License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

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This license will terminate upon notice to you if you violate the terms of this license. The AMA is a third party beneficiary to this license.

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

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Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT-4 only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT-4 is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT-4. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
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July 27, 2015

Requesting an Exception for Untimely Notices of Election (NOEs)

The following addresses issues seen by the CGS claims department when reviewing provider documentation submitted for hospice request for exception of untimely notices of election (NOEs). Please share this information with your billing staff.

It is important that your documentation identifies the beneficiary and the claim to which the request applies. In addition, it is also helpful to include a contact name and phone number in case the CGS claims department needs to contact your agency.
The requirements in Change Request (CR) 8877 are effective for dates of service on/after October 1, 2014. Some provider documentation being submitted with exception requests include a copy of Section 20.1.1 of the Centers for Medicare & Medicaid Services (CMS) Pub. 100-04, Ch. 11. Section 20.1.1 of that manual currently shows (in red font), "(Rev. 3118, Issued: 11-16-14, Effective: 10-01-14, Implementation: 04-06-15)". The provider documentation implies that their claim was before the 04-06-15 implementation date and therefore does not apply to the CR 8877 timely NOE requirements. Please note that the Rev. 3118 (the Transmittal number) is not related to the requirements in CR 8877; therefore, in this case the exception request is denied.

NOTE: At the end of each chapter of the CMS internet only manuals (IOMs), you will find a list of "Transmittals Issued for this Chapter". Transmittals are listed along with the issued date, subject, implementation date, and CR#. This is a great resource to reference to determine what revisions have been made to each section in a chapter.

License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

AMA Disclaimer of Warranties and Liabilities.

CMS Disclaimer

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

Requesting an Exception for Untimely Notices of Election (NOEs)

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