May 1, 2009, Home Health & Hospice Medicare A Newsline - CGS

When denying a claim because of these edits, your Medicare contractor will notify the beneficiary usingMedicare Summary Notice (MSN) message 29.33 - Your claim has been denied by Medicare because youmay have funds set aside from your settlement to pay for your future medical expenses and prescriptiondrug treatment related to your injury(ies).In addition, Medicare will use Reason Code 201, Group Code PR, and Remark Code MA01, on outboundclaims and/or remittance advice transactions when Medicare denies claims based on the WCMSA presence.Also, on 271 inquiry reply transactions, Medicare will reflect the WCMSA on the 271 response with “EB”followed by the qualifier WC.Additional InformationYou can find the official instruction (CR 5371) issued to your Medicare contractor in two transmittals:http://www.cms.hhs.gov/Transmittals/downloads/R1703CP.pdf andhttp://www.cms.hhs.gov/Transmittals/downloads/R65MSP.pdf on the CMS Web site.If you have questions regarding this issue, refer to the “Contact Us” page of our Web site and select “PhoneUs” to call the Provider Contact Center.Disclaimer: This article was prepared as a service to the public and is not intended to grant rights or impose obligations. Thisarticle may contain references or links to statutes, regulations, or other policy materials. The information provided is onlyintended to be a general summary. It is not intended to take the place of either the written law or regulations. We encouragereaders to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of theircontents.Payment for Maintenance and Servicing of Certain Oxygen Equipment as a Result ofthe Medicare Improvements for Patients and Providers Act (MIPPA) of 2008The Centers for Medicare & Medicaid Services (CMS) has provided the following Medicare LearningNetwork (MLN) Matters article. This MLN Matters article and other CMS articles can be found on theCMS Web site at: http://www.cms.hhs.gov/MLNMattersArticlesMLN Matters Number: MM6404 Related Change Request (CR) #: 6404Related CR Release Date: March 20, 2009 Effective Date: July 1, 2009Related CR Transmittal #: R461OTN Implementation Date: July 6, 2009Provider Types AffectedSuppliers submitting claims to Medicare contractors (regional home health intermediaries (RHHIs), and/ordurable medical equipment Medicare administrative contractors (DME MACs)) for oxygen servicesprovided to Medicare beneficiaries.Provider Action NeededThis article is based on CR 6404 which provides additional instructions regarding maintenance andservicing of oxygen concentrators and transfilling equipment resulting from implementation of Section144(b) of the MIPPA. Earlier instructions pertaining to the MIPPA changes for oxygen equipment wereHome Health & Hospice May 1, 2009 13Medicare A Newsline Vol. 16, No. 8