The Medicare Monthly Review, MMR-2011-01, January 2011 - CGS

In accordance with Title XVIII Section 1833 of the Social Security Act, providers/suppliers must submitmedical record documentation to support claims for Medicare services upon request. It is theresponsibility of the billing facility/physician/supplier to obtain additional supporting documentationfrom a third party (hospital, nursing home, etc.), as necessary.Providing medical records of Medicare patients to the CERT contractor does not violate the HealthInsurance Portability and Accountability Act (HIPAA). Patient authorization is not required torespond to this request.Additional information on CERT and these special studies (supplemental measures) can be found onwww.paymentaccuracy.gov.For specific questions about CERT or these special studies, please contact the Clinical Provider Outreachand Education team at 800-338-6101 or by e-mail at Clinical.Education@wellpoint.com. Please provide theCERT CID number, business type (e.g., Part A, Part B, and DME) and region (state).Updates for January 2011LCD for Magnetic Resonance Angiography (MRA) (L25367)R8 (effective 01/01/2011):CORRECTION/CLARIFICATION - ICD-9-CM code 435.9 (Unspecified transientcerebral ischemia) was added as a payable diagnosis for all head and neck codes (CPT codes 70544,70545,70546, 70547, 70548, 70549) for claims submitted on or after 08/01/2010. The descriptor for CPT code74185 was revised for the 2011 annual CPT code update. Minor changes made to update for NationalGovernment Services template. No notice given and none required.New LCD/Articles:Colorectal Cancer Screening – Medical Policy Article (A50548)Article published January 2011: This article replaces Local Coverage Determination L26402 andSupplemental Instructions Article A45928 on Colorectal Cancer Screening.Article for TheraSkin® – Related to LCD L26003 (A50504)Article published January 2011: Original version of article.LCD for Posterior Tibial Nerve Stimulation for Voiding Dysfunction (L31391)Effective 01/03/2011: Revised during the notice period for annual 2011 CPT code update. CPT codes64999, 97014, and 97032 were deleted from the policy and replaced with CPT code 64566.Article for Posterior Tibial Nerve Stimulation for Voiding Dysfunction – Supplemental InstructionsArticle (A50267)Article published January 2011: Revised during the notice period for annual 2011 CPT code update. CPTcodes 64999, 97014, and 97032 were deleted from the policy and replaced with CPT code 64566.LCD/Article Revisions:December Revision:LCD for Nesiritide Infusion for Heart Failure (L26418)CPT codes and descriptors are only copyright 2010 American Medical Association (or such other date publication of CPT)The Medicare Monthly Review 6 MMR 2011-01, January 2011