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.
A/B |
Date |
Subject |
MM# |
|
7/16/2019 |
July 2019 Update of the Ambulatory Surgical Center (ASC) Payment System |
MM11328 |
|
7/15/2019 |
Tropical Storm Barry and Medicare Disaster Related Louisiana Claims |
SE19014 |
|
7/15/2019 |
Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.3 Effective October 1, 2019 |
MM11357 |
|
7/15/2019 |
Update to Coverage of Intravenous Immune Globulin for Treatment of Primary Immune Deficiency Diseases in the Home |
MM11295 |
|
7/12/2019 |
Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2019 |
MM11344 |
|
7/10/2019 |
Pre-Diabetes Services: Referring Patients to the Medicare Diabetes Prevention Program |
SE19001 |
|
7/10/2019 |
Reduce Risk of Opioid Overdose Deaths by Avoiding and Reducing Co-Prescribing Benzodiazepines |
SE19011 |
|
7/10/2019 |
Emergency Medical Treatment and Labor Act (EMTALA) and the Born-Alive Infant Protection Act |
SE19012 |
|
7/10/2019 |
Medicare Plans to Modernize Payment Grouping and Code Editor Software |
SE19013 |
|
7/10/2019 |
Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations (Revised) |
SE19007 |
|
7/9/2019 |
October 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files |
MM11343 |
|
7/9/2019 |
Medicare Summary Notice (MSN) Changes to Assist Beneficiaries Enrolled in the Qualified Medicare Beneficiary (QMB) Program (Revised) |
MM11230 |
|
7/3/2019 |
July 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.2 (Revised) |
MM11298 |
|
7/3/2019 |
Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment (Revised) |
MM11280 |
|
7/2/2019 |
Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2020 |
MM11347 |
|
7/2/2019 |
July Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule (Revised) |
MM11334 |
|
7/1/2019 |
Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – July 2019 Update (Revised) |
MM11296 |
|
6/10/2019 |
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 |
MM11321 |
|
5/31/2019 |
July 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) |
MM11318 |
|
5/29/2019 |
Documentation of Medical Necessity of the Home Visit; and Physician Management Associated with Superficial Radiation Treatment |
MM11273 |
|
5/29/2019 |
Chimeric Antigen Receptor (CAR) T-Cell Therapy Revenue Code and HCPCS Setup Revisions |
SE19009 |
|
5/22/2019 |
Additional Processing Instructions to Update the Standard Paper Remit (SPR) |
MM11289 |
|
5/20/2019 |
Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update |
MM11252 |
|
5/20/2019 |
Claim Status Category and Claim Status Codes Update |
MM11292 |
|
5/20/2019 |
Proper Use of Modifier 59 (Revised) |
SE1418 |
|
5/17/2019 |
Reporting the HCPCS Level II Modifiers of the Patient Relationship Categories and Codes |
MM11259 |
|
5/10/2019 |
Educational Resources to Assist Chiropractors with Medicare Billing (Revised) |
SE1603 |
|
5/10/2019 |
Use of the AT modifier for Chiropractic Billing (New Information Along with Information in MM3449) (Revised) |
SE1602 |
|
5/10/2019 |
Medicare Coverage for Chiropractic Services – Medical Record Documentation Requirements for Initial and Subsequent Visits (Revised) |
SE1601 |
|
5/8/2019 |
International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) |
MM11229 |
|
5/7/2019 |
MM11152 – Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) (Revised) |
MM11152 |
|
5/3/2019 |
Re-implementation of the AMCC Lab Panel Claims Payment System Logic |
MM11248 |
|
5/3/2019 |
Documentation of Evaluation and Management Services of Teaching Physicians |
MM11171 |
|
5/3/2019 |
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - July 2019 Update |
MM11293 |
|
5/3/2019 |
Updating Fiscal Intermediary Shared System (FISS) for Pricing Drugs at Different Rates Depending on Provider Type |
MM11199 |
|
5/3/2019 |
Medicare Physician Fee Schedule Database File Record Layout |
MM11191 |
|
5/3/2019 |
Systems Changes to Allow IPPS-Excluded Hospitals to Operate IPPS-Excluded Units |
MM11173 |
|
5/1/2019 |
Typhoon Yutu and Medicare Disaster Related Commonwealth of the Northern Mariana Islands Claims (Revised) |
SE18024 |
|
4/30/2019 |
Quarterly Update to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) |
MM11215 |
|
4/19/2019 |
Implementation to Exchange the List of Enrollment in Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System. (Reissued) |
MM11003 |
|
4/19/2019 |
Medicare Fee-for-Service (FFS) Response to the 2018 Alaska Earthquake (Revised) |
SE18027 |
|
4/17/2019 |
National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) (Revised) |
MM10878 |
|
4/16/2019 |
Pub. 100-04, Chapter 29 – Appeals of Claims Decisions - Revisions |
MM11042 |
|
4/16/2019 |
New Waived Tests |
MM11231 |
|
3/29/2019 |
Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.2 Effective July 1, 2019 |
MM11227 |
|
3/29/2019 |
The Supplemental Security Income/Medicare Beneficiary Data for Fiscal Year 2017 for Inpatient Prospective Payment System Hospitals, Inpatient Rehabilitation Facilities, and Long Term Care Hospitals |
MM11187 |
|
3/29/2019 |
Correction of the Fiscal Year (FY) 2019 Inpatient Prospective Payment System (IPPS) Pricer |
MM11208 |
|
3/28/2019 |
Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2019 |
MM11224 |
|
3/28/2019 |
Evaluation and Management (E/M) When Performed with Superficial Radiation Treatment (Revised) |
MM11137 |
|
3/27/2019 |
Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations |
SE19007 |
|
3/27/2019 |
July 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files |
MM11225 |
|
3/22/2019 |
April 2019 Update of the Ambulatory Surgical Center (ASC) Payment System |
MM11232 |
|
3/22/2019 |
Billing for Hospital Part B Inpatient Services |
MM11181 |
|
3/22/2019 |
Update to the Payment for Grandfathered Tribal Federally Qualified Health Centers (FQHCs) for Calendar Year (CY) 2019 |
MM11203 |
|
3/20/2019 |
April 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) |
MM11216 |
|
3/20/2019 |
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2019 Update (Revised) |
MM11163 |
|
3/15/2019 |
Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update |
MM11204 |
|
3/15/2019 |
April 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.1 |
MM11192 |
|
3/14/2019 |
National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) |
MM10878 |
|
3/11/2019 |
Next Generation Accountable Care Organization (NGACO) Model Post Discharge Home Visit HCPCS (Revised) |
MM10907 |
|
3/7/2019 |
New Medicare Beneficiary Identifier (MBI) Get It, Use It (Revised) |
SE18006 |
|
3/4/2019 |
Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting and Reporting Data for the Private Payor Rate-Based Payment System |
SE19006 |
|
3/3/2019 |
Revising the Remittance Advice Messaging for the 20-Hour Weekly Minimum for Partial Hospitalization Program Services (Revised) |
MM11066 |
|
2/27/2019 |
NCD 20.4 Implantable Cardiac Defibrillators (ICDs) (Revised) |
MM10865 |
|
2/26/2019 |
Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits |
MM11135 |
|
2/22/2019 |
Ensuring Organ Acquisition Charges Are Not Included in the Inpatient Prospective Payment System (IPPS) Payment Calculation (Revised) |
MM11087 |
|
2/20/2019 |
Healthcare Provider Taxonomy Codes (HPTCs) April 2019 Code Set Update |
MM11121 |
|
2/20/2019 |
April Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule |
MM11179 |
|
2/20/2019 |
Modification of the MCS Claims Processing System Logic for Modifier 59, XE, XS, XP, and XU Involving the National Correct Coding Initiative (NCCI) Procedure to Procedure (PTP) Column One and Column Two Codes |
MM11168 |
|
2/19/2019 |
Local Coverage Determinations (LCDs) (Revised) |
MM10901 |
|
2/8/2019 |
Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)—Clarification of Payment Rules and Expansion of International Classification of Diseases Tenth Edition (ICD-10) Diagnosis Codes |
MM11022 |
|
2/7/2019 |
Update to Intensive Cardiac Rehabilitation (ICR) Programs |
MM11117 |
|
2/7/2019 |
International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) |
MM11134 |
|
2/7/2019 |
Medicare Fee-for-Service (FFS) Response to the 2018 California Wildfires (Revised) |
SE18025 |
|
2/6/2019 |
Common Working File (CWF) Provider Queries National Provider Identifier (NPI) Verification |
MM10983 |
|
2/5/2019 |
Processing Instructions to Update the Standard Paper Remit (SPR) |
MM11112 |
|
2/5/2019 |
Independent Laboratory Billing of Laboratory Tests for End-Stage Renal Disease (ESRD) Beneficiaries and the Sunset of the CB Modifier |
MM11061 |
|
2/1/2019 |
Guidance on Coding and Billing Date of Service on Professional Claims (Revised) |
SE17023 |
|
1/31/2019 |
Common Working File (CWF) Provider Queries National Provider Identifier (NPI) and Submitter Identification (ID) Verification (Revised) |
MM10983 |
|
1/29/2019 |
Processing Veterans Administration (VA) Inpatient Claims Exempt from Present on Admission (POA) Reporting |
MM11053 |
|
1/29/2019 |
April 2019 Quarterly ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files |
MM11151 |
|
1/29/2019 |
Updates to Reflect Removal of Functional Reporting Requirements and Therapy Provisions of the Bipartisan Budget Act of 2018 |
MM11120 |
|
1/24/2019 |
Total Knee Arthroplasty (TKA) Removal from the Medicare Inpatient-Only (IPO) List and Application of the 2-Midnight Rule (Reissued) |
SE19002 |
|
1/24/2019 |
Hurricane Maria and Medicare Disaster Related United States Virgin Islands and Commonwealth of Puerto Rico Claims (Revised) |
SE17028 |
|
1/24/2019 |
Communication Technology Based Services and Payment for Rural Health Clinic (RHCs) and Federally Qualified Health Centers (FQHCs) |
MM10843 |
|
1/23/2019 |
January 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) (Revised) |
MM11099 |
|
1/23/2019 |
Calendar Year (CY) 2019 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule (Revised) |
MM11064 |
|
1/18/2019 |
New Electronic System for Provider Reimbursement Review Board Appeals |
SE19004 |
|
1/18/2019 |
Calendar Year (CY) 2019 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment (Revised) |
MM11076 |
|
1/18/2019 |
Proof of Delivery Documentation Requirements |
SE19003 |
|
1/16/2019 |
January 2019 Update of the Ambulatory Surgical Center (ASC) Payment System |
MM11108 |
|
1/9/2019 |
Total Knee Arthroplasty (TKA) Removal from the Medicare Inpatient-Only (IPO) List and Application of the 2-Midnight Rule (Rescinded) |
SE19002 |
|
1/11/2019 |
2019 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List |
MM11085 |
|
1/11/2019 |
New Waived Tests |
MM11080 |
|
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 |
|
1/11/2019 |
Medicare Claims Processing Manual, Chapter 30 Revisions |
MM10848 |
|
1/11/2019 |
Clinical Laboratory Fee Schedule – Medicare Travel Allowance Fees for Collection of Specimens |
MM11146 |
|
1/11/2019 |
Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) (Revised) |
MM10567 |
|
1/8/2019 |
International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) (Revised) |
MM11005 |
|
1/4/2019 |
January 2019 Update of the Ambulatory Surgical Center (ASC) Payment System |
MM11108 |
|
1/3/2019 |
Updates to Immunosuppressive Guidance |
MM11072 |
|
1/3/2019 |
Home Health Rural Add-on Payments Based on County of Residence (Revised) |
MM10782 |
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