evekhm/cms_iom_500 huggingface dataset:
(Medicare Claims Processing Manual)
by Transmittal 2614 11/27/2012  8097 R2570CP  10/26/2012  Annual Type of Service (TOS) Update  Rescinded and replaced by Transmittal 2598 01/07/2013  8082 R2563CP  10/11/2012  Revised and Clarified Place of Service (POS) Coding Instructions  Rescinded and replaced by Transmittal 2613 04/01/2013  7631 R2561CP  09/28/2012  Revised and Clarified Place of Service (POS) Coding Instructions  Rescinded and replaced by Transmittal 2563 04/01/2013  7631 R2516CP  08/10/2012  New Non -Physician Specialty Code for Centralized Flu  01/07/2013  7884 R2462CP  04/27/2012  New Physician Specialty Code for Sleep Medicine and Sports Medicine  10/01/2012  7600 R2435CP  03/29/2012  Revised and Clarified Place of Service (POS) Coding Instructions  Rescinded and replaced by Transmittal 2561 10/01/2012  7631 Rev #  Issue Date  Subject  Impl Date  CR#  R2407CP  02/03/2012  Revised and Clarified Place of Service (POS) Coding Instructions  Rescinded and replaced by Transmittal 2435 04/02/2012  7631 R2375CP  12/22/2011  Annual Type of Service (TOS) Update  01/03/2012  7586 R2325CP  10/26/2011  Annual Type of Service (TOS) Update  Rescinded and replaced by Transmittal 2375 01/03/2012  7586 R2284CP  08/26/2011  Clarification to Chapter 26, Section 10- 4-Items 14 -33-Provider of Service or Supplier Information  09/26/2011  7538 R2261CP  07/29/2011  Affordable Care Act  Section 3113  Laboratory Demonstration for Certain Complex Diagnostic Tests (This CR fully rescinds and replaces CR 7413)  01/03/2012  7516 R2248CP  06/24/2011  New Specialty Code for Advanced Diagnostic Imaging Accreditation  04/01/2011  7175 R2226CP  05/20/2011  Affordable Care Act -Section 3113-Laboratory Demonstration for Certain Complex Diagnostic Tests (This CR fully rescinds and replaces CR 7278)  This CR rescinded and replaced by CR 7516, Transmittal 2261
(Medicare Claims Processing Manual)
Affordable Care Act -Section 3113-Laboratory Demonstration for Certain Complex Diagnostic Tests (This CR fully rescinds and replaces CR 7278)  This CR rescinded and replaced by CR 7516, Transmittal 2261  01/03/2012  7413 R2204CP  04/29/2011  Type of Service (TOS) Corrections  10/03/2011  7407 R2192CP  04/12/2011  New Specialty Code for Advanced Diagnostic Imaging Accreditation  Rescinded and replaced by Transmittal 2248 07/05/2011  7175 R2191CP  04/08/2011  New Specialty Code for Advanced Diagnostic Imaging Accreditation  Rescinded and replaced by Transmittal 2192 07/05/2011  7175 Rev #  Issue Date  Subject  Impl Date  CR#  R2173CP  03/11/2011  Affordable Care Act  Section 3113  Laboratory Demonstration for Certain Complex Diagnostic Tests  Rescinded and replaced by CR 7413, Transmittal 2226 7/05/2011 7278 R2162CP  02/22/2011  Updates to the Internet Only Manual Pub. 100-04, Chapter 1 -  General Billing Requirements, Chapter 15 -  Ambulance, and Chapter 26 -  Completing and Processing Form CMS -1500 Data Set  03/21/2011  7018 R2144CP  01/28/2011  Affordable Care Act  Section 3113  Laboratory Demonstration for Certain Complex Diagnostic Tests  Rescinded and replaced by Transmittal 2173 7/05/2011 7278 R2126CP  12/23/2010  Annual Type of Service (TOS) Update  01/03/2011  7185 R2124CP  12/23/2010  Updates to the Internet Only Manual Pub. 100-04, Chapter 1 -  General Billing Requirements, Chapter 15 -  Ambulance, and Chapter 26 -  Completing and Processing Form CMS -1500 Data Set -  Rescinded and replaced by Transmittal 2162 01/25/2011  7018 R2103CP  11/19/2010  Fractional Mileage Units Submitted on Ambulance Claims  01/03/2011  7065 R2098CP  11/19/2011  New Physician Specialty Codes for Cardiac Electrophysiology and Sports Medicine  04/04/2011  7209 R2079CP  10/29/2010  New Specialty Code for Advanced Diagnostic Imaging Accreditation  Rescinded and replaced by Transmittal 2191 04/04/2011  7175 R2072CP  10/22/2010  Annual Type
(Medicare Claims Processing Manual)
7209 R2079CP  10/29/2010  New Specialty Code for Advanced Diagnostic Imaging Accreditation  Rescinded and replaced by Transmittal 2191 04/04/2011  7175 R2072CP  10/22/2010  Annual Type of Service (TOS) Update  Rescinded and replaced by Transmittal 2126 01/03/2011  7185 Rev #  Issue Date  Subject  Impl Date  CR#  R2065CP  10/15/2010  Fractional Mileage Units Submitted on Ambulance Claims  Rescinded and replaced by Transmittal 2103 01/03/2011  7065 R2041CP  08/31/2010  Revisions to Claims Processing Instructions for Services Rendered in Place of Service Home  01/03/2011  6947 R2035CP  08/27/2010  Change Physician Specialty Code 12 to Osteopathic Manipulative Medicine  01/03/2011  6890 R2030CP  08/20/2010  New Durable Medical Equipment, Prosthetics. Orthotics, and Supplies (DMEPOS) Specialty Code for Ocularists  01/03/2011  6891 R2029CP  08/13/2010  Fractional Mileage Units Submitted on Ambulance Claims  Rescinded and replaced by Transmittal 2065 01/03/2011  7065 R2015CP  07/30/2010  Revisions to Claims Processing Instructions for Services Rendered in Place of Service Home -  Rescinded and replaced by Transmittal 2041. 01/03/2011  6947 R2003CP  07/19/2010  New Physician Specialty Code for Geriatric Psychiatry  04/05/2010  6533 R1974CP  05/21/2010  Cardiac Rehabilitation and Intensive Cardiac Rehabilitation  10/04/2010  6850 R1970CP  05/21/2010  Updated Form CMS -1500 Information  10/04/2010  6929 R1931CP  03/12/2010  Revision of the Internet Only Manual (IOM) to Remove References to Purchased Diagnostic Test and Replace With Language Consistent With the Anti -Markup Rule  06/14/2010  6627 R1910CP  02/05/2010  Type of Service (TOS) Corrections  04/05/2010  6835 Rev #  Issue Date  Subject  Impl Date  CR#  R1873CP  12/11/2009  Place of Service (POS) and Date of Service (DOS) Instructions for the Interpretation (Professional Component) and Technical Component of Diagnostic Tests -  Rescinded
(Medicare Claims Processing Manual)
Issue Date  Subject  Impl Date  CR#  R1873CP  12/11/2009  Place of Service (POS) and Date of Service (DOS) Instructions for the Interpretation (Professional Component) and Technical Component of Diagnostic Tests -  Rescinded  01/04/2010  6375 R1869CP  12/11/2009  New Place of Service (POS) Code for Walk -in Retail Health Clinic  03/11/2010  6752 R1836CP  10/27/2009  New Physician Specialty Code for Geriatric Psychiatry   Rescinded and replaced by Transmittal 2003  04/05/2010  6533 R1830CP  10/16/2009  Annual Type of Service (TOS) Update  01/04/2010  6693 R1823CP  10/02/2009  Place of Service (POS) and Date of Service (DOS) Instructions for the Interpretation (Professional Component) and Technical Component of Diagnostic Tests  Rescinded and replaced by Transmittal 1873 01/04/2010  6375 R1806CP  08/28/2009  October 2009 Update to the Ambulatory Surgical Center (ASC) Payment System; Summary of Payment Policy Changes  10/05/2009  6629 R1725CP  05/01/2009  Requirements for Specialty Codes  07/06/2009  6303 R1715CP  04/24/2009  New Physician Specialty Code for Hospice and Palliative Care  10/05/2009  6311 R1686CP  02/20/2009  New Non -Physician Practitioner Specialty Code for Speech Language Pathologists  07/06/2009  6292 R1638CP  11/20/2008  Annual Type of Service (TOS) Update  01/05/2009  6272 R1637CP  11/14/2008  Annual Type of Service (TOS) Update -  Rescinded and replaced by Transmittal 1638 01/05/2009  6272 R1586CP  09/05/2008  Pneumococcal Pneumonia, Influenza Virus, and Hepatitis B Vaccines  10/06/2008  6079 Rev #  Issue Date  Subject  Impl Date  CR#  R1552CP  07/18/2008  VMS Recognition of New Specialty Codes for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) With Pedorthic Personnel, Medical Supply Companies With Pedorthic Personnel, and Rehabilitation Agencies.  (DME MACs Only)  01/05/2009  5930
(Medicare Claims Processing Manual)
Prosthetics, Orthotics and Supplies (DMEPOS) With Pedorthic Personnel, Medical Supply Companies With Pedorthic Personnel, and Rehabilitation Agencies.  (DME MACs Only)  01/05/2009  5930 R1481CP  03/21/2008  Type of Service (TOS) Corrections  04/07/2008  5977 R1432CP  02/01/2008  Medicare Fee for Service Legacy Provider IDs Prohibited on Form CMS -1500 and Form CMS -1450 (UB -04) Claims  04/07/2008  5858 R1420CP  01/25/2008  Clarification Regarding the Coordination of Benefits Agreement (COBA) Medigap Claim- Based Crossover Process  02/01/2008  5837 R1412CP  01/11/2008  Reporting of Hematocrit or Hemoglobin Levels on All Claims for the Administration of Erythropoiesis Stimulating Agents (ESAs), Implementation of New Modifiers for Non -ESRD Indications, and Reporting of Hematocrit/Hemoglobin Levels on all Non-ESRD, Non -ESA Claims Requesting Payment for Anti -Anemia Drugs  04/07/2008  5699 R1410CP  01/11/2008  Annual Type of Service (TOS) Update  01/07/2008  5838 R1401CP  12/21/2007  Medicare Shared Systems Modifications Necessary to Accept and Crossover to Medicaid National Drug Codes (NDC) And Corresponding Quantities Submitted on Form CMS -1500 Paper Claims  04/07/2008  5835 R1398CP  12/19/2007  Annual Type of Service (TOS) Update (Replaced by Transmittal 1410)  01/07/2008  5838 R1393CP  12/14/2007  Revised Guidance for Completing Form CMS -1500 01/07/2008  5749 Rev #  Issue Date  Subject  Impl Date  CR#  R1369CP  11/02/2007  Crossover of Assignment of Benefits Indicator (CLM08) From Paper Claim Input  04/07/2008  5780 R1366CP  11/02/2007  Update to Place of Service (POS) Code Set: New Code for Temporary Lodging 04/07/2008  5777 R1325CP  08/29/2007  Testing and Implementation of 2008 Ambulatory Surgical Center (ASC) Payment System Changes  01/07/2008  5680 R1308CP
(Medicare Claims Processing Manual)
Code for Temporary Lodging 04/07/2008  5777 R1325CP  08/29/2007  Testing and Implementation of 2008 Ambulatory Surgical Center (ASC) Payment System Changes  01/07/2008  5680 R1308CP  07/20/2007  Testing and Implementation of 2008 Ambulatory Surgical Center (ASC) Payment System Changes  Replaced by Transmittal 1325  Replaced by Transmittal 1325 01/07/2008  5680 R1215CP  03/30/2007  Revisions to Form CMS -1500 Submission Requirements  04/30/2007  5489 R1191CP  03/02/2007  Type of Service (TOS) Corrections  04/02/2007  5510 R1086CP  10/27/2006  Annual Type of Service (TOS) Update  01/02/2007  5361 R1058CP  09/15/2006  Additional Requirements Necessary to Implement the Revised Health Insurance Claim Form CMS -1500 (08/05)  01/02/2007  5060 R1049CP  09/01/2006  Update to the Place of Service (POS) Code Set to Add a Code for Prison/Correctional Facility  01/02/2007  4316 R1010CP  07/28/2006  Additional Requirements Necessary to Implement the Revised Health Insurance Claim Form CMS -1500 (08/05)  Rescinded and replaced by Transmittal 1058 01/02/2007  5060 R980CP  06/14/2006  Changes Conforming to CR 3648 Instructions for Therapy Services -  Replaces Rev. 941 10/02/2006  4014 Rev #  Issue Date  Subject  Impl Date  CR#  R941CP  05/05/2006  Changes Conforming to CR 3648 Instructions for Therapy Services  10/02/2006  4014 R899CP  03/31/2006  Revised Heath Insurance Claim Form CMS -1500 10/02/2006  4293 R870CP  02/24/2006  Type of Service (TOS) Corrections  04/03/2006  4322 R735CP  10/31/2005  Processing All Diagnosis Codes Reported on Claims Submitted to Carriers  04/03/2006  4097 R727CP  10/28/2005  Annual Type of Service (TOS)  01/03/2006  4145 R549CP  04/29/2005  Update to the Place of Service (POS) Code Set to Add a Code for Pharmacy  10/03/2005  3819 R511CP
(Medicare Claims Processing Manual)
Service (TOS)  01/03/2006  4145 R549CP  04/29/2005  Update to the Place of Service (POS) Code Set to Add a Code for Pharmacy  10/03/2005  3819 R511CP  03/28/2005  Type of Service (TOS) Corrections  04/18/2005  3788 R506CP  03/18/2005  Updated Manual Instructions for Item 24G (Days or Units)  07/01/2005  3753 R476CP  02/18/2005  Type of Service (TOS) Corrections  04/04/2005  3717 R400CP  12/16/2004  Incorrect Reporting of MTUS Indicator When Drugs are Billed Using an NDC Code  04/04/2005  3435 R359CP  11/04/2004  2005 Annual Type of Service (TOS)  01/03/2005  3519 R349CP  10/29/2004  2005 Annual Type of Service (TOS)  01/03/2005  3519 R335CP  10/29/2004  Correction of Reporting of MTUS Indicator When Drugs are Billed Using an NDC Code   Rescinded and replaced by Transmittal 400 04/04/2005  3435 R317CP  10/22/2004  Clarification to Chapter 26  N/A 3431 R228CP  07/16/2004  Lab and Carrier Processing of Claims for Reference Lab Services When there is No 08/16/2004  3267 Rev #  Issue Date  Subject  Impl Date  CR#  Face -to-Face Encounter with the Beneficiary  R153CP  04/30/2004  Correction of Type of Service (TOS) Inconsistencies  10/04/2004  3189 R148CP  04/23/2004  Describing the Identity of the Ordering and Supervising Physician on Form CMS -1500 Paper Claim  05/24/2004  3138 R145CP  04/23/2004  Deletion of the Data Element Requirements Matrix for Carriers from Chapter 1 and Chapter 26  05/24/2004  3164 R121CP  03/19/2004  Manualization of Program Memorandum B -03-040, CR 2730, Dated May 16, 2003, Regarding Place of Service (POS) Codes and Revises the Wording of the Group Home Code, 14  04/01/2004  3087 R108CP  02/27/2004  Correction of Type of Service (TOS) Inconsistencies in CR 2929
(Medicare Claims Processing Manual)
Codes and Revises the Wording of the Group Home Code, 14  04/01/2004  3087 R108CP  02/27/2004  Correction of Type of Service (TOS) Inconsistencies in CR 2929 03/29/2004  3018 R005CP  10/10/2003  Update to 2004 HCPCS/Type of Service Crosswalk  01/01/2004  2929 R001CP  10/01/2003  Initial Publication of Manual  NA NA Back to top of Chapter
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Article - Accreditation and Credentialing Requirements for Polysomnography LCD L36593 (A55958)
CMS National Coverage PolicyN/AArticle TextRevision effective date:For services performed on or after07/01/2018Accreditation and credentialing requirements:Please be aware of the following changes to accreditation and credentialing requirements:The related Polysomnography LCD sets forth the following standards for sleep centers that perform the technical component (TC) of polysomnography (PSG) and sleep testing (including home sleep testing):1.The sleep center or laboratory must maintain documentation on file that indicates it is accredited by either:the American Academy of Sleep Medicine (AASM), ortheAccreditation Commission for Health Care (ACHC), orthe Ambulatory Care Accreditation Program of the Joint CommissionThis documentation must be available on request. The AASM, ACHC, or Joint Commission accreditation applies to the hospital and freestanding facilities (including sleep clinics that are part of a physicians office, and all other non-hospital-based facilities where sleep studies are performed.Diagnostic testing performed in an Independent Diagnostic Testing Facility (IDTF) must follow the supervision and credentialing guidelines set forth by CMS and/or this A/B MAC.The sleep laboratory or testing facility must be affiliated with a hospital or be under the direction and control of a physician (MD/DO) who meets 1 of the following requirements, even though the diagnostic test may be performed in the absence of direct physician supervision.The raw data from all sleep tests must be reviewed and the tests must be interpreted by a physician who meets at least 1 of the following requirements:Certification in Sleep Medicine by the American Board of Sleep Medicine (ABSM) or by a member board of either the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA)A completed fellowship in sleep medicine through an Accreditation Council for Graduate Medical Education (ACGME)accredited program. Following the completed fellowship, certification in sleep medicine is completed within 2 examination cycles through the ABSM or a member board of either the ABMS or the AOASleep centers in Jurisdiction M have been subject to these regulations since the implementation of the LCD on October 1, 2015 and similar regulations that appeared in previous versions of the Polysomnography LCD.
Article - Accreditation and Credentialing Requirements for Polysomnography LCD L36593 (A55958)
Sleep centers in Jurisdiction M have been subject to these regulations since the implementation of the LCD on October 1, 2015 and similar regulations that appeared in previous versions of the Polysomnography LCD.Sleep centers in Jurisdiction J prior to February 26, 2018 were not required to meet similar standards by the previous contractor. All sleep centers in Jurisdiction J must now obtain accreditation by 1 of the 3 organizations listed above by July 1, 2018 in order to continue to render services to Medicare beneficiaries and submit claims to this A/B MAC.Revision effective date:For services performed on or after10/01/20182. As noted above in section 1, and as of October 1, 2018, outpatient sleep centers affiliated with a hospital, which is currently accredited by the Joint Commission (formerly JCAHO) through the hospitals accreditation are required to have ambulatory care accreditation for the sleep center in order to continue to render services to Medicare beneficiaries and submit claims to this A/B MAC.3. There is a new physician-credentialing standard published by the Joint Commission (formerly JCAHO) for ambulatory care organizations providing sleep center services that reduces quality variation and aligns credentialing requirements for all sleep testing facilities defined by the Polysomnography LCD. Specifically, as of January 1, 2018, the Joint Commission requires that organizations verify that physicians haveat least 1of the following qualifications before granting initial or revised privileges to physicians responsible for interpreting sleep studies:Certification in Sleep Medicine by the ABSM or by a member board of either the ABMS or the AOAORA completed fellowship in sleep medicine through an ACGMEaccredited program. Following thecompleted fellowship, certification in sleep medicine is completed within 2 examination cycles through the ABSM or a member board of either the ABMS or the AOA.