decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2001 / AB-01-126
Subscribe or sign in to view the full article.
Article Overview
This article explains CMS instructions for Medicare contractors involved in DMEPOS pricing updates for 2002. It covers the timing of fee schedule file releases, which organizations receive them, how new items are handled through gap-filling, quarterly revision workflows, and the record layouts used to submit and receive fee schedule data. The memorandum is relevant to Medicare DMEPOS billing and pricing staff, carriers, DMERCs, and related CMS stakeholders who manage fee schedule updates and transmissions.
Why This Topic Matters
It documents the operational process contractors used to receive, update, and transmit 2002 DMEPOS payment data. Readers need it to understand the scope of the annual update process, the parties involved, and the administrative structure for revising fee schedule amounts.
Article Sections
-
Transmittal AB-01-126 / Change Request 1856
Introductory transmittal information, date, and the subject of the memorandum are presented here. It establishes the scope of the payment update guidance.
-
2002 DMEPOS Fee Schedule File
This section describes the fee schedule file releases, recipients, release timing, and general implementation timeline for the 2002 payment files. It also addresses how contractors are to use the updated schedules.
-
Gap-filling Instructions
This section outlines the process for handling newly listed items that require carrier gap-filling and identifies how the related base fee schedule work is divided among contractor types. It also discusses special handling for certain jurisdictions and categories.
-
DMEPOS Update Factors for 2002
This section summarizes the 2002 update factors and category-level changes affecting DMEPOS fee schedules. It references the legislative basis for the annual adjustments.
-
Quarterly Update Schedule for 2002 DMEPOS Fee Schedule
This section lays out the process and schedule for submitting corrections and revised amounts during 2002. It includes responsibilities for contractors, regional offices, and CMS units, along with notice and adjustment procedures.
-
ATTACHMENT A
The attachment provides the file submission format for revisions to DMEPOS fee schedule data. It specifies record fields, file naming conventions, and submission details.
-
ATTACHMENT B
This attachment provides the revised record layout for 2002 DMEPOS fee schedule data. It defines the data fields used in the fee schedule file and the associated sorting and status indicators.
What You Will Learn
- How CMS organized the 2002 DMEPOS fee schedule update process
- What types of contractor and intermediary organizations were included in the distribution and implementation workflow
- How gap-filled items were grouped and processed at a high level
- What general update factors applied to DMEPOS categories for 2002
- How quarterly revisions and file transmissions were structured
- What information was required in the submission and record-layout attachments
Who Should Read This
- Medicare DMEPOS billing and coding staff
- DMERCs and local Part B carriers
- CMS payment and claims operations staff
- Durable medical equipment fee schedule administrators
- Healthcare reimbursement analysts
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com