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CMS Manual System  Department of Health & Human Services (DHHS)  Pub 100 -20 One -Time Notification  Centers for Medicare & Medicaid Services (CMS)  Transmittal  727 Date: July 9, 2010   Change Request 6912   Transmittal 725, dated July 2, 2010 is rescinded  and replaced by Transmittal 727, dated July 9, 2010. The implementation date and July 2010 reporting requirements are being changed in order to give contractors sufficient time to mail the notification letters to the affected providers. Additionally, Code 72200 is being removed from the list of CPT codes because it is a standard x- ray code and is not a code used for advanced diagnostic im aging services.  All other information remains the same.  SUBJECT: Mailing To All Individual Practitioners, Medical Groups and Clinics and Independent Diagnostic Testing Facilities (IDTF) Who Are Billing or Have Billed For Advanced Diagnostic Imaging Services.  I. SUMMARY OF CHANGES: The Centers for Medicare and Medicaid Services (CMS) and its Medicare carriers and Medicare Administrative Contractors (A/B MACs) provide general outreach to physicians, non-physician practitioners and other provider and supplier types about their enrollment and reporting responsibili ties.  The attached letter will inform enrolled physicians, non -physician practitioners and independent diagnostic testing facilities (IDTFs) about the need to become accredited to continue to furnish advanced diagnostic imaging services to Medicare benefi ciaries on or after January 1, 2012.  EFFECTIVE DATE: August 2, 2010  IMPLEMENTATION DATE: August 13, 2010  Disclaimer for manual changes only: The revision date and transmittal number apply only to red i talicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents.  II. CHANGES IN MANUAL I NSTRUCTIONS: (N/A if manual is not updated)  R=REVISED, N=NEW, D=DELETED- Only One Per Row.   R/N/D  CHAPTER / SECTION / SUBSECTION / TITLE  N/A   III. FUNDING:  For Fiscal Intermediaries (FIs), Regional Home Health Intermediaries (RHHIs) and/or Carriers:  No additional funding will be provided by CMS; Contractor activities are to be carried out within their operating budgets.   For Medicare Administrative Contractors (MACs):  The Medicare Administrative Contractor is hereby advised that this constitutes tec hnical direction as defined in your contract. CMS does not construe this as a change to the MAC Statement of Work. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by  the Contracting Officer. If the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in question and immediately notify the Contracting Officer, in wr iting or by e -mail, and request formal directions regarding continued performance requirements.   IV. ATTACHMENTS:   One-Time Notification     *Unless otherwise specified, the effective date is the date of service.  Attachment  One-Time Notification   Pub. 100 -20 Transmittal: 727 Date: July 9 , 2010  Change Request:  6912   Transmittal 725, dated July 2, 2010 is rescinded  and replaced by Transmittal 727, dated July 9, 2010. The implementation date and July 2010 reporting requirements are being changed in order to give contractors sufficient time to mail the notification letters to the affected providers. Additionally, Code 72200 is being removed from the list of CPT codes because it is a standard x- ray code and is not a c ode used for advanced diagnostic imaging services.  All other information remains the same.  SUBJECT :  Mailing T o All Individual Practitioners, Medical Groups and Clinics and Independent Diagnostic Testing Facilities (IDTF) Who Are Billing or Have Billed For  Advanced Diagnostic Imaging Services    Effective Date:  August 2, 2010  Implementation Date:   August 13, 2010   I. GENERAL INFORMATION  A. Background :  The  Centers for Medicare & M edicaid S ervices  (CMS) and its  Medicare carriers and Medicare Administrative Contractors (A/B MACs)  provide  general outreach  to physicians , non- physician practitioners and other provider and supplier types about the ir enrollment and reporting responsibilities.   The attached  letter will inform enrolled physicians, n on-physician practitioners and i ndependent diagnostic t esting facilities  (IDTFs) about the need to become accredited to continue to furnish a dvanced diagnostic i maging services to Medicare beneficiaries on or after January 1, 2012.   B. Policy:   Section 135(a) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) amended section 1834(e) of the Social Security Act and required the Secretary to designate organizations to accredit suppliers, including but not limited to physicians, non- physician practit ioners and Independent Diagnostic Testing Facilities, that furnish the technical component (TC) of advanced diagnostic imaging services.   MIPPA specifically defines advanced diagnostic imaging procedures as including diagnostic magnetic resonance imaging ( MRI), computed tomography (CT), and nuclear medicine imaging such as positron emission tomography (PET).  The law also authorizes the Secretary to specify other diagnostic imaging services in consultation with physician specialty organizations and other st akeholders.  MIPPA expressly excludes from the accreditation requirement x -ray, ultrasound, and fluoroscopy procedures.  The law also excludes from the CMS accreditation requirement diagnostic and screening mammography which are subject to quality oversight by the Food and Drug Administration under the Mammography Quality Standards Act.  II. BUSINESS REQUIREMENTS  TABLE   Use Shall"  to denote  a mandatory requirement   Number  Requirement  Responsibility (place an X in each applicable column)    A/B DME FI CARRHHShared -System Maintainers  OTHER  MAC  MAC RIER I FISS MCS VMS CWF 6912. 1 Contractors shall send the attached letter 5 times to enrolled physician s, non- physician practitioner s, including single and multi -specialty clinics,  and IDTFs  who have bil led the Medicare program for advanced diagnostic testing services (see attached related CPT Codes) within the preceding six month period and continues to have Medicare billing privileges with the contractor.  X   X       6912. 1.1 The mailing s shall occur i n August  and October of 2010 and January, April and July of 2011.  X   X       6912. 1.2 When more than one physician or non -physician practitioner is operating within a group, such as a single specialty or multispecialty clinic, only the group shall  receiv e the letter, not each of the individual physicians or non- physician practitioners working for the group.  X   X       6912. 1.3 If any additional suppliers not listed above submit claims for advanced diagnostic testing  during this initiative, the contracto r shall include that supplier in the next quarterly mailing.  X   X       6912. 2 Contractors shall not mail the attached letter to any supplier with an inactive Medicare billing status . X   X       6912. 3 Contractors shall use the Pay To or Practice Locat ion address found in the Multi -Carrier  System ( MCS ) when mailing this letter to a physician, non- physician practitioner or IDTF with approved PECOS enrollment record.  X   X       6912. 3.1 Contractors shall retrieve and use the Pay To or Practice Location address found in the  Multi- Carrier System for suppliers described above furnishing advance diagnostic testing services that  do not have an enrollment record in PECOS. X   X       6912.3.2  To simplify operations, the contractor shall  extract all addresses for these mailings from the MCS.  X   X       6912. 4 Contractors shall reproduce the attached letter on their own Medicare letterhead  and mail in standard envelope s. X   X       6912. 4.1 Contractors shall complete the letter with the appropriate date, nam e, address, contact and signature prior to mailing.  X   X       6912. 5 Contractors shall not take any action for returned letters outside of placing them in the provider file . X   X       6912. 6 Contractors shall complete the first mailing by August 13, 2010 and each subsequent  mailing within 10 days of the calendar quarter  through July 2011.  X   X        III. PROVIDER EDUCATION TABLE   Number Requirement  Responsibility (place an X in each applicable column)    A/B  MAC DME  MAC FI CARRIER RHHI Shared -System Maintainers  OTHER FISS MCS VMS CWF 6912. 7 A provider education article related to this instruction will be available at http://www.cms .hhs.gov/MLNMattersArticles/  shortly after this CR is released.  You will receive notification of the article release via the established "MLN Matters" listserv.  Contractors shall post this article, or a direct link to this article, on their Web site and  include information about it in a listserv message within one week of the availability of the provider education article.  In addition, the provider education article shall be included in your next regularly scheduled bulletin.  Contractors are free to supplement MLN Matters articles with localized information that would benefit their provider community in maintaining Medicare provider enrollment data correctly.  X   X         IV. SUPPORTING INFORMATION  Section A:  For any recommendations and supporting information associated with listed requirements , use the box below:  Use "Should" to denote a recommendation.  X-Ref  Requirement Number  Recommendations or other supporting information:  N/A    Section B :  For all other recommendations and supporting informa tion,  use this space :    N/A   V. CONTACTS   Pre-Implementation Contact(s):  August Nemec  OFM/DPSE ( 410) 786- 0612  Post-Implementation Contact(s):  August Nemec  OFM/DPSE ( 410) 786- 0612   VI. FUNDING   Section A:  For Fiscal Intermediaries  (FIs) , Carri ers, a nd Regional Home Health  Intermediaries  (RHHIs) :  No additional funding will be provided by CMS; contractor activities are to be carried out within their operating budgets.   Section B:  For Medicare Administrative Contractors (MAC s): The Medicare Administrativ e Contractor is hereby advised that this constitutes technical direction  as defined in your contract. CMS  does  not construe this as a change to the MAC Statement of W ork. The contractor is not obligated to incur costs in excess of the amounts allot ted in your contract unless and until specifically authorized by the Contracting Officer. If the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in questi on and immediately notify the Contracting Officer, in writing or by e -mail, and request formal directions regarding continued performance requirements.    ATTACHMENTS (2)  Supplier Billed Advanced Medical Imaging CPT codes for Section 135 (a) of the MIPPA t o Receive Accreditation Requirement Notification Letter   70336  70540  71250  72125  73200  74150 70450  70542  71260  72126  73201  74160 70460  70543  71270  72127  73202  74170 70470  70544  71275  72128  73206  74175 70480  70545  71550  72129  73218  74181 70481  70546  71551  72130  73219  74182 70482  70547  71552  72131  73220  74183 70486  70548  71555  72132  73221  74185 70487  70549    72133  73222 70488  70551    72141  73223 70490  70552    72142  73225 70491  70553    72146  73700 70492  70554    72147  73701 70496  70555    72148  73702 70498  70557    72149  73706