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November 2023 MLN Articles

Published on 

Wednesday, November 29, 2023

 | Billing 
 | Coding 
 | Documentation 
 | Medicare Coverage 

October 30, 2023: MLN MM13390: ICD-10 & Other Coding Revisions to National Coverage Determinations: April 2024 Update (CR 1 of 2)

CMS advises providers to make sure your billing staff knows about newly available codes, recent coding changes, and NCD coding information.  https://www.cms.gov/files/document/mm13390-icd-10-other-coding-revisions-national-coverage-determinations-april-2024-update-cr-1-2.pdf

 

October 30, 2023: MLN MM13391: ICD-10 & Other Coding Revisions to National Coverage Determinations: April 2024 Update (CR 2 of 2)

CMS advises providers to make sure your billing staff knows about newly available codes, recent coding changes, and NCD coding information. https://www.cms.gov/files/document/mm13391-icd-10-other-coding-revisions-national-coverage-determinations-april-2024-update-cr-2-2.pdf

 

November 3, 2023: MLN MM13244: Separate Payment for Disposable Negative Pressure Wound Therapy Devices on Home Health Claims

Effective January 1, 2024, Medicare will make separate payment for HCPCS code A9272 on type of bill (TOB) 032x, instead of 034x. Also, Medicare Administrative Contractors (MACs) will apply deductible and coinsurance.

https://www.cms.gov/files/document/mm13244-separate-payment-disposable-negative-pressure-wound-therapy-devices-home-health-claims.pdf

 

November 6, 2023: MLN MM13055: Allowing Audiologists to Provide Certain Diagnostic Tests Without a Physician Order – Revised

Initially published June 1, 2023, this article was revised on November 6, 2023 to add two new CPT codes effective January 1, 2024, based on Change Request (CR) 13279.

https://www.cms.gov/files/document/mm13055-audiologists-may-provide-certain-diagnostic-tests-without-physician-order.pdf

 

November 9, 2023: MLN MM13331: Provider Enrollment Changes to the Medicare Program Integrity Manual

Effective January 1, 2024, Medicare will cover services provided by Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs). CMS advises that providers make sure your billing staff is aware of this change. https://www.cms.gov/files/document/mm13331-provider-enrollment-changes-medicare-program-integrity-manual.pdf

 

November 13, 2023: MLN MM13278: ICD-10 & Other Coding Revisions to National Coverage Determinations: January 2024 Update - Revised

This article was first released August 9, 2023. With this revision, CMS has added information about CPT codes related to NCD 90.2 (Next Generation Sequencing) and NCD 210.1 (Prostate Screening Tests). https://www.cms.gov/files/document/mm13278-icd-10-other-coding-revisions-national-coverage-determinations-january-2024-update.pdf

 

November 13, 2023: MLN MM13286: Lymphedema Compression Treatment Items: Implementation

Effective January 1, 2024, there will be a new Medicare DMEPOS benefit category for standard and custom-fitted compression garments and additional lymphedema compression treatment items. This article includes codes, billing, and payment guidance for your billing staff. https://www.cms.gov/files/document/mm13286-lymphedema-compression-treatment-items-implementation.pdf

 

In addition to reviewing this MLN article, I encourage you to visit CMS’ webpage Lymphedema Compression Treatment Items to learn about what’s covered, how often are the items covered, who is eligible, and the responsibilities and billing guidance for DMEPOS suppliers providing these items. https://www.cms.gov/medicare/payment/fee-schedules/dmepos-fee-schedule/lymphedema-compression-treatment-items

 

November 21, 2023: MLN MM13272: Edits to Prevent Payment of G2211 with Office/Outpatient Evaluation and Management Visit and Modifier 25

CMS finalized a rule to make the O/O E/M visit complexity add-on code G2211 separately payable by assigning the active status indicator to it, effective January 1, 2024. Note that CMS will not pay when you report an associated O/O E/M visit with modifier 25. https://www.cms.gov/files/document/mm13272-edits-prevent-payment-g2211-office/outpatient-evaluation-and-management-visit-and-modifier.pdf

 

November 27, 2023: MLN MM13455: New Waived Tests

CMS advises providers to make sure your billing staff know about Clinical Laboratory Improvement Amendments (CLIA) requirements, new CLIA-waived test approved by the FDA, and use of modifier QW for CLIA-waived tests. https://www.cms.gov/files/document/mm13455-new-waived-tests.pdf

Article Author: Beth Cobb, RN, BSN, ACM, CCDS
Beth Cobb, RN, BSN, ACM, CCDS, is the Manager of Clinical Analytics at Medical Management Plus, Inc. Beth has over twenty-five years of experience in healthcare including eleven years in Case Management at a large multi-facility health system. In her current position, Beth is a principle writer for MMP’s Wednesday@One weekly e-newsletter, an active member of our HIPAA Compliance Committee, MMP’s Education Department Program Director and co-developer of MMP’s proprietary Compliance Protection Assessment Tool.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.