Industry Notes: CMS Holding Colorectal Cancer Screening and Hepatitis B Vaccine Claims

Why This Topic Matters

These CMS updates can affect claim acceptance, payment timing, required claim data elements, and provider participation in federal programs. Staying current helps organizations avoid avoidable denials or holds and track policy changes that may influence operations and reimbursement.

Article Sections

1. Claims-processing issues for preventive services and Hepatitis B vaccine claims

   Summarizes CMS corrections related to claim suspension and payment issues affecting certain Medicare Part B and outpatient submissions.

2. Community-based Care Transitions Program and Partnership for Patients

   Describes CMS funding activity tied to care transitions, rehospitalization reduction, and broader patient-safety initiatives.

3. Type of Admission codes on institutional claims

   Explains claim-edit updates involving institutional claim data requirements and related reason codes.

4. Specialty code 95 for advanced diagnostic imaging accreditation

   Notes a CMS specialty designation update affecting how provider type is identified on claims.

5. Durable medical equipment competitive bidding delay

   Covers timing changes announced for a later round of Medicare competitive bidding for durable medical equipment.