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

End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials including but not limited to CGS fee schedules, general communications, Part B Medicare Bulletin, and related materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA website.

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

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CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

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

End User License Agreement

These materials contain Current Dental Terminology, Fourth Edition (CDT), copyright © 2002, 2004 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

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2017 DME MAC Jurisdiction B News

NOTE: All articles and announcements for 2017 are available on our Articles Archive Page

July 2017

• Cures Act Claims and Crossovers – 07.21.17
• MLN Connects® for Thursday, July 20, 2017 – 07.20.17
• Scheduled Maintenance to myCGS on July 21, 2017 – 07.20.17
• CGS Continues to Adjust CURES Act Claims! – 07.14.17
• Special Edition – Thursday, July 13, 2017 – 07.14.17
• Condition of Payment Prior Authorization (PA) Program for HCPCs Codes K0856 and K0861 Has Been Expanded Nationally – 07.13.17
• MLN Connects® for Thursday, July 13, 2017 – 07.13.17
• Correct Coding – A5513 Custom Molding Requirements – 07.13.17
• MM9968 CURES Act Mass Adjustment Reminders! – 07.11.17
• CGS Begins MM9968 CURES Act Mass Adjustments! – 07.10.17
• Revised: Extension of the Transition to the Fully Adjusted Durable Medical Equipment Prosthetics, Orthotics, and Supplies Payment Rates Under Section 16007 of the 21st Century Cures Act [MLN Matters MM9968] – 07.06.17
• Revised: Qualified Medicare Beneficiary Indicator in the Medicare Fee-For-Service Claims Processing System [MLN Matters MM9911] – 07.06.17
• MLN Connects® for Thursday, July 6, 2017 – 07.06.17
• The 3rd Quarter 2017 Drug Fees are now available. – 07.03.17
• Updated Repair Modifiers Tool & Spreadsheet – RT & LT Modifier Changes – 07.03.17
• The Summer 2017 DME Jurisdiction B Supplier Manual is now available – 07.03.17
• The Summer 2017 DME MAC Insider is now available – 07.03.17

June 2017

• Using HCPCS Code A9270 With "ROLLATOR" Walkers – 06.30.17
• MLN Connects® for Thursday, June 29, 2017 – 06.29.17
• Modernized National Plan and Provider Enumeration System [MLN Matters SE17016] – 06.29.17
• LCD and Policy Article Summary for June 29, 2017 – 06.29.17
• Targeted Probe and Educate (TPE) Pilot For Jurisdiction B – 06.27.17
• MLN Connects® for Thursday, June 22, 2017 – 06.22.17
• Correct Coding - Center Mount Elevating Leg Rest – 06.22.17
• Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - October 2017 [MLN Matters MM10128] – 06.21.17
• Do You Have Questions? We Have Answers! – 06.20.17
• 21st Century CURES Act Mass Adjustments – What You Need to Know! – 06.19.17
• MLN Connects® for Thursday, June 15, 2017 – 06.15.17
• Requesting Additional Tax IDs in myCGS – 06.13.17
• Revised: New Common Working File (CWF) Medicare Secondary Payer (MSP) Type for Liability Medicare Set-Aside Arrangements (LMSAs) and No-Fault Medicare Set-Aside Arrangements (NFMSAs) [MLN Matters MM9893] – 06.12.17
• Surgical Dressings Comments and Response Summary – 06.08.17
• LCD and Policy Article Summary for June 8, 2017 – Drafts Released to Final – 06.08.17
• MLN Connects® for Thursday, June 8, 2017 – 06.08.17
• Policy Article Revision Summary for June 8, 2017 – 06.08.17
• Top 5 Reasons to Attend the Nashville, TN JB/JC Mega Workshop on June 21, 2017! – 06.06.17
• Lower Limb Prosthetic Covers and Covering Systems - Appropriate Coding and Billing – 06.06.17
• Registering for myCGS—Be Sure to Choose the Correct Role – 06.02.17
• Scheduled End of the Intravenous Immune Globulin (IVIG) Demonstration [MLN Matters SE17008] – 06.01.17
• Policy Article Revisions Summary for June 1, 2017 – 06.01.17
• Attention myCGS Users: Change to EIDM Password Requirements – 06.01.17
• Claim Status Category and Claim Status Codes Update [MLN Matters MM10043] – 06.01.17
• Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) Committee on Operating Rules for Information Exchange (CORE) [MLN Matters MM10041] – 06.01.17
• Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP), and PC Print Update [MLN Matters MM10040] – 06.01.17
• MLN Connects® for Thursday, June 1, 2017 – 06.01.17

May 2017

• Revised: Two New "K" Codes for Therapeutic Continuous Glucose Monitors [MLN Matters MM10013] – 05.31.17
• Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - July 2017 Update [MLN Matters MM10107] – 05.31.17
• Physicians! Are You Ordering Diabetic Shoes for Your Patients? – 05.30.17
• Supplies and Accessories Used With Beneficiary Owned Equipment – 05.30.17
• Learn How Easy It Is To Get Payments Electronically! – 05.30.17
• MLN Connects® for Thursday, May 25, 2017 – 05.25.17
• LCD and Policy Article Revisions Summary for May 25, 2017 – 05.25.17
• Revised: Prohibition on Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) Program [MLN Matters SE1128] – 05.19.17
• Updated Advance Beneficiary Notice – Required for Use June 21, 2017 – 05.19.17
• Glucose Monitors LCD and Related Policy Article – Revised – 05.18.17
• LCD and Policy Article Revisions Summary for May 18, 2017 – 05.18.17
• MLN Connects® for Thursday, May 18, 2017 – 05.18.17
• Revised: New Common Working File (CWF) Medicare Secondary Payer (MSP) Type for Liability Medicare Set-Aside Arrangements (LMSAs) and No-Fault Medicare Set-Aside Arrangements (NFMSAs) [MLN Matters MM9893] – 05.16.17
• Less Paper and Faster Payments! – 05.16.17
• Status Report for Quarter 1 – 2017: HCPCS Code A4253 – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Code A4353 – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Code E0277 – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Code E0570 Service-Specific DCR Prepayment Review – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Code E0601 – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Code E1390 – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Codes E0260, E0294, E0301, E0303, E0912 – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Code J7507 Service-Specific Prepayment Review – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Codes K0001, K0002, K0003, K0004, K0006, K0007, K0008, K0009, E1161, and Accessories E0973, K0195 – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Codes J7605, J7606, J7613, J7620 & J7626 Service-Specific Prepayment Review – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Code L0450-L0640 – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Code A6197-A6199 – 05.15.17
• Status Report for Quarter 1 – 2017: HCPCS Code A6210-A6212 – 05.15.17
• Revised: April Quarterly Update for 2017 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule [MLN Matters MM9988] – 05.12.17
• Are You Signed up to Receive Electronic Remittance Advices? – 05.11.17
• MLN Connects® for Thursday, May 11, 2017 – 05.11.17
• LCD and Policy Article Revisions Summary for May 11, 2017 – 05.11.17
• CGS Summary Article: Extension of the Transition to the Fully Adjusted Durable Medical Equipment, Prosthetics, Orthotics and Supplies Payment Rates under Section 16007 of the 21st Century Cures Act – 05.08.17
• UPDATED Billing Instructions for E2609 (Custom-Fabricated Seat) and E2617 (Custom-Fabricated Back) – 05.05.17
• Revised: Qualified Medicare Beneficiary Indicator in the Medicare Fee-For-Service Claims Processing System [MLN Matters MM9911] – 05.05.17
• Revised: The Process of Prior Authorization [MLN Matters MM9940] – 05.05.17
• July Quarterly Update for 2017 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule [MLN Matters MM10071] – 05.05.17
• Two New "K" Codes for Therapeutic Continuous Glucose Monitors [MLN Matters MM10013] – 05.05.17
• MLN Connects® for Thursday, May 4, 2017 – 05.04.17
• Continuous Glucose Monitors – Frequently Asked Questions – 05.04.17
• LCD and Policy Article Revisions Summary for May 4, 2017 – 05.04.17
• Improvements to the Adjudication Process of Serial Claims [MLN Matters SE17010] – 05.02.17
• Responding to Additional Documentation Requests (ADRs) – 05.01.17

April 2017

• MLN Connects® Special Edition – Friday, April 28, 2017 – 04.28.17
• Scheduled Maintenance to myCGS on April 28, 2017 – 04.27.17
• MLN Connects® for Thursday, April 27, 2017 – 04.27.17
• LCD and Policy Article Revisions Summary for April 27, 2017 – 04.27.17
• Receive Your Medicare Payment Information Faster! – 04.21.17
• Billing Instructions – Continuous Glucose Monitors – 04.20.17
• LCD and Policy Article Revisions Summary for April 20, 2017 – 04.20.17
• MLN Connects® for Thursday, April 20, 2017 – 04.20.17
• The 1st and 2nd Quarter 2017 Drug Fees have been revised. – 04.19.17
• MLN Connects® for Thursday, April 13, 2017 – 04.13.17
• July 2017 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revision to Prior Quarterly Pricing Files [MLN Matters MM10016] – 04.12.17
• Acknowledgement of Your Redetermination Requests – 04.11.17
• Correct Coding – Interferential Current (IFC) Therapy Devices – 04.06.17
• DME Information Forms (DIFs) Usage for Enteral and Parenteral Nutrition and External Infusion Pumps - Revised – 04.06.17
• MLN Connects® for Thursday, April 6, 2017 – 04.06.17
• LCD and Policy Article Revisions Summary for April 6, 2017 – 04.06.17
• Incorrect Denials for Portable Oxygen Equipment – 04.05.17
• The 2nd Quarter 2017 DMEPOS Fee Schedule is now available in Searchable, PDF, and CSV formats. – 04.04.17
• DMEPOS Order Requirements for Changing Suppliers [MLN Matters MM9886] – 04.03.17
• The Spring 2017 DME MAC Insider is now available – 04.03.17
• The Spring 2017 DME Jurisdiction B Supplier Manual is now available – 04.03.17

March 2017

• MLN Connects® for Thursday, March 30, 2017 – 03.30.17
• Temporary Interruption in myCGS and IVR Availability Due to Quarterly System Maintenance: March 31–April 2, 2017 – 03.30.17
• LCD and Policy Article Revisions Summary for March 30, 2017 – 03.30.17
• CGS Listens! Announcing Process Improvements – 03.29.17
• ICD-10 Coding Revisions to National Coverage Determination (NCDs) [MLN Matters MM9861] – 03.29.17
• Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - July 2017 [MLN Matters MM10004] – 03.23.17
• Coding and Coverage – Therapeutic Continuous Glucose Monitors (CGM) – 03.23.17
• MLN Connects® for Thursday, March 23, 2017 – 03.23.17
• Reclassification of Certain DME to the Capped Rental Payment Category – 03.23.17
• LCD and Policy Article Revisions Summary for March 23, 2017 – 03.23.17
• Attention CSI Users: Change in Password Requirements Beginning March 23, 2017 – 03.22.17
• Standard Documentation Requirements for All Claims Submitted to DME MACs – 03.16.17
• Correct Coding and Coverage – Braces Constructed Primarily of Elastic or Other Fabric Materials - Revised – 03.16.17
• MLN Connects® for Thursday, March 16, 2017 – 03.16.17
• LCD and Policy Article Revisions Summary for March 16, 2017 – 03.16.17
• Correct Coding – Interferential Current (IFC) Therapy Devices – 03.16.17
• Items Provided on a Recurring Basis and Request for Refill Requirements – Annual Reminder – 03.16.17
• April Quarterly Update for 2017 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule [MLN Matters MM9988] – 03.13.17
• Completion of Certificates of Medical Necessity – Annual Reminder – 03.09.17
• MLN Connects® for Thursday, March 9, 2017 – 03.09.17
• Reminder – Oxygen Qualification Tests and Documentation – 03.09.17
• Payment for Oxygen Volume Adjustments and Portable Oxygen Equipment [MLN Matters MM9848] – 03.08.17
• CGS Discontinues Medical Review Denial Letters – 03.08.17
• Extension of the Transition to the Fully Adjusted Durable Medical Equipment Prosthetics, Orthotics, and Supplies Payment Rates Under Section 16007 of the 21st Century Cures Act [MLN Matters MM9968] – 03.02.17
• MLN Connects® for Thursday, March 2, 2017 – 03.02.17
• Updates to the "Medicare Claims Processing Manual," Pub. 100-04, Chapters 12, 17 and 23 to Correct Remittance Advice Messages [MLN Matters MM9906] – 03.02.17
• Healthcare Provider Taxonomy Codes (HPTCs) April 2017 Code Set Update [MLN Matters MM9869] – 03.02.17
• Guidance on Implementing System Edits for Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) [MLN Matters MM9904] – 03.02.17
• Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update [MLN Matters MM9878] – 03.01.17

February 2017

• New Common Working File (CWF) Medicare Secondary Payer (MSP) Type for Liability Medicare Set-Aside Arrangements (LMSAs) and No-Fault Medicare Set-Aside Arrangements (NFMSAs) [MLN Matters MM9893] – 02.24.17
• MLN Connects® for Thursday, February 23, 2017 – 02.23.17
• JW Modifier Use – Correct Coding – Revised - Effective for Claims with Dates of Service On or After January 1, 2017 – 02.23.17
• Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program – April 2017 [MLN Matters MM9971] – 02.17.17
• Extension of Payment Change for Group 3 Complex Rehabilitative Power Wheelchairs Accessories and Seat and Back Cushions under Section 16005 of the 21st Century Cures Act [MLN Matters MM9966] – 02.17.17
• Qualified Medicare Beneficiary Indicator in the Medicare Fee-For-Service Claims Processing System [MLN Matters MM9911] – 02.17.17
• MLN Connects® for Thursday, February 16, 2017 – 02.17.17
• Changes to Infusion Drug Reimbursement – 02.16.17
• MLN Connects® for Thursday, February 9, 2017 – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code A4253 – Service-Specific DCR Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code A4253 – Service-Specific Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code A4353 – Service-Specific Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code A6197-A6199 – Service-Specific Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code A6210-A6212 – Service-Specific Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code E0277 – Service-Specific Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code E0570 – Service-Specific DCR Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code E0601 – Service-Specific Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code E1390 – Service-Specific DCR Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code E1390 – Service-Specific Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code E0260, E0294, E0301, E0303, E0912 – Service-Specific Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Code L0637 – Service-Specific Prepayment Review – 02.10.17
• Status Report for Quarter 4 2016: HCPCS Codes K0001, K0002, K0003, K0004, K0006, K0007, K0008, K0009, E1161 and Accessories E0973, K0195 – Service-Specific Prepayment Review – 02.10.17
• Reopenings for Nebulizer Claims due to Diagnosis Codes – 02.08.17
• MLN Connects® for Thursday, February 2, 2017 – 02.03.17

January 2017

• The Process of Prior Authorization [MLN Matters MM9940] – 01.31.17
• Retired: DME Information Forms (DIFs) Usage for Enteral and Parenteral Nutrition and External Infusion Pumps - Revised – 01.19.17
• MLN Connects® for Thursday, January 19, 2017 – 01.19.17
• Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement [MLN Matters MM9771] – 01.18.17
• April 2017 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files [MLN Matters MM9945] – 01.18.17
• MLN Connects® for Thursday, January 12, 2017 – 01.12.17
• 2017 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List [MLN Matters MM9903] – 01.12.17
• Revised: Centers for Medicare & Medicaid Services (CMS) 855S Application - Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers [MLN Matters SE17004] – 01.10.17
• Change to the DME MAC Jurisdiction B Provider Call Center Staff Training Schedule for 2017 – 01.10.17
• Noncovered Items – 01.06.17
• MLN Connects® Provider eNews for Thursday, January 5, 2017 – 01.05.17
• CGS System Maintenance Scheduled Saturday, January 14th: Notice of Service Disruptions – 01.05.17
• Hospital Beds and Pressure Reducing Support Surfaces - Billing Instruction – 01.05.17
• DME MACs LCD Format Change – 01.05.17
• The 1st Quarter 2017 DMEPOS Fee Schedule is now available in Searchable, PDF, and CSV formats. – 01.04.17
• The 1st Quarter 2017 Drug Fees are now available. – 01.03.17
• LCD and Policy Article Revisions Summary for December 29, 2016 – 01.03.17
• The Winter 2017 DME MAC Insider is now available – 01.03.17
• The Winter 2017 DME Jurisdiction B Supplier Manual is now available – 01.03.17
• The acceptance of a voluntary refund as repayment for the claim specified in no way affects or limits the rights of the Federal Government, or any of its agencies or agents, to pursue any appropriate criminal, civil, or administrative remedies arising from or relating to these or any other claims. – 01.03.17

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