CMS Identified Technical Issues

For claims with dates of service or “Through Dates” on or after April 1, 2013, the issues affect (1) all Home Health final claims, (2) outpatient Critical Access Hospital (CAH) and Rural Health Clinic (RHC) claims where dollars have been applied to the beneficiary deductible, and (3) the remittance advice summary payment amount for Medicare Advantage inpatient prospective payment system (IPPS) claims with indirect medical education (IME).  Actual payments and the claim-level payment amounts on the remittance advice are correct for these Medicare Advantage IPPS IME claims.  Final home health, outpatient CAH and RHC, and Medicare Advantage IPPS IME claims with dates of service or “Through Dates” prior to April 1, 2013, are unaffected.  In addition, for claims pending with or received by the Medicare claims administration contractors on or after April 1, 2013, the issues affect (1) all claims for assistant-at-surgery services, and (2) all Ambulatory Surgical Center claims.  As a result of these issues, CMS has instructed its Medicare claims administration contractors to hold all of these specific claim types until April 14, 2013, when system fixes are expected to be implemented.  These claims will be released into processing on April 15, 2013.  The claim hold should have minimal impact on provider cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 for paper claims) after the date of receipt. 

 

CMS regrets any inconvenience and is working to resolve these issues as quickly as possible.  For more information see http://content.govdelivery.com/bulletins/gd/USCMS-73e463

 

AACE
Guidelines

AACE Clinical Practice Guidelines are systematically developed, evidence-based documents that assist practitioners about appropriate health care decisions

AACE Position Statements

AACE's Position Statements meet rigorous criteria before being published and utilized and serve as one of the worlds' most trusted sources

AACE
Publications

AACE continually strives to bring to the world definitive protocols, guidelines and discoveries which further and enhance the greater medical health of the general public.

Find an Endocrinologist

Find an Endocrinologist in your area by entering a ZIP code, or your city and state using our search feature.