Program_Memos / 2002 / AB-02-156

Why This Topic Matters

It helps readers determine whether they need to follow a Medicare coverage and claims-processing update tied to a specific HCPCS service and a defined implementation date. The article is useful for organizations responsible for claim submission, denial notices, remittance handling, and provider communications.

Article Sections

1. Billing and recognition requirements

   Introduces the affected service category and the billing and system-recognition requirements described in the memorandum.

2. Claims requirements for intermediaries and carriers

   Summarizes the general claims submission references and administrative instructions for intermediary and carrier processing.

3. Payment requirements

   Describes where payment information is located and the general payment framework for the service under Medicare Part B.

4. General claims processing instructions

   Provides high-level guidance for remittance advice, denial handling, and related claims-processing communications.

5. Remittance advice notice

   Addresses the use of standard remittance reason and remark codes when claims are denied under the memorandum's timing rules.

6. Medicare summary notice (MSN) messages

   Lists the Medicare beneficiary notice language to use for claims denied because the service occurred before the applicable date.

7. Provider notification

   Explains how contractors are instructed to communicate the update to providers through routine outreach channels.