November 9, 2023: MLN MM13331: Provider Enrollment Changes to the Medicare Program Integrity Manual
Effective January 1, 2024, Medicare will cover services provided by Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs). CMS advises that providers make sure your billing staff is aware of this change. https://www.cms.gov/files/document/mm13331-provider-enrollment-changes-medicare-program-integrity-manual.pdf
November 13, 2023: MLN MM13278: ICD-10 & Other Coding Revisions to National Coverage Determinations: January 2024 Update - Revised
This article was first released August 9, 2023. With this revision, CMS has added information about CPT codes related to NCD 90.2 (Next Generation Sequencing) and NCD 210.1 (Prostate Screening Tests). https://www.cms.gov/files/document/mm13278-icd-10-other-coding-revisions-national-coverage-determinations-january-2024-update.pdf
November 13, 2023: MLN MM13286: Lymphedema Compression Treatment Items: Implementation
Effective January 1, 2024, there will be a new Medicare DMEPOS benefit category for standard and custom-fitted compression garments and additional lymphedema compression treatment items. This article includes codes, billing, and payment guidance for your billing staff. https://www.cms.gov/files/document/mm13286-lymphedema-compression-treatment-items-implementation.pdf
In addition to reviewing this MLN article, I encourage you to visit CMS’ webpage Lymphedema Compression Treatment Items to learn about what’s covered, how often are the items covered, who is eligible, and the responsibilities and billing guidance for DMEPOS suppliers providing these items. https://www.cms.gov/medicare/payment/fee-schedules/dmepos-fee-schedule/lymphedema-compression-treatment-items
November 21, 2023: MLN MM13272: Edits to Prevent Payment of G2211 with Office/Outpatient Evaluation and Management Visit and Modifier 25
CMS finalized a rule to make the O/O E/M visit complexity add-on code G2211 separately payable by assigning the active status indicator to it, effective January 1, 2024. Note that CMS will not pay when you report an associated O/O E/M visit with modifier 25. https://www.cms.gov/files/document/mm13272-edits-prevent-payment-g2211-office/outpatient-evaluation-and-management-visit-and-modifier.pdf
November 27, 2023: MLN MM13455: New Waived Tests
CMS advises providers to make sure your billing staff know about Clinical Laboratory Improvement Amendments (CLIA) requirements, new CLIA-waived test approved by the FDA, and use of modifier QW for CLIA-waived tests. https://www.cms.gov/files/document/mm13455-new-waived-tests.pdf
