tci Medicare Compliance & Reimbursement - 2003 Issue 31

PROGRAM MEMO ROUNDUP

Starting Jan. 1, 2004, patients will have a better sense of what's going on if claims get denied because of a local medical review policy or a national coverage determination. In an Aug. 1 program memorandum (AB-03-112; http://cms.hhs.gov/manuals/pm_trans/AB03112.pdf), the Centers for Medicare & Medicaid Services orders contractors to be sure that they tell beneficiaries the specific LMPR or NCD numbers associated with any claims denials for Part A services. In other recent program memoranda, CMS: adjusts mileage payment policies for rural ground ambulance services (AB-03-110; http://cms.hhs.gov/manuals/pm_trans/AB03110.pdf); lays out claims processing instructions for incomplete...

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