgical Days for Critical Access Hospital (CAH) Method II (Revised)

MM10425

Part A

6/20/2018

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

MM10781

Part A

6/20/2018

Quarterly Update to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) (Revised)

MM10818

Part B

6/19/2018

Medicare Coverage for Chiropractic Services – Medical Record Documentation Requirements for Initial and Subsequent Visits (Revised)

SE1601

Part A

6/19/2018

July 2018 Integrated Outpatient Code Editor (I/OCE) Specification Version 19.2 (Revised)

MM10699

Part APart B

6/12/2018

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

MM10707

Part APart B

6/11/2018

Update of Internet Only Manual (IOM), Medicare Claims Processing Manual, Publication 100-04, Chapter 18 - Preventive and Screening Services, and Chapter 35 - Independent Diagnostic Testing Facility (IDTF)

MM10735

Part APart B

6/11/2018

Provider/Supplier Reporting of Adverse Legal Actions

MM10558

Part B

6/11/2018

Provider Enrollment – Unlicensed Residents

SE18008

Part APart B

6/1/2018

Claim Status Category and Claim Status Codes Update

MM10777

Part APart B

6/4/2018

E/M Service Documentation Provided By Students (Manual Update) (Revised)

MM10412

Part B

6/4/2018

New Q Code for In-Line Cartridge Containing Digestive Enzyme(s)

MM10626

Part APart B

5/29/2018

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

MM10667

Part A

5/29/2018

Diagnosis Code Update for Add-on Payments for Blood Clotting Factor Administered to Hemophilia Inpatients (Revised)

MM10474

Part APart B

5/22/2018

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

MM10644

Part APart B

5/21/2018

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

MM10620

Part APart B

5/18/2018

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

MM10622

Part APart B

5/18/2018

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

MM10566

Part A

5/18/2018

Changes to the End-Stage Renal Disease (ESRD) Facility Claim (Type of Bill 72X) to Accommodate Dialysis Furnished to Beneficiaries with Acute Kidney Injury (AKI) (Revised)

MM9598

Part APart B

5/16/2018

Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) (Revised)

MM10295

Part A

5/15/2018

Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) PPS Extensions per the Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act Included in the Bipartisan Budget Act of 2018

MM10547

Part APart B

5/15/2018

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

MM10642

Part APart B

5/15/2018

Updates to Publication 100-04, Chapters 1 and 27, to Replace Remittance Advice Remark Code (RARC) MA61 with N382

MM10619

Part APart B

5/10/2018

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

MM10622

Part APart B

5/3/2018

Medicare Cost Report E-Filing (MCReF)

MM10611

Part APart B

4/27/2018

New Physician Specialty Code for Medical Genetics and Genomics

MM10457

Part APart B

4/27/2018

Processing Instructions to Update the Identification Code Qualifier Being Used in the NM108 Data Element at the 2100 Loop, NM1- Patient Name Segment in the 835 Guide

MM10565

Part B

4/16/2018

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 24.2 Effective July 1, 2018

MM10593

Part B

4/16/2018

Change in Type of Service (TOS) for Current Procedural Terminology (CPT) Code 77067

MM10607

Part APart B

4/16/2018

Ambulance Transportation for a SNF Resident in a Stay Not Covered by Part A – Medicare Benefit Policy Manual, Chapter 10, and Medicare Claims Processing Manual, Chapter 15

MM10550

Part B

4/9/2018

New Waived Tests

MM10586

Part APart B

4/9/2018

Increased Ambulance Payment Reduction for Non-Emergency Basic Life Support (BLS) Transports to and from Renal Dialysis Facilities 

MM10549

Part APart B

4/9/2018

Modifications to the Implementation of the Paperwork (PWK) Segment of the Electronic Submission of Medical Documentation (esMD) System (Revised)

MM10397

Part APart B

4/9/2018

Claims Processing Actions to Implement Certain Provisions of the Bipartisan Budget Act of 2018 (Revised)

MM10531

Part APart B

4/3/2018

Medicare Fee-for-Service (FFS) Response to the 2017 California Wildfires (Revised)

SE17035

Part APart B

4/3/2018

Medicare Fee-for-Service (FFS) Response to the 2017 Southern California Wildfires (Revised)

SE17037

Part A

4/2/2018

Institutional Billing for No Cost Items

MM10521

Part APart B

4/2/2018

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

MM10567

Part APart B

4/2/2018

Proper Coding for Specimen Validity Testing Billed in Combination with Drug Testing

SE18001

Part A

4/2/2018

Skilled Nursing Facility Value-Based Purchasing Program Updated

SE18003

Part APart B

3/22/2018

Adjustments to Qualified Medicare Beneficiary (QMB) Claims Processed Under CR 9911

MM10494

Part APart B

3/22/2018

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

MM10503

Part A

3/22/2018

April 2018 Integrated Outpatient Code Editor (I/OCE) Specifications Version 19.1 (Revised)

MM10514

Part A

3/22/2018

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

MM10515

Part A

3/16/2018

Billing Requirements for OPPS Providers with Multiple Service Locations

SE18002

Part APart B

3/16/2018

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

MM10512

Part A

3/16/2018

The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2016 for Inpatient Prospective Payment System (IPPS) Hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCH)

MM10527

Part APart B

3/16/2018

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

MM10445

Part B

3/14/2018

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

MM10530

Part APart B

3/14/2018

Reinstating the Qualified Medicare Beneficiary Indicator in the Medicare Fee-For-Service Claims Processing System from CR9911 (Revised)

MM10433

Part APart B

3/12/2018

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

MM10454

Part APart B

3/5/2018

Appropriate Use Criteria for Advanced Diagnostic Imaging – Voluntary Participation and Reporting Period - Claims Processing Requirements – HCPCS Modifier QQ

MM10481

Part APart B

3/2/2018

ICD-10 and Other Coding Revisions to National Coverage Determinations (NCDs) (Revised)

MM10473

Part A

2/27/2018

Update to the Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) for Calendar Year (CY) 2018 - Recurring File Update (Revised)

MM10480

Part B

2/27/2018

Form CMS-855O Processing Guide

MM10355

Part APart B

2/20/2018

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

MM10402

Part APart B

2/20/2018

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

MM10489

Part APart B

2/20/2018

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

MM10488

Part B

2/15/2018

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

SE1514

Part APart B

2/13/2018

Replacement of Mammography HCPCS Codes, Waiver of Coinsurance and Deductible for Preventive and Other Services, and Addition of Anesthesia and Prolonged Preventive Services

MM10181

Part B

2/13/2018

Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits

MM10446

Part B

2/6/2018

New “K” Code for Therapeutic Shoe Inserts

MM10436

Part B

2/6/2018

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 24.1, Effective April 1, 2018

MM10472

Part APart B

1/25/2018

Next Generation Accountable Care Organization – Implementation (Revised)

SE1613

Part APart B

1/24/2018

Next Generation Accountable Care Organization (NGACO) Year Three Benefit Enhancements (Revised)

MM10044

Part A

1/22/2018

Update to the Medicare Benefit Policy Manual (Pub. 100-02, Chapter 11 - End Stage Renal Disease (ESRD), Section 100)

MM10366

Part APart B

1/22/2018

ICD-10 and Other Coding Revisions to National Coverage Determinations (NCDs) (Revised)

MM10318

Part APart B

1/22/2018

Hurricane Nate and Medicare Disaster Related Alabama, Florida, Louisiana and Mississippi Claims (Revised)

SE17034

Part APart B

1/18/2018

Medically Unlikely Edits (MUE) and Bilateral Surgical Procedures (Revised)

SE1422

Part B

1/16/2018

2018 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List

MM10416

Part B

1/16/2018

Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits

MM10446

Part A

1/12/2018

Implementation of the Transitional Drug Add-On Payment Adjustment for ESRD Drugs (Revised)

MM10065

Part A

1/11/2018

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

MM10350

Part B

1/8/2018

New Waived Tests

MM10418

Part APart B

1/8/2018

Calendar Year (CY) 2018 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule

MM10395

Part APart B

1/8/2018

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

MM10447

Part APart B

1/4/2018

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

MM10424

Part APart B

1/4/2018

Proper Use of Modifier 59

SE1418

Part B

1/3/2018

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

MM10441

Part APart B

1/3/2018

Suppression of the Standard Paper Remittance Advice (SPR) in 45 days if also Receiving Electronic Remittance Advice (ERA) (Revised)

MM10151

Part APart B

1/3/2018

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

MM10448


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Last modified:  11/12/2018