Outpatient Facility Coding Alert - 2009 Issue 15
INDUSTRY NOTES: CMS Scraps Timeliness Advice From Recent CMS-855 Transmittal
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Article Overview
This article summarizes several Medicare administration and compliance developments. It reviews a CMS enrollment transmittal update, discusses a reported fraud case that mentions coding and modifier concerns, and outlines proposed changes affecting durable medical equipment competitive bidding and supplier notice requirements. It is aimed at practices, billing staff, and suppliers following CMS policy and compliance updates.
Why This Topic Matters
The article matters because it tracks CMS and Medicare operational changes that can affect enrollment workflows, compliance risk, and supplier participation in competitive bidding programs.
Article Sections
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CMS enrollment transmittal update
Discusses a CMS enrollment transmittal that was reissued and then rescinded, along with its relevance to Medicare enrollment processes.
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Modifier misuse allegations in a Medicare fraud case
Summarizes allegations involving Medicare billing, reported procedures, and concerns about coding practices in a legal matter.
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Competitive bidding proposals for DME suppliers
Reviews proposed changes affecting durable medical equipment suppliers, including beneficiary notice requirements, grandfathering concepts, and related payment issues.
What You Will Learn
- How CMS updates can affect Medicare enrollment administration
- What types of compliance concerns are raised in a reported modifier misuse case
- What categories of supplier requirements are discussed in the competitive bidding proposals
- Which CMS policy areas are changing or under review
Who Should Read This
- Medical billing professionals
- Practice managers
- Compliance staff
- Durable medical equipment suppliers
- Medicare enrollment staff
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