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General 2005

CPT codes, descriptions and other data only are copyright 2005 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature ,descriptors and other data contained therein) is copyright by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

mpr05210 Termination of the Existing Eligibility File-Based Crossover Process at All Medicare Contractors
mpr05209 Healthcare Common Procedure Coding System (HCPCS) Updates to the Fiscal Intermediary Shared System (FISS) Edit for Epoetin Alfa and Darbepoetin Alfa
mpr05208 Telehealth Originating Site Facility Fee Payment Amount Update
mpr05207 Fee Schedule Update for 2006 for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
mpr05206 Medicare’s Implementation of the National Provider Identifier (NPI): The Second in the Series of Special Edition Medlearn Matters Articles on NPI-Related Activities
mpr05205 January 2006 Outpatient Prospective Payment System Code Editor (OPPS OCE) Specifications Version 7.0
mpr05204 January 2006 Non-Outpatient Prospective Payment System Outpatient Code Editor (Non-OPPS OCE) Specifications Version 21.1
mpr05203 January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS) Manual Instruction: Changes to Coding and Payment for Drug Administration -- MANUALIZATION
mpr05202 January 2006 Update of the Hospital Outpatient Prospective Payment System (OPPS) Manual Instruction: Changes to Coding and Payment for Observation
mpr05201 Stem Cell Transplantation
mpr05200 Supplying Fee and Inhalation Drug Dispensing Fee Revisions and Clarifications
mpr05199 Therapy Caps to Be Effective January 1, 2006
mpr05198 Ambulance Inflation Factor for CY 2006
mpr05197 Medical Review Matching of Electronic Claims and Additional Documentation in the Medical Review Process
mpr05196 Resubmission of Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS) Claims with Chronic Renal Failure Comorbid Condition
mpr05195 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2006
mpr05194 Update of Healthcare Common Procedure Coding System (HCPCS) Codes, File Names, Descriptions and Instructions for Retrieving the 2006 Ambulatory Surgical Center (ASC) HCPCS Additions, Deletions, and Master Listing
mpr05193 2006 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment
mpr05192 Auditory Osseointegrated and Auditory Brainstem Devices
mpr05191 Payment Allowances for the Influenza Virus Vaccine (CPT 90655, 90656, 90657, and 90658) and the Pneumococcal Vaccine (CPT 90732) When Payment Is Based on 95 Percent of the Average Wholesale Price (AWP)
mpr05190 January 2006 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective January 1, 2006, and Revisions to January 2005, April 2005, July 2005, and October 2005 Quarterly ASP Medicare Part B Drug Pricing Files
mpr05189 Update to Medicare Deductible, Coinsurance, and Premium Rates for 2006
mpr05188 Remittance Advice Remark Code and Claim Adjustment Reason Code Update
mpr05187 National Monitoring Policy for EPO and Aranesp for End Stage Renal Disease (ESRD) Patients Treated in Renal Dialysis Facilities
mpr05186 Modification of Roster Billing for Mass Immunizers Billing for Inpatient Part B Services (Type of Bills 12X and 22X)
mpr05185 New Condition Codes 49 and 50
mpr05184 Rituximab
mpr05183 Redefined Type of Bill (TOB), 14x, for Non-Patient Laboratory Specimens
mpr05182 Revised October 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective October 1, 2005
mpr05181 Modifiers for Transportation of Portable X-Rays (R0075) When Billed by Skilled Nursing Facilities (SNFs)
mpr05180 Changes for Medicare’s Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Evaluation and Management (E&M) Services Billed by Hospitals to Fiscal Intermediaries (FIs)
mpr05179 Coverage by Medicare Advantage (MA) Plans for Implantable Automatic Cardiac Defibrillator (ICD) Services Not Previously Included in MA Capitation Rates
mpr05178 Use of Value Codes (VCs) 48 and 49 on End Stage Renal Disease (ESRD) Bills
mpr05177 Clarification and Update to Hospital Billing Instructions and Payment for Epoetin Alfa (EPO) and Darbepoetin Alfa (Aranesp) for Beneficiaries with End Stage Renal Disease (ESRD)
mpr05176 Radiation Therapy
mpr05175 Investigational Device Exemptions (IDEs)
mpr05174 Admission Questions to Ask Medicare Beneficiaries
mpr05173 Pamidronate Disodium For Use in Hypercalcemia Associated With Malignancy, With Or Without Bone Metastases
mpr05172 Pamidronate Disodium for Use in Osteoporosis
mpr05171 2006 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments
mpr05170 Smoking and Tobacco-Use Cessation Counseling Services: Common Working File (CWF) Inquiry for Providers
mpr05169 Payment Window Edit Corrections Within the Common Working File (CWF)
mpr05168 MMA - New G Code for Power Mobility Devices (PMDs) RESCINDED
mpr05167 New ICD-9-CM Code for Beneficiaries with Chronic Kidney Disease
mpr05166 Correction to Change Request 3949 to Add 23x Type of Bill
mpr05165 Update to Repetitive Billing Instructions in Medicare Claims Processing Manual
mpr05164 Manual Update on Medical Nutrition Therapy (MNT) Services - Manualization
mpr05163 Medicare Bad Debt Payments
mpr05162 Changes in Inpatient Rehabilitation Facility Prospective Payment System for FY 2006
mpr05161 Inpatient Rehabilitation Facility (IRF) Annual Update - Prospective Payment System (PPS) Pricer Changes for FY 2006
mpr05160 Hospital Audit Workload Updates Related to Medicare Secondary Payer
mpr05158 Implementation of the Centers for Medicare & Medicaid Services (CMS) Ruling 05-01Regarding Presbyopia-Correcting Intraocular Lenses (IOLs) for Medicare
mpr05157 2006 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB)
mpr05156 MMA – Changes to Chapter 29 – General Appeals Process in Initial Determinations
mpr05155 Changes to Chapter 29 - Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Date May 1, 2005)
mpr05154 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2005
mpr05153 MMA - Medicare Health Support Programs (Formerly Known as Medicare Chronic Care Improvement Programs)
mpr05152 Coverage of Aprepitant for Chemotherapy-Induced Emesis
mpr05151 Radiopharmaceutical Diagnostic Imaging Agents Codes Applicable to PET Scan Services Performed on or After January 28, 2005
mpr05150 Medicare Contractor Provider Satisfaction Survey (MCPSS) Fact Sheet
mpr05149 Redesigned Skilled Nursing Facility (SNF) Consolidated Billing (CB) Annual Update File and Discontinuation of the SNF Healthcare Common Procedure Coding System (HCPCS) Help File
mpr05148 Medical Review Additional Documentation Requests (ADRs)
mpr05147 Fiscal Year (FY) 2006 Payment for Services Furnished in Ambulatory Surgical Centers (ASCs)
mpr05146 Requirements for Voided, Canceled, and Deleted Claims
mpr05145 New Mailing Address for Freedom of Information Act (FOIA) Requests
mpr05144 National Modifier and Condition Code to be Used to Identify Disaster Related Claims
mpr05143 Infliximab Re-Probe Review
mpr05142 Financial Liability for Services Subject to Home Health Consolidated Billing
mpr05141 Clarification of the Medicare Requirements for submission of compliant MSP claims as required by HIPAA
mpr05140 October Update to the 2005 Medicare Physician Fee Schedule Database - REVISED
mpr05139 October 2005 Outpatient Prospective Payment System Outpatient Code Editor (OPPS OCE) Specifications Version 6.3
mpr05138 October 2005 Quarterly Fee Schedule Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
mpr05137 October 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)
mpr05136 Enforcement of Hospital Inpatient Bundling: Carrier Denial of Ambulance Claims During an Inpatient Stay
mpr05135 New mailing P.O. Box for all PA Part A claims
mpr05134 October Update to the 2005 Medicare Physician Fee Schedule Database
mpr05133 Change in the Provider Service Center Phone Numbers
mpr05132 October 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File and Revisions to April 2005 Quarterly ASP Medicare Part B Pricing File, Effective October 1, 2005
mpr05131 Claim Status Code/Claim Status Category Code Update
mpr05130 Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2006
mpr05129 New Fiscal Intermediary Edit to Identify Potentially Excessive Medicare Payments
mpr05128 Late Submission Penalty Protocol Within the Inpatient Rehabilitation Facility Prospective Payment System
mpr05127 Medicare Provider Feedback Town Hall Meeting
mpr05125 Billing for the Administration of Drugs and Biologicals (specifically Low Osmolar Contrast Material (LOCM)) in a Method II Critical Access Hospital (CAH) RESCINDED
mpr05124 New HCPCS Codes and System Edits for Supplies and Accessories for Ventricular Assist Devices – Full Replacement of CR3761
mpr05123 Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus (PPV), Influenza Virus, and Hepatitis B Virus) and their Administration at Renal Dialysis Facilities (RDFs)
mpr05122 Remittance Advice Remark Code and Claim Adjustment Reason Code Update
mpr05121 Irinotecan Re-Probe Review
mpr05120 Update to Current National Uniform Billing Committee (NUBC) Codes
mpr05119 Modification of FISS Edits for Colorectal Cancer Screening Services (HCPCS Codes G0104, G0106, G0107, G0120, and G0328) Furnished at Skilled Nursing Facilities (SNFs)
mpr05118 The Number of Durable Medical Equipment Pricing Files That Must Be Maintained Online for Medicare – DMERC, FI, and RHHI Only
mpr05117 July 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS)
mpr05116 Cochlear Implantation
mpr05115 Coverage and Billing for Ultrasonic Stimulators for Nonunion Fracture Healing
mpr05114 Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
mpr05113 Update of Healthcare Common Procedure Coding System (HCPCS) Codes and File Names, Descriptions, and Instructions for Retrieving the 2005 Ambulatory Surgical Center (ASC) HCPCS Additions, Deletions, and Master Listing
mpr05112 Instructions to Revise the Comprehensive Error Rate Testing (CERT) Shared System Module Including Instructions to Install and Operate the Revised CERT Module for Calculating Fiscal Intermediary (FI) Line Level Error Rates
mpr05111 National Provider Identifier and Medicare Remittance Advice Initiative
mpr05110 New Healthcare Common Procedure Coding System (HCPCS) Drug Codes
mpr05109 An Algorithmic Approach to Determine if Mobility Assistive Equipment Is Reasonable and Necessary for Medicare Beneficiaries with a Personal Mobility Deficit (CR 3791 - Mobility Assistive Equipment (MAE))
mpr05108 Contacts at Highmark Medicare Services
mpr05107 Rituximab Pre-Pay Service Specific Re-Probe
mpr05106 July 2005 Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) Specifications Version 6.2
mpr05105 Smoking and Tobacco Use Cessation Counseling
mpr05104 July Quarterly Update to 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
mpr05103 Updated Requirements for Autologous Stem Cell Transplantation (AuSCT) for Amyloidosis
mpr05101 July Quarterly Update for 2005 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule
mpr05100 MMA – New April 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File and Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File
mpr05099 New Patient Status Code to Define Discharges or Transfers to a Critical Access Hospital (CAH)
mpr05098 Posters Regarding Medicare Prescription Drug Coverage Now Available For Display
mpr05097 Revisions to the Medicare Benefit Policy Manual (Pub 100-02), Chapter 15, Sections 220 and 230 Regarding Therapy Services
mpr05096 Clarifying Manual Instructions for Coding and Payment for Drug Administration Under the Hospital Outpatient Prospective Payment System (OPPS)
mpr05095 Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA)
mpr05094 Provider Notification Regarding National Provider Identifier (NPI)
mpr05093 July Update to the 2005 Medicare Physician Fee Schedule Database
mpr05092 Payments to Ambulatory Surgery Centers (ASCs) for New CPT Code 66711
mpr05091 Correction of 2005 Payment Fees for Clinical Laboratory Travel – Codes P9603 and P9604
mpr05090 Billing for Hemophilia Blood Clotting Factors (Medicare Claims Processing Manual (Pub. 100-04), Chapter 17, Section 80.4)
mpr05089 Fiscal Intermediary (FI) Reporting of Add-on-Payments That Do Not Result in a Specific Increase or Decrease in the Amount Reported as Payable for a Claim or a Service on a Remittance Advice
mpr05088 Teaching Adjustment for the Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS)
mpr05087 Expansion of Various Alpha and Numeric Fields Within the Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE)
mpr05086 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2005
mpr05085 Correction to the Use of Group Codes for the Enforcement of Mandatory Electronic Submission of Medicare Claims
mpr05084 July Quarterly Update for 2005 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule
mpr05083 New HCPCS Codes and System Edits for Supplies and Accessories for Ventricular Assist Devices
mpr05082 Healthcare Provider Taxonomy Code (HPTC) Update
mpr05081 Abarelix for the Treatment of Prostate Cancer

mpr05080

MMA - July 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective July 1, 2005
mpr05079 MMA - Implementation of the Physician Scarcity Area (PSA) Bonus and Revision to the Health Professional Shortage Area (HPSA) Payment to a Critical Access Hospital (CAH)
mpr05078 MMA - Revisions to Medicare Appeals Process for Fiscal Intermediaries (CR Title-Appeals Transition – BIPA 521 Appeals)
mpr05077 Outpatient Therapy Services (Physical, Occupational, and Speech-Language Pathology Therapies) - RETIRED
mpr05076 Expanded Coverage for PET Scans for Cervical and Other Cancers, New Coding for PET Scans, and Billing Requirements for PET Scans for Specific Indications of Cervical and Other Cancers
mpr05075 Clarification for Change Request (CR) 3267
mpr05074 Medicare Announces Delay in Processing Certain Claims No Later Than April 18, 2005
mpr05073 MMA - Clarification for Outpatient Prospective Payment System (OPPS) Hospitals Billing the Initial Preventive Physical Exam (IPPE)
mpr05072 MMA - April 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes
mpr05071 Inquiries to the Provider Service Center for Non Claim Related Inquiries – Update to Provider Notice 04 - 090
mpr05070 Modification to the Fiscal Intermediary Standard System (FISS) Regarding Ambulance Services Billed on 18x and 21x Types of Bill (TOB)
mpr05069 New HCPCS Codes for Intravenous Immune Globulin (IVIG)
mpr05068 Anti-Cancer Chemotherapy for Colorectal Cancer
mpr05067 Update to Fiscal Year (FY) 2005 Pricer for Inpatient Prospective Payment System (IPPS) Hospitals
mpr05065 Inpatient Rehabilitation Facility  (IRF) Service-Specific Probe Review
mpr05064 New Contrast Agents Healthcare Common Procedure Coding System (HCPCS) Codes
mpr05063 Claims Edited by CWF for Medicare Beneficiaries in State or Local Custody Under a Penal Authority
mpr05062 Clinical Implications Related to the Inpatient Psychiatric Facility Prospective Payment System
mpr05061 Billing for Implantable Automatic Defibrillators for Beneficiaries in a Medicare Advantage (MA) Plan and Use of the QR Modifier to Identify Patient Registry Participation
mpr05060 April 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File, Effective April 1, 2005, and New January 2005 Quarterly ASP File
mpr05059 Levocarnitine for use in the Treatment of Carnitine Deficiency in End Stage Renal Disease (ESRD) Patients – Clarification of Coverage
mpr05058 MMA - Diabetes Screening Tests
mpr05057 Claims Status Code/Claims Status Category Code Update
mpr05056 April 2005 Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) Specifications Version 6.1
mpr05055 Deletion of Inactive Highmark Medicare Services LAN User IDs
mpr05054 Calculating Payment-to-Cost Ratios (PCR) for Purposes of Determining Transitional Corridor Payments under the Outpatient Prospective Payment System (OPPS)
mpr05053 Coordination of Benefits Agreement (COBA) Detailed Error Report Notification Process
mpr05052 Update - Coordination of Benefits (COB) and Claims Crossover
mpr05050 Medicare Secondary Payer (MSP) Cost Avoided Claims
mpr05049 Proposed FY 2006 Wage Index Files Availability and Correction Process
mpr05048 Update of Healthcare Common Procedure Coding System (HCPCS) Codes and File Names, Descriptions, and Instruction for Retrieving the 2005 Ambulatory Surgical/Surgery Center (ASC) HCPCS Deletions and Master Listing
mpr05047 1st Update to the 2005 Medicare Physician Fee Schedule Database
mpr05046 MMA- Revisions to Payment for Services Provided Under a Contractual Arrangement
mpr05045 Infusion Pumps: C-Peptide Levels as a Criterion for Use
mpr05044 Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 11.1, Effective April 1, 2005
mpr05043 MMA - Processing Durable Medical Equipment (DME), Orthotics, Prosthetics, Drugs, and Surgical Dressings Claims for Indian Health Services (IHS) and Tribally Owned and Operated Hospitals or Hospital-Based Facilities including Critical Access Hospitals (CAHs)
mpr05042 Interest Payment on Clean Claims Not Paid Timely
mpr05041 Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File
mpr05040 Update to 100-04 and Therapy Code Lists
mpr05039 Intensity Modulated Radiotherapy (IMRT) Re-Probe Review
mpr05038 Standardization of Fiscal Intermediary Use of Group and Claim Adjustment Reason Codes and Calculation and Balancing of TS2 and TS3 Segment Data Elements
mpr05037 Full Replacement of Change Request 3427, Transmittal 342, Issued on October 29, 2004 - Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site
mpr05036 Psychotherapy Notes
mpr05035 Modification to Online Medicare Secondary Payer Questionnaire
mpr05034 Hepatitis B Surface B Antibody, HCPC CPT 86706
mpr05033 Hospital Outpatient Prospective Payment System (OPPS): Use of Modifiers –52, –73 and –74 for Reduced or Discontinued Services
mpr05032 April 2005 Quarterly Fee Schedule Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
mpr05031 Updating the Common Working File (CWF) Editing for Pap Smear (Q0091) and Adding a New Low Risk Diagnosis Code (V72.31) for Pap Smear and Pelvic Examination
mpr05030 Remittance Advice Remark Code and Claim Adjustment Reason Code Update
mpr05029 Counterpulsation (ECP) for Severe Angina
mpr05028 Influenza Treatment Demonstration
mpr05027 Update to Fiscal Year 2005 Wage Index for Inpatient Prospective Payment System (IPPS) and Outpatient Prospective Payment System (OPPS) Hospitals
mpr05026 Fiscal Intermediary (FI) Standard Paper Remittance (SPR) Advice Changes
mpr05025 MMA - Payment of Ambulance Services to Indian Health Service (IHS)/Tribal Hospitals
mpr05024 Revisions to January 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File
mpr05023 Procedures for Unsolicited/Voluntary Refund Checks Submitted to the Medicare Program
mpr05022 Irinotecan Service Specific Probe
mpr05021 Medical Review (MR) of Rural Air Ambulance Services
mpr05020 Administrative Simplification Compliance Act (ASCA) Enforcement of Mandatory Electronic Submission of Medicare Claims
mpr05019 Update to Billing Requirements for Positron Emission Tomography (PET) Scans for Dementia and Neurodegenerative Diseases and Update for Special Payment Procedures for all PET Scan Services Performed in Critical Access Hospitals
mpr05018 Modification to Reporting of Diagnosis Codes for Screening Mammography Claims
mpr05017 Denials Due to Insufficient Documentation from the CERT Contractor
mpr05016 Zoledronic Acid (Zometa) Service Specific Re-Probe
mpr05015 MMA - January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes
mpr05014 Pamidronate Disodium
mpr05013 Nesiritide
mpr05012 Health Care Eligiblity/Benefit Inquiry and Response
mpr05011 Payment for Referred Laboratory Automated Multi-Channel Chemistry (AMCC) Tests
mpr05010 Ambulance Fee Schedule – Medical Conditions List
mpr05009 MMA - 2005 Drug Administration Coding Revisions
mpr05008 Skilled Nursing Facility (SNF) Consolidated Billing Service Furnished Under an“Arrangement”with an Outside Entity
mpr05007 Full Replacement of CR 3308, Fiscal Intermediary Shared System (FISS) Changes to Allow for Provider Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills
mpr05006 Ambulance Inflation Factor
mpr05005 January 2005 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of OPPS Outpatient Code Editor (OCE) Data Changes and OPPS PRICER Logic; Changes to Payment for Diagnostic Mammography
mpr05004 Emergency Update to the 2005 Medicare Physician Fee Schedule
mpr05003 Extension of Interrupted Stay Policy Under Long Term Care Hospital (LTCH) Prospective Payment System (PPS)
mpr05002 MMA - Use of Group Health Plan Payment System to Pay Capitated Payments to Chronic Care Improvement Organizations Serving Medicare Fee-For-Service Beneficiaries Under Section 721 of the MMA
mpr05001 MMA - Initial Preventive Physical Examination

 

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