Source: https://www.federalregister.gov/documents/2004/12/30/04-28156/medicare-and-medicaid-programs-quarterly-listing-of-program-issuances-july-2004-through-september
Timestamp: 2018-04-27 07:23:32
Document Index: 2284475

Matched Legal Cases: ['art.\n09', '§\u2009921', 'art 414', 'art 402', 'art 146', 'art 146', 'art 484', 'arts 405', 'arts 417', 'arts 403', 'arts 405', 'arts 403', 'arts 410', 'arts 431', 'art 402', 'art 414', 'arts 431', 'art 411', 'art 406', 'art 493', 'arts 431']

Federal Register :: Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-July 2004 Through September 2004
Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-July 2004 Through September 2004
69 FR 78428
78428-78442 (15 pages)
CMS-9024-N
04-28156
Addendum V—National Coverage Determinations [July 2004 Through September 2004]
IDE Category
Addendum VII-Approval Numbers for Collections of Information
https://www.federalregister.gov/d/04-28156 https://www.federalregister.gov/d/04-28156
This notice lists CMS manual instructions, substantive and interpretive regulations, and other Federal Register notices that were published from July 2004 through September 2004, relating to the Medicare and Medicaid programs. This notice provides information on national coverage determinations (NCDs) affecting specific medical and health care services under Medicare. Additionally, this notice identifies certain devices with investigational device exemption (IDE) numbers approved by the Food and Drug Administration (FDA) that potentially may be covered under Medicare. Finally, this notice also includes listings of all approval numbers from the Office of Management and Budget for collections of information in CMS regulations.
Section 1871(c) of the Social Security Act requires that we publish a list of Start Printed Page 78429Medicare issuances in the Federal Register at least every 3 months. Although we are not mandated to do so by statute, for the sake of completeness of the listing, and to foster more open and transparent collaboration efforts, we are also including all Medicaid issuances and Medicare and Medicaid substantive and interpretive regulations (proposed and final) published during this 3-month time frame.
Those wishing to subscribe to program manuals should contact either the Government Printing Office (GPO) Start Printed Page 78430or the National Technical Information Service (NTIS) at the following addresses:
In addition, individuals may contact regional depository libraries that receive and retain at least one copy of most Federal Government publications, either in printed or microfilm form, for use by the general public. These libraries provide reference services and interlibrary loans; however, they are not sales outlets. Individuals may obtain information about the location of the nearest regional depository library from any library. For each CMS publication listed in Addendum III, CMS publication and transmittal numbers are shown. To help FDLs locate the materials, use the CMS publication and transmittal numbers. For example, to find the Medicare National Coverage Determinations publication titled “Islet Cell Transplantation,” use CMS-Pub. 100-03, Transmittal No. 18.
An extensive descriptive listing of Medicare manuals and memoranda was published on June 9, 1988, at 53 FR 21730 and supplemented on September 22, 1988, at 53 FR 36891 and December 16, 1988, at 53 FR 50577. Also, a complete description of the former CIM (now the NCDM) was published on August 21, 1989, at 54 FR 34555. A brief description of the various Medicaid manuals and memoranda that we maintain was published on October 16, 1992, at 57 FR 47468. Start Printed Page 78431
Addendum III.—Medicare and Medicaid Manual Instructions July Through September 2004
08 Standard Terminology for Claims Processing Systems Standard Terminology Chart.
09 Transmittal rescinded and replaced with Transmittal 10.
10 Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year 2005. Basis for Determining the Part A Coinsurance Amounts. Part B Annual Deductible.
18 This revision rescinded Transmittal 12.
19 Hospital Services Covered Under Part B Outpatient Observation Services.
20 This revision rescinded Transmittal 17.
21 Medicare Comprehensive Outpatient Rehabilitation Facility Coverage.
Comprehensive Outpatient Rehabilitation Facility Services Provided by Medicare.
Optional Comprehensive Outpatient Rehabilitation Facility Services.
Rules for Provision of Services.
Prosthetic and Orthotic Devices and Supplies.
Home Environment Evaluation.
22 This revision rescinded transmittal 15.
17 Manualization of the Negotiated Clinical Diagnostic Laboratory National Coverage Determinations.
Urine Culture, Bacterial.
Human Immunodeficiency Virus Testing (Prognosis Including Monitoring).
Human Immunodeficiency Virus Testing (Diagnosis).
Serum Iron Studies.
Collagen Crosslinks, Any Method.
Glycated Hemoglobin/Glycated Protein.
Digoxin Therapeutic Drug Assay.
Tumor Antigen by Immunoassay.
Hepatitis Panel/Acute Hepatitis Panel.
18 Islet Cell Transplantation.
Pancreas Transplants (Effective July 1, 1999).
Islet Cell Transplantation in the Context of a Clinical Trial (Effective October 1, 2004).
19 Blood-Derived Products for Chronic Non-Healing Wounds.
20 Issued to a specific audience, not posted to Internet/Intranet due to sensitivity of Instruction.
21 Magnetic Resonance Spectroscopy for Diagnosing Brain Tumors.
Medicare Claims Processing (CMS-Pub. 100-04).
222 Skilled Nursing Facility Consolidated Billing Requirements for Durable Medical Equipment Prosthetic, Orthotics & Supplies.
Skilled Nursing Facility Consolidated Billing and Durable Medical Equipment Provided by Durable Medical Equipment Prosthetic, Orthotics & Supplies Suppliers.
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223 Positron Emissions Tomography Scans and Related Claims Processing.
Use of Gamma Cameras and Full Ring and Partial Ring Positron Emissions Scanners.
Positron Emissions Tomography Scans for Imaging of the Perfusion of the Heart Using Rubidium 82.
Expanded Coverage of Positron Emission Tomography Scans for Solitary Pulmonary Nodules.
Expanded Coverage of Positron Emissions Tomography Scans Effective for Services on or after July 1, 1999.
Expanded Coverage of Positron Emissions Tomography Scans Effective for Services on or after July 1, 2001.
Expanded Coverage of Positron Emissions Tomography Scans for Breast Cancer Effective for Dates on or after October 1, 2002.
Coverage of Positron Emissions Tomography Scans for Myocardial Viability.
Coverage of Positron Emissions Tomography Scans for Thyroid Cancer.
Coverage of Positron Emissions Tomography Scans for Perfusion of the Heart Using Ammonia N-13.
224 October Quarterly Update to 2004 Annual Update of Health Common Procedure Coding System Codes Used For Skilled Nursing Facility.
Consolidated Billing Enforcement.
225 Changes to the Laboratory National Coverage Determination Edit Software for October 2004.
226 Quarterly Update of Health Common Procedure Coding System Codes Used for Home Health Consolidated Billing Enforcement.
Home Health Prospective Payment System Consolidated Billing and Primary Home Health Agency.
227 Local Medical Review Policy/Local Coverage Determination Medicare.
Summary Notice Message Revision.
228 General Policy.
229 Additional Clarification of Bill Type 22x and 23x Submitted by Skilled Nursing Facilities With Instructions for Involuntarily Moving A Beneficiary Out of the Skilled Nursing Facility and Ending a Benefit Period.
Skilled Nursing Facility Prospective Payment System and Consolidated Billing Overview.
Consolidated Billing Requirements for Skilled Nursing Facility.
Other Excluded Services Beyond the Scope of a Skilled Nursing Facility Part A Benefit.
Outpatient Surgery and Related Procedures “ Inclusions.
Dialysis and Dialysis Related Services to a Beneficiary With End Stage Renal Disease.
Coding Applicable to Epoetin Services.
Coding for Darbepoetin Alfa.
Screening and Preventive Services.
Situations that Require a Discharge or Leave of Absence.
Billing Procedures for Periodic Interim Payment Method of Payment Ending A Benefit Period.
Other Billing Situations.
Billing for Outpatient Skilled Nursing Facility Services
230 Update to the Claims Status Codes.
Health Care Claims Status Category Codes and Health Care Claims Status Codes for Use with Health Care Claims Status Request and Response.
231 Indian Health Service or Tribal Critical Access Hospital Payment Methodology for Inpatient and Outpatient Services.
Payment for Inpatient Services Furnished by an Indian Health Service or Tribal Critical Access Hospital.
Payment for Outpatient Services Furnished by an Indian Health Service or Tribal Critical Access Hopsital.
232 Issued to a specific audience, not posted to Internet/Intranet due to confidentiality of instruction.
233 Issued to a specific audience, not posted to Internet/Intranet due to confidentiality of instruction.
234 Standardized Responses to Provider Inquiries Regarding the Negotiated Laboratory National Coverage Determinations Edit Software.
235 Instructions for Downloading the Medicare Zip Code File.
236 2005 Durable Medical Equipment Prosthetic, Orthotics & Supplies Pricing.
File Record Layout Expansion and New Pricing Procedures for Certain Durable Medical Equipment Prosthetic, Orthotics & Supplies Items Based on Modifiers.
Payment of Durable Medical Equipment Prosthetic, Orhtotics & Supplies Items based on Modifiers.
Intermediary Format for Durable Medical Equipment, Prosthetic, Orthotic and Supply Fee Schedule.
237 Implementation of Patient Status Code 65, Discharged/Transferred to a Psychiatric Hospital or Psychiatric Distinct Part Unit of a Hospital.
238 Health Insurance Portability and Accountability Act Institutional Health Care Claim Implementation Guide Additional Updates.
239 Transmittal 239 is Rescinded and replaced with Transmittal 270.
240 Expansion of the Existing Interrupted Stay Policy Under Long Term Care.
241 Processing Part B Claims for Indian Health Services.
Services That May Be Paid to Indian Health Service/Tribe/Tribal Organization Facilities.
Start Printed Page 78433
Services Paid Under the Physician Fee Schedule.
Prosthetics Devices.
Claims Processing Requirements for Benefits, Improvements & Protection Act of 2000 Services.
Claims Processing Requirements for Medicare Modernization Act Enrollment and Billing for Durable Medical Equipment, Prosthetic, Orthotics & Supplies.
Claims Processing for Durable Medical Equipment, Prosthetic, Orthotics & Supplies.
Enrollment for Durable Medical Equipment, Prosthetic, Orthotics & Supplies.
Claims Submission for Durable Medical Equipment, Prosthetic, Orthotics & Supplies.
Enrollment and Billing for Clinical Laboratory and Ambulance Services Claims Submission and Processing for Clinical Laboratory and Ambulance Service.
Enrollment for Clinical Laboratory and Ambulance Services and Part B drugs.
242 Quarterly Update to Correct Coding Initiative edits, Version 10.3, Effective October 1, 2004.
243 Patient Status Code and Reason for Patient Visit for the Hospital Outpatient Prospective Payment System.
Patient Status Code and Reason for Patient Visit for the Hospital.
244 Transmittal 244 is Rescinded and Replaced with Transmittal 269.
245 Issued to a specific audience, not posted to Internet/Intranet due to confidentiality of instruction.
246 Issued to a specific audience, not posted to Internet/Intranet due to confidentiality of instruction.
247 Issued to a specific audience, not posted to Internet/Intranet due to confidentiality of instruction.
248 Durable Medical Equipment Regional Carrier/Local Carriers/Statistical Analysis Durable Medical Equipment Regional Carrier—Drug Pricing Limits as of January 1, 2005.
Medicare Modernization Act Drug Pricing-Average Sales Price.
Regional Carrier Drugs.
Detailed Procedures for Determining Average Wholesale Price and the Drug.
Payment Allowance Limits.
Injections Furnished to End Stage Renal Disease Beneficiaries.
249 New Medicare Summary Notice Message 31.18.
250 Coordination of Benefits Agreement Claims Selection Options.
Consolidated Claims Crossover Process.
251 Editing Of Hospital And Skilled Nursing Facility Part B Inpatient Services.
Inpatient Part B Hospital Services.
Editing of Hospital Part B Inpatient Services. Billing for Inpatient Skilled Nursing Facility Services Paid Under Part B.
Editing of Skilled Nursing Facilities Part B Inpatient Services.
252 Paper Remittance Advice format change to accommodate the forced balancing Amount to balance at the claim level as well as the provider level, a flat file change, and a change in the companion document for fiscal intermediaries.
253 Fiscal Intermediary Shared System Changes to Allow for Provider Liability Days on Skilled Nursing Facility and Swing Bed Facility Inpatient Bills.
254 October 2004 Outpatient Prospective Payment System Code Editor Specifications Version 5.3.
255 October Update to the Medicare Outpatient Code Editor Version 20.0 for Bills From Hospitals That Are Not Paid Under the Outpatient Prospective Payment System.
256 Use of Group Health Plan Payment System/Medicare Managed Care System To Pay Capitated Payments to Chronic Care Improvement Organizations Serving Medicare Fee-For-Service Beneficiaries Under Section 721 of the Medicare Modernization Act.
257 Shared Systems Changes for Medicare Part B Drugs for End Stage Renal Disease Independent Dialysis Facilities.
258 New Waived Tests—October 1, 2004.
259 Scheduled Release for October Updates to Software Programs and Pricing/Coding Files.
260 Cryosurgery of the Prostate.
Cryosurgery of the Prostate Gland.
261 Billing and Requirements for Islet Cell Transplantation for Beneficiaries in a National Institutes of Health Clinical Trial.
Billing Requirements for Islet Cell Transplantation for Beneficiaries in a National Institutes of Health Clinical Trial.
Healthcare Common Procedural Coding System Codes for Carriers.
Applicable Modifier for Islet Cell Transplant Claims for Carriers.
Special Billing and Payment Requirements for Carriers.
Special Billing and Payment Requirements for Intermediaries.
Special Billing and Payment Requirements Medicare Advantage Beneficiaries.
262 Confidential.
263 Inpatient Rehabilitation Facility Annual Update: Prospective Payment System.
Pricer Changes for Fiscal Year 2005.
Outlier Payments: Cost-to-Charge Ratios.
264 This Transmittal is Rescinded and Replaced with Transmittal 271.
265 Issued to a specific audience, not posted to Internet/Intranet due to confidentiality of instruction.
266 Revision of Common Working File Editing for Same-Day, Same-Provider Acute Care Readmissions.
267 Crossover Patients in New Long Term Care Hospital.
Billing Procedures for a Provider Assigned Multiple Provider Numbers or a Change in Provider Number.
Crossover Patients in New Long Term Care Hospital.
268 Medicare Part A Skilled Nursing Facility Prospective Payment.
System Pricer Update Fiscal Year 2005.
269 This Transmittal Replaces Transmittal 244.
270 This Transmittal Replaces Transmittal 239.
271 This Transmittal Replaces Transmittal 264.
272 October Quarterly Update for 2004 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Fee Schedule.
273 Modification of CMS’ Medicare Contingency Plan for Health Insurance Portability & Accountability Act Implementation.
Payment Floor Standards.
Determining and Paying Interest.
274 Good Cause Waiver of Late Claim Filing Payment Reduction Penalty.
Preparing Common Working File Claim Records for Services Subject to 10 Percent Payment Reduction.
275 The Supplemental Security Income/Medicare Beneficiary Data for Fiscal Year 2003 for Inpatient Prospective Payment System Hospitals.
276 Further Information Related to CR 3175, Distinct Part Units of Critical Access Hospitals.
Requirements for Critical Access Hospital Services, Critical Access Hospital Skilled Nursing Care Services and Distinct Part Units.
Inpatient Rehabilitation Facility Prospective Payment System.
Billing Requirements Under Inpatient Rehabilitation Facility Prospective Payment System.
277 Sensitive.
278 This Transmittal is no longer sensitive and can be posted to Internet/Intranet.
279 Issued to a specific audience, not posted to Internet/Intranet due to sensitivity of instruction.
280 Issued to a specific audience, not posted to Internet/Intranet due to sensitivity of instruction.
281 Issued to a specific audience, not posted to Internet/Intranet due to confidentiality of instruction.
282 This Transmittal replaces Transmittal 274.
283 2005 Healthcare Common Procedure Coding System Annual Update Reminder.
Health Care Common Procedure Coding System Annual Update Reminder.
284 Durable Medical Equipment Regional Carriers Only—Appeals of Duplicate Claims.
285 Addition of Physician Assistants, Nurse Practitioners and Clinical Nurse.
Specialists as Emergency On-Call Providers for Critical Access Hospitals.
Costs of Emergency Room On-Call Providers.
286 Medicare Physician Fee Schedule Database 2005 File Layout.
287 Schedule for Completing the Calendar Year 2005 Fee Schedule Updates and the Participating Physician Enrollment Procedures.
288 Fiscal Year 2005 Payment for Services Furnished in Ambulatory Surgical Centers.
289 File Descriptions and Instructions for Retrieving the 2005 Pricing Files Through CMS” Mainframe Telecommunications System.
Recurring Update Notification Containing New Pricing File Names and Retrieval Dates for 2005.
290 October 2004 Update of the Hospital Outpatient Prospective Payment System.
291 Use of Transmission Date in the Service Date/Assessment Date Field for Inpatient Rehabilitation Facility Prospective Payment System Claims.
Payment Adjustment for Late Transmission of Patient Assessment Data.
292 Confidential.
293 Confidential.
294 Sensitive/Controversial.
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295 Transmittal 214 is Rescinded and Replaced with Transmittal 295.
296 This Transmittal replaces Transmittal 196.
297 Reasonable Charge Update for 2005 for Splints, Casts, Dialysis Supplies, Dialysis Equipment, Therapeutic Shoes, and Certain Intraocular Lenses.
298 This Transmittal replaces Transmittal 295.
299 Use of Condition Code 44, “Inpatient Admission Changed to Outpatient”.
300 Payment For Outpatient End Stage Renal Disease-Related Services.
301 Transmittal 301 Replaces Transmittal 251.
302 Nursing Facility Visits (Codes 99301-99313).
303 Instructions for Completion of Form CMS-1450.
304 Transmittal 304 Replaces Transmittal 205.
17 Clarification of CR 3064.
18 Application of the Medicare Secondary Payer for the Working Aged Provision and the Medicare Secondary for the Disabled Provision to Former Spouses and Certain Family Members With Coverage Under the Federal Employees Health Benefits Program.
Individuals Not Subject to the Limitation on Payment.
Individuals Not Subject to Medicare Secondary Payer Provision.
19 Clarification of Medicare Secondary Payer Rules in Relation to a Temporary Leave of Absence.
Rules Defining Employees Covered by Group Health Plans and Large Group Health Plans.
49 Procedures For Re-Issuance and Stale Dating of Medicare Checks
50 Unsolicited/Voluntary Refunds
Office of Inspector General Initiatives.
Unsolicited/Voluntary Refund Accounts.
Receiving and Processing Unsolicited/Voluntary Refund Checks When Identifying Information Is Provided.
51 This transmittal is rescinded and replaced with Transmittal 52.
52 Notice of New Interest Rate for Medicare Overpayments and Underpayments.
53 Change Request 3367, Debt Collection System, replaces Change Request 2952, Debt Collection System
54 Notification to Providers of Intent to Complete a Post-Payment Audit.
Contractor's Responsibility Prior to Submission of Cost Reports.
Medicare State Operations Manual (Pub. 100-07)
02 Provider Identification Number.
79 Local Medical Review Policy/Local Coverage Determination Medicare Summary.
Notice Message Revision.
80 Program Integrity Management Fraud and Abuse Complaint Screening Revisions. Complaint Screening.
81 Implementation of the Quarterly Strategy Analysis.
The Quarterly Strategy Analysis.
The Quarterly Strategy Analysis Format.
Problem Specific Activities.
Problem Specific Activity Definitions.
82 Home Health Demand Bills.
Effectuating Favorable Final Appellate.
Decisions That a Beneficiary Is “Confined to Home” .
Medical Review of Home Health Demand Bills.
83 Program Integrity Management Revisions for Chapter 4.
Program Safeguard Contractor and Medicare Contractor Benefit Integrity Unit.
Medical Review for Benefit Integrity Purposes.
Investigation, Case, and Suspension Entries.
07 Confidential.
56 Administrative Contracting Requirements.
57 Coverage of Clinical Trials.
Diagnostic Coding and Guidelines for Data Collection From Provider Network.
58 Terminology.
59 State and County Code Corrections.
Completion of Enrollment Form.
Passive Elections.
Eligibility Requirements for Medicare Medical Savings Account Plans.
Annual Elective Period.
Open Enrollment Period Through 2005.
Open Enrollment Period in 2006.
Open Enrollment Period in 2007 and Beyond.
Open Enrollment for Newly Eligible Individuals in 2006 and Beyond.
Open Enrollment Period for Institutionalized Individuals in 2006 and Beyond.
Special Enrollment Period for Beneficiaries Age 65.
60 Streamlined Marketing Review Process.
File and Use.
Guidelines for Advertising and Pre-Enrollment Materials.
Guidelines for Advertising Materials.
Guidelines for Pre-Enrollment Materials.
61 Emergency and Urgently Needed Services.
62 Revisions to Chapter 13—Medicare+Choice Beneficiary Grievances, Organization Determinations and Appeals.
05 Use of Group Health Plan Payment System to Pay Capitated Payments to Non-Health Plan Demonstration/Program Sites Serving Medicare Fee For Service Beneficiaries—Updated List of Plan Numbers.
06 Revision of CR 3269 for the Demonstration Project to Clarify the Definition of Homebound (Homebound Demonstration).
92 Additional Instructions Related to the “Redistribution of Unused Resident Positions,” Section 422 of the Medicare Modernization Act of 2003 P.L. 108-173, for Purposes of Graduate Medical Education Payments.
93 Temporary Skilled Nursing Facility Extension.
94 Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act.
Transaction Release Testing.
95 Modifications to Post-payment Adjustment Process for Home Health Prospective Payment System Claims Failing to Report Prior Inpatient Discharges.
96 Annual Changes to the Amount in Controversy Thresholds For the Administrative Law Judge and Judicial Review.
Levels of the Claim Appeals Process as Required by Section 940 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
97 Implementation of the Business Segment Identifier in the Healthcare Integrated General Ledger Accounting System.
98 Change to Previous Transmittal Regarding the Discounted Use of Revenue Code 0910.
99 This One-Time Notification is a full replacement for Transmittal 86.
100 This Transmittal is Rescinded and Replaced with Transmittal 103.
101 Change of the Premera Blue Cross Medicare Part A Plan Under Contract to BCBSA to a Part A Fiscal Intermediary Contract with Noridian Mutual Insurance Company in the States of Washington and Alaska.
102 Update to the Healthcare Provider Taxonomy Codes/Medicare Specialty Code Crosswalk.
103 This Transmittal replaces Transmittal 100.
104 Confidential.
105 Confidential.
106 Medicare Modernization Act Drug Pricing Update-Payment Limits for J9045 (Carboplatin Injection) and (Rituximab Cancer Treatment).
107 Common Working File Analysis to Process Claims Per the Renovated Override Code Processing (re: CR3190) and Common Working File Analysis to Review System Edits for Additional 2-byte Modifiers Added in CR3190 (Phase 2).
108 New Remark Code Message for Use With Claims for Parental Pumps-Durable Medical Equipment Regional Carrier Only.
109 Billing Instructions for ADVATE rAHF-PFM on Medicare Claims.
110 Medicare Modernization Act Drug Pricing Update-Payment Limits for J100 (Depo-estradiol cypionate inj).
111 Creation of Common Working File Auxilliary File and Associated Logic to Property.
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Calculate Medicare-Equivalent Deductibles for Department of Veteran Affairs Claims.
112 This Transmittal replaces Transmittal 109.
113 Implementation of § 921 of the Medicare Modernization Act Provider Customer Program.
114 Sensitive.
115 Instructions for Fiscal Intermediary Standard System and Multi-Carrier System Healthcare Integrated General Ledger Accounting System Changes.
116 Notification of Medlearn Matters Article for Confidential Change Request (CR) 3301.
[July 2004 Through September 2004]
July 1, 2004 40288 42 CFR Part 414 CMS-1492-IFC Medicare Program; Medicare Ambulance MMA Temporary Rate Increases Beginning July 1, 2004.
July 23, 2004 44036 CMS-1334-N Medicare Program; Public Meeting in Calendar Year 2004 for Coding and Payment Determinations for Power Wheelchairs.
July 23, 2004 44035 CMS-1364-N Medicare Program; August 30, 2004, Meeting of the Practicing Physicians Advisory Council and Request for Nominations.
July 23, 2004 44034 CMS-4074-N Medicare Program; Meeting of the Advisory Panel on Medicare Education—September 9, 2004.
July 23, 2004 44031 CMS-3142-NC Medicare Program; Evaluation Criteria and Standards for Quality Improvement Program Contracts.
July 23, 2004 44029 CMS-3112-NC2 Medicare Program; Adjustment in Payment Amounts for New Technology Intraocular Lenses Furnished by Ambulatory Surgical Centers.
July 23, 2004 44027 CMS-2202-PN Medicare and Medicaid Programs; Application by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc., for Continued Deeming Authority for Ambulatory Surgical Centers.
July 23, 2004 44013 CMS-2187-N State Children's Health Insurance Program (SCHIP); Extended Availability of Unexpended SCHIP Funds From the Appropriation for Fiscal Years 1998 Through 2001; and Provision of Authority for Qualifying States To Use a Portion of SCHIP Funds for Medicaid Expenditures.
July 23, 2004 43956 42 CFR Part 402 CMS-6146-P Medicare Program; Revised Civil Money Penalties, Assessments, Exclusions, and Related Appeals Procedures.
July 23, 2004 43926 45 CFR Part 146 CMS-2033-F Requirements for the Group Health Insurance Market; Non-Federal Governmental Plans Exempt From HIPAA Title I Requirements.
July 23, 2004 43924 45 CFR Part 146 CMS-2152-F2 Amendment to the Interim Final Regulation for Mental Health Parity.
July 30, 2004 45822 CMS-4068-N Medicare Program; Open Public Meeting Regarding the Development of the Model Guidelines for Categories and Classes of Drugs.
July 30, 2004 45775 CMS-1249-N Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities—Update.
July 30, 2004 45721 CMS-1360-N Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Fiscal Year 2005.
July 30, 2004 45640 42 CFR Part 484 CMS-1265-CN Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2005; Correction Notice.
July 30, 2004 45604 42 CFR Parts 405 and 411 CMS-6014-F Medicare Program; Interest Calculation.
August 3, 2004 46866 42 CFR Parts 417 and 422 CMS-4069-P Medicare Program; Establishment of the Medicare Advantage Program.
August 3, 2004 46632 42 CFR Parts 403, 411, 417, and 423 CMS-4068-P Medicare Program; Medicare Prescription Drug Benefit.
August 5, 2004 47488 42 CFR Parts 405, 410, 411, 414, 418, 424, 484, and 486 CMS-1429-P Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005.
August 5, 2004 47446 CMS-1275-N Medicare Program; Meeting of the Advisory Panel on Ambulatory Payment Classification Groups—September 1, 2, and 3, 2004.
Start Printed Page 78438
August 11, 2004 48916 42 CFR Parts 403, 412, 413, 418, 460, 480, 482, 483, 485, and 489 CMS-1428-F Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2005 Rates.
August 16, 2004 50448 42 CFR Parts 410, 411, 419 CMS-1427-P Medicare Program; Proposed Changes to the Hospital Outpatient and Prospective Payment System and Calendar Year 2005 Payment Rates.
August 27, 2004 52723 CMS-1279-N2 Medicare Program; Public Meeting of the Program Advisory and Oversight Committee (PAOC) for Quality Standards and Competitive Acquisition of Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS).
August 27, 2004 52722 CMS-3136-N Medicare Program; Meeting of the Medicare Coverage Advisory Committee—September 28, 2004.
August 27, 2004 52721 CMS-5025-CN Medicare Program; Medicare Replacement Drug Demonstration; Correction.
August 27, 2004 52710 CMS-1264-N Medicare Program; Hospice Wage Index for Fiscal Year 2005.
August 27, 2004 52706 CMS-4067-PN Medicare and Medicaid Programs; Application by the Utilization Review Accreditation Commission (URAC) for Deeming Authority for Medicare Advantage.
August 27, 2004 52700 CMS-2201-N State Children's Health Insurance Program; Final Allotments to States, the District of Columbia, and U.S. Territories and Commonwealths for Fiscal Year 2005.
August 27, 2004 52699 CMS-1269-N2 Medicare Program; Second Request for Nominations for Two Specific Categories of Members of the Emergency Medical Treatment and Labor Act (EMTALA) Technical Advisory Group (TAG).
August 27, 2004 52620 42 CFR Parts 431 and 457 CMS-6026-P Medicaid Program and State Children's Health Insurance Program (SCHIP): Payment Error Rate Measurement.
August 27, 2004 52620 42 CFR Part 402 CMS-6146-CN Medicare Program; Revised Civil Money Penalties, Assessments, Exclusions, and Related Appeals Procedures.
September 9, 2004 54674 CMS-8020-N Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible Beginning January 1, 2005.
September 9, 2004 54673 CMS-8022-N Medicare Program; Part A Premium for 2005 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement, Thursday, September 9, 2004.
September 9, 2004 54671 CMS-8021-N Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for 2005, Thursday, September 9, 2004.
September 14, 2004 55440 CMS-6027-N Medicare Program; September 30, 2004 Open Door Forum: Requirements for Coordination Between Plans Primary or Secondary to Medicare Part D Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA).
September 16, 2004 55763 42 CFR Part 414 CMS-1380-F Medicare Program; Manufacturer Submission of Manufacturer's Average Sales Price (ASP) Data for Medicare Part B Drugs and Biologicals.
September 24, 2004 57325 CMS-3141-N Procedure for Producing Guidance Documents Describing Medicare's Coverage Process.
September 24, 2004 57325 CMS-3137-N Medicare Program; Meeting of the Medicare Coverage Advisory Committee—November 4, 2004.
September 24, 2004 57324 CMS-2200-N4 Medicare Program; Meeting of the State Pharmaceutical Assistance Transition Commission—October 14, 2004.
September 24, 2004 57312 CMS-9023-N Medicare and Medicaid Programs; Quarterly Listing of Program Issuances—April 2004 Through June 2004.
September 24, 2004 57310 CMS-4077-PN Medicare and Medicaid Programs; Application by the National Committee for Quality Assurance Preferred Provider Organization for Deeming Authority for Medicare Advantage.
September 24, 2004 57308 CMS-2208-PN Medicare and Medicaid Programs; Application by the American Osteopathic Association for Continued Approval of Deeming Authority for Hospitals.
September 24, 2004 57307 CMS-2256-PN Medicare and Medicaid Programs; Application by the Community Health Accreditation Program (CHAP) for Home Health Agencies.
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September 24, 2004 57305 CMS-2204-PN Medicare and Medicaid Programs; Application by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) for Home Health Agencies.
September 24, 2004 57304 CMS-3154-N Medicare Program; Request for Nominations for Members for the Medicare Coverage Advisory Committee.
September 24, 2004 57244 42 CFR Parts 431 and 457 CMS-6026-CN Medicaid Program and State Children's Health Insurance Program (SCHIP); Payment Error Rate Measurement; Correction.
September 24, 2004 57226 42 CFR Part 411 CMS-1810-IFC2 Medicare Program; Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships (Phase II); Correcting Amendment.
September 24, 2004 57224 42 CFR Part 406 CMS-4018-F Medicare Program; Continuation of Medicare Entitlement When Disability Benefit Entitlement Ends Because of Substantial Gainful Activity.
September 24, 2004 57859 42 CFR Part 493 Laboratory Requirements; OFR Correction.
September 30, 2004 58596 42 CFR Parts 431 and 457 CMS-6026-CN Medicaid Program and State Children's Health Insurance Program (SCHIP); Payment Error Rate Measurement; OFR Correction.
A national coverage determination (NCD) is a determination by the Secretary with respect to whether or not a particular item or service is covered nationally under Title XVIII of the Social Security Act, but does not include a determination of what code, if any, is assigned to a particular item or service covered under this title, or determination with respect to the amount of payment made for a particular item or service so covered. We include below all of the NCDs that were issued during the quarter covered by this notice. The entries below include information concerning completed decisions as well as sections on program and decision memoranda, which also announce pending decisions or, in some cases, explain why it was not appropriate to issue an NCD. We identify completed decisions by the section of the NCDM in which the decision appears, the title, the date the publication was issued, and the effective date of the decision. Information on completed decisions as well as pending decisions has also been posted on the CMS website at http://cms.hhs.gov/​coverage.
Manualization of Negotiated Clinical Diagnostic Laboratory NCDs N/A R17NCD 07/02/2004 07/02/2004
Changes to the Laboratory NCD Edit Software for October 2004 N/A R225CP 04/09/2004 10/04/2004
Blood-Derived Products for Chronic Non-Healing Wounds 270.3 R19NCD 07/30/2004 07/23/2004
Islet Cell Transplantation 260.3.1 R18NCD 07/30/2004 10/04/2004
MRS for Diagnosing Brain Tumors 220.2.1 R21NCD 09/10/2004 09/10/2004
The following list includes all Category B IDEs approved by FDA during the 2nd quarter, July 2004 Through September 2004.
G030093
G030237
G040049
G040052
G040057
G040091
G040092
G040094
G040096
G040098
G040099
G040100
G040102
G040103
G040104
G040105
G040109
G040113
G040119
G040122
G040124
G040126
G040128
G040129
G040130
G040134
G040137
G040142
G040143
G040144
G040145
G040146
G040147
G040149
G040150 Start Printed Page 78440
G040153
G040154
G040160
G980099
0938-0242 488.26, 442.30
0938-0355 488.26, 442.30
Start Printed Page 78441
0938-0778 422.111, 422.64
0938-0832 489 and 491
0938-0910 422.624, 422.626, 422.620
[FR Doc. 04-28156 Filed 12-29-04; 8:45 am]