Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-July Through September 2007, 73990-74086 [E7-24489]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 72, Number 248 (Friday, December 28, 2007)]
[Notices]
[Pages 73990-74086]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-24489]



[[Page 73989]]

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Part II





Department of Health and Human Services





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Centers for Medicare & Medicaid Services



Medicare and Medicaid Programs; Quarterly Listing of Program 
Issuances--July Through September 2007; Notice

Federal Register / Vol. 72, No. 248 / Friday, December 28, 2007 / 
Notices

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-9042-N]


Medicare and Medicaid Programs; Quarterly Listing of Program 
Issuances--July Through September 2007

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

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SUMMARY: This notice lists CMS manual instructions, substantive and 
interpretive regulations, and other Federal Register notices that were 
published from July 2007 through September 2007, 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. This notice also includes 
listings of all approval numbers from the Office of Management and 
Budget for collections of information in CMS regulations and a list of 
Medicare-approved carotid stent facilities. Included in this notice is 
a list of the American College of Cardiology's National Cardiovascular 
Data registry sites, active CMS coverage-related guidance documents, 
and special one-time notices regarding national coverage provisions. 
Also included in this notice is a list of National Oncologic Positron 
Emissions Tomography Registry sites, a list of Medicare-approved 
ventricular assist device (destination therapy) facilities, a list of 
Medicare-approved lung volume reduction surgery facilities, a list of 
Medicare-approved clinical trials for fluorodeoxyglucose positron 
emissions tomogrogphy for dementia, and a list of Medicare-approved 
bariatric surgery facilities.
    Section 1871(c) of the Social Security Act requires that we publish 
a list of Medicare 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.

FOR FURTHER INFORMATION CONTACT: It is possible that an interested 
party may need specific information and not be able to determine from 
the listed information whether the issuance or regulation would fulfill 
that need. Consequently, we are providing contact persons to answer 
general questions concerning these items. Copies are not available 
through the contact persons. (See Section III of this notice for how to 
obtain listed material.)
    Questions concerning CMS manual instructions in Addendum III may be 
addressed to Timothy Jennings, Office of Strategic Operations and 
Regulatory Affairs, Centers for Medicare & Medicaid Services, C4-26-05, 
7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call 
(410) 786-2134.
    Questions concerning regulation documents published in the Federal 
Register in Addendum IV may be addressed to Gwendolyn Johnson, Office 
of Strategic Operations and Regulatory Affairs, Centers for Medicare & 
Medicaid Services, C4-14-03, 7500 Security Boulevard, Baltimore, MD 
21244-1850, or you can call (410) 786-6954.
    Questions concerning Medicare NCDs in Addendum V may be addressed 
to Patricia Brocato-Simons, Office of Clinical Standards and Quality, 
Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security 
Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-0261.
    Questions concerning FDA-approved Category B IDE numbers listed in 
Addendum VI may be addressed to John Manlove, Office of Clinical 
Standards and Quality, Centers for Medicare & Medicaid Services, C1-13-
04, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call 
(410) 786-6877.
    Questions concerning approval numbers for collections of 
information in Addendum VII may be addressed to Melissa Musotto, Office 
of Strategic Operations and Regulatory Affairs, Regulations Development 
and Issuances Group, Centers for Medicare & Medicaid Services, C5-14-
03, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call 
(410) 786-6962.
    Questions concerning Medicare-approved carotid stent facilities in 
Addendum VIII may be addressed to Sarah J. McClain, Office of Clinical 
Standards and Quality, Centers for Medicare & Medicaid Services, C1-09-
06, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call 
(410) 786-2994.
    Questions concerning Medicare's recognition of the American College 
of Cardiology-National Cardiovascular Data Registry sites in Addendum 
IX may be addressed to JoAnna Baldwin, MS, Office of Clinical Standards 
and Quality, Centers for Medicare & Medicaid Services, C1-09-06, 7500 
Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 
786-7205.
    Questions concerning Medicare's active coverage-related guidance 
documents in Addendum X may be addressed to Janet Brock, Office of 
Clinical Standards and Quality, Centers for Medicare & Medicaid 
Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, 
or you can call (410) 786-2700.
    Questions concerning one-time notices regarding national coverage 
provisions in Addendum XI may be addressed to Ellie Lund, Office of 
Clinical Standards and Quality, Centers for Medicare & Medicaid 
Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, 
or you can call (410) 786-2281.
    Questions concerning National Oncologic Positron Emission 
Tomography Registry sites in Addendum XII may be addressed to Stuart 
Caplan, RN, MAS, Office of Clinical Standards and Quality, Centers for 
Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard, 
Baltimore, MD 21244-1850, or you can call (410) 786-8564.
    Questions concerning Medicare-approved ventricular assist device 
(destination therapy) facilities in Addendum XIII may be addressed to 
JoAnna Baldwin, MS, Office of Clinical Standards and Quality, Centers 
for Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard, 
Baltimore, MD 21244-1850, or you can call (410) 786-7205.
    Questions concerning Medicare-approved lung volume reduction 
surgery facilities listed in Addendum XIV may be addressed to JoAnna 
Baldwin, MS, Office of Clinical Standards and Quality, Centers for 
Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard, 
Baltimore, MD 21244-1850, or you can call (410) 786-7205.
    Questions concerning Medicare-approved bariatric surgery facilities 
listed in Addendum XV may be addressed to Kate Tillman, RN, MA, Office 
of Clinical Standards and Quality, Centers for Medicare & Medicaid 
Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, 
or you can call (410) 786-9252.
    Questions concerning fluorodeoxyglucose positron emission

[[Page 73991]]

tomography for dementia trials listed in Addendum XVI may be addressed 
to Stuart Caplan, RN, MAS, Office of Clinical Standards and Quality, 
Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security 
Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-8564.
    Questions concerning all other information may be addressed to 
Gwendolyn Johnson, Office of Strategic Operations and Regulatory 
Affairs, Regulations Development Group, Centers for Medicare & Medicaid 
Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850, 
or you can call (410) 786-6954.

SUPPLEMENTARY INFORMATION: 

I. Program Issuances

    The Centers for Medicare & Medicaid Services (CMS) is responsible 
for administering the Medicare and Medicaid programs. These programs 
pay for health care and related services for 39 million Medicare 
beneficiaries and 35 million Medicaid recipients. Administration of the 
two programs involves (1) furnishing information to Medicare 
beneficiaries and Medicaid recipients, health care providers, and the 
public and (2) maintaining effective communications with regional 
offices, State governments, State Medicaid agencies, State survey 
agencies, various providers of health care, all Medicare contractors 
that process claims and pay bills, and others. To implement the various 
statutes on which the programs are based, we issue regulations under 
the authority granted to the Secretary of the Department of Health and 
Human Services under sections 1102, 1871, 1902, and related provisions 
of the Social Security Act (the Act). We also issue various manuals, 
memoranda, and statements necessary to administer the programs 
efficiently.
    Section 1871(c)(1) of the Act requires that we publish a list of 
all Medicare manual instructions, interpretive rules, statements of 
policy, and guidelines of general applicability not issued as 
regulations at least every 3 months in the Federal Register. We 
published our first notice June 9, 1988 (53 FR 21730). Although we are 
not mandated to do so by statute, for the sake of completeness of the 
listing of operational and policy statements, and to foster more open 
and transparent collaboration, we are continuing our practice of 
including Medicare substantive and interpretive regulations (proposed 
and final) published during the respective 3-month time frame.

II. How To Use the Addenda

    This notice is organized so that a reader may review the subjects 
of manual issuances, memoranda, substantive and interpretive 
regulations, NCDs, and FDA-approved IDEs published during the subject 
quarter to determine whether any are of particular interest. We expect 
this notice to be used in concert with previously published notices. 
Those unfamiliar with a description of our Medicare manuals may wish to 
review Table I of our first three notices (53 FR 21730, 53 FR 36891, 
and 53 FR 50577) published in 1988, and the notice published March 31, 
1993 (58 FR 16837). Those desiring information on the Medicare NCD 
Manual (NCDM, formerly the Medicare Coverage Issues Manual (CIM)) may 
wish to review the August 21, 1989, publication (54 FR 34555). Those 
interested in the revised process used in making NCDs under the 
Medicare program may review the September 26, 2003, publication (68 FR 
55634).
    To aid the reader, we have organized and divided this current 
listing into 11 addenda:
     Addendum I lists the publication dates of the most recent 
quarterly listings of program issuances.
     Addendum II identifies previous Federal Register documents 
that contain a description of all previously published CMS Medicare and 
Medicaid manuals and memoranda.
     Addendum III lists a unique CMS transmittal number for 
each instruction in our manuals or Program Memoranda and its subject 
matter. A transmittal may consist of a single or multiple 
instruction(s). Often, it is necessary to use information in a 
transmittal in conjunction with information currently in the manuals.
     Addendum IV lists all substantive and interpretive 
Medicare and Medicaid regulations and general notices published in the 
Federal Register during the quarter covered by this notice. For each 
item, we list the--
    [cir] Date published;
    [cir] Federal Register citation;
    [cir] Parts of the Code of Federal Regulations (CFR) that have 
changed (if applicable);
    [cir] Agency file code number; and
    [cir] Title of the regulation.
     Addendum V includes completed NCDs, or reconsiderations of 
completed NCDs, from the quarter covered by this notice. Completed 
decisions are identified 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.
     Addendum VI includes listings of the FDA-approved IDE 
categorizations, using the IDE numbers the FDA assigns. The listings 
are organized according to the categories to which the device numbers 
are assigned (that is, Category A or Category B), and identified by the 
IDE number.
     Addendum VII includes listings of all approval numbers 
from the Office of Management and Budget (OMB) for collections of 
information in CMS regulations in title 42; title 45, subchapter C; and 
title 20 of the CFR.
     Addendum VIII includes listings of Medicare-approved 
carotid stent facilities. All facilities listed meet CMS standards for 
performing carotid artery stenting for high risk patients.
     Addendum IX includes a list of the American College of 
Cardiology's National Cardiovascular Data registry sites. We cover 
implantable cardioverter defibrillators (ICDs) for certain indications, 
as long as information about the procedures is reported to a central 
registry.
     Addendum X includes a list of active CMS guidance 
documents. As required by section 731 of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-
173, enacted on December 8, 2003), we will begin listing the current 
versions of our guidance documents in each quarterly listings notice.
     Addendum XI includes a list of special one-time notices 
regarding national coverage provisions. We are publishing a list of 
issues that require public notification, such as a particular clinical 
trial or research study that qualifies for Medicare coverage.
     Addendum XII includes a listing of National Oncologic 
Positron Emission Tomography Registry (NOPR) sites. We cover positron 
emission tomography (PET) scans for particular oncologic indications 
when they are performed in a facility that participates in the NOPR.
     Addendum XIII includes a listing of Medicare-approved 
facitilites that receive coverage for ventricular assist devices used 
as destination therapy. All facilities were required to meet our 
standards in order to receive coverage for ventricular assist devices 
implanted as destination therapy.
     Addendum XIV includes a listing of Medicare-approved 
facilities that are eligible to receive coverage for lung volume 
reduction surgery. Until May 17, 2007, facilities that participated in 
the National Emphysema Treatment Trial are also eligible to receive 
coverage.
     Addendum XV includes a listing of Medicare-approved 
facilities that meet minimum standards for facilities modeled in part 
on professional society statements on competency. All facilities

[[Page 73992]]

must meet our standards in order to receive coverage for bariatric 
surgery procedures.
     Addendum XVI includes a listing of Medicare-approved 
clinical trials for fluorodeoxyglucose positron emission tomography 
(FDG-PET) for dementia and neurodegenerative diseases.

III. How To Obtain Listed Material

A. Manuals

    Those wishing to subscribe to program manuals should contact either 
the Government Printing Office (GPO) or the National Technical 
Information Service (NTIS) at the following addresses:

Superintendent of Documents, Government Printing Office, ATTN: New 
Orders, P.O. Box 371954, Pittsburgh, PA 15250-7954, Telephone (202) 
512-1800, Fax number (202) 512-2250 (for credit card orders); or
National Technical Information Service, Department of Commerce, 5825 
Port Royal Road, Springfield, VA 22161, Telephone (703) 487-4630.

    In addition, individual manual transmittals and Program Memoranda 
listed in this notice can be purchased from NTIS. Interested parties 
should identify the transmittal(s) they want. GPO or NTIS can give 
complete details on how to obtain the publications they sell. 
Additionally, most manuals are available at the following Internet 
address: https://cms.hhs.gov/manuals/default.asp.

B. Regulations and Notices

    Regulations and notices are published in the daily Federal 
Register. Interested individuals may purchase individual copies or 
subscribe to the Federal Register by contacting the GPO at the address 
given above. When ordering individual copies, it is necessary to cite 
either the date of publication or the volume number and page number.
    The Federal Register is also available on 24x microfiche and as an 
online database through GPO Access. The online database is updated by 6 
a.m. each day the Federal Register is published. The database includes 
both text and graphics from Volume 59, Number 1 (January 2, 1994) 
forward. Free public access is available on a Wide Area Information 
Server (WAIS) through the Internet and via asynchronous dial-in. 
Internet users can access the database by using the World Wide Web; the 
Superintendent of Documents home page address is https://
www.gpoaccess.gov/fr/, by using local WAIS client software, 
or by telnet to swais.gpoaccess.gov, then log in as guest (no password 
required). Dial-in users should use communications software and modem 
to call (202) 512-1661; type swais, then log in as guest (no password 
required).

C. Rulings

    We publish rulings on an infrequent basis. CMS Rulings are 
decisions of the Administrator that serve as precedent final opinions 
and orders and statements of policy and interpretation. They provide 
clarification and interpretation of complex or ambiguous provisions of 
the law or regulations relating to Medicare, Medicaid, Utilization and 
Quality Control Peer Review, private health insurance, and related 
matters. Interested individuals can obtain copies from the nearest CMS 
Regional Office or review them at the nearest regional depository 
library. We have, on occasion, published rulings in the Federal 
Register. Rulings, beginning with those released in 1995, are available 
online, through the CMS Home Page. The Internet address is https://
cms.hhs.gov/rulings.

D. CMS' Compact Disk--Read Only Memory (CD-ROM)

    Our laws, regulations, and manuals are also available on CD-ROM and 
may be purchased from GPO or NTIS on a subscription or single copy 
basis. The Superintendent of Documents list ID is HCLRM, and the stock 
number is 717-139-00000-3. The following material is on the CD-ROM 
disk:
     Titles XI, XVIII, and XIX of the Act.
     CMS-related regulations.
     CMS manuals and monthly revisions.
     CMS program memoranda.
    The titles of the Compilation of the Social Security Laws are 
current as of January 1, 2005. (Updated titles of the Social Security 
Laws are available on the Internet at https://www.ssa.gov/OP_Home/
ssact/comp-toc.htm.) The remaining portions of CD-ROM are updated on a 
monthly basis.
    Because of complaints about the unreadability of the Appendices 
(Interpretive Guidelines) in the State Operations Manual (SOM), as of 
March 1995, we deleted these appendices from CD-ROM. We intend to re-
visit this issue in the near future and, with the aid of newer 
technology, we may again be able to include the appendices on CD-ROM.
    Any cost report forms incorporated in the manuals are included on 
the CD-ROM disk as LOTUS files. LOTUS software is needed to view the 
reports once the files have been copied to a personal computer disk.

IV. How To Review Listed Material

    Transmittals or Program Memoranda can be reviewed at a local 
Federal Depository Library (FDL). Under the FDL program, government 
publications are sent to approximately 1,400 designated libraries 
throughout the United States. Some FDLs may have arrangements to 
transfer material to a local library not designated as an FDL. Contact 
any library to locate the nearest FDL.
    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 Benefit Policy publication titled ``Ultrasound Diagnostic 
Procedures,'' use CMS-Pub. 100-03, Transmittal No. 72.

(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance, Program No. 93.774, Medicare--
Supplementary Medical Insurance Program, and Program No. 93.714, 
Medical Assistance Program)

    Dated: December 10, 2007.
Jacquelyn Y. White,
Director, Office of Strategic Operations and Regulatory Affairs.

Addendum I

    This addendum lists the publication dates of the most recent 
quarterly listings of program issuances.
September 23, 2005 (70 FR 55863)
December 23, 2005 (70 FR 76290)
March 24, 2006 (71 FR 14903)
June 23, 2006 (71 FR 36101)
September 29, 2006 (71 FR 57604)
December 22, 2006 (71 FR 77202)
March 30, 2007 (72 FR 15282)
June 22, 2007 (72 FR 34508)
September 28, 2007 (72 FR 55282)

Addendum II--Description of Manuals, Memoranda, and CMS Rulings

    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

[[Page 73993]]

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.

  Addendum III--Medicare and Medicaid Manual Instructions July Through
                             September 2007
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         Transmittal No.             Manual/Subject/Publication Number
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             Medicare General Information (CMS-Pub. 100-01)
------------------------------------------------------------------------
45..............................  Cancellation of Data File Extract in
                                   CR 3801.
46..............................  Implement New Contractor ID for Single
                                   Testing Contractor; Standard System
                                   Testing Requirements for Maintainers,
                                   Beta Testers, and Contractors.
47..............................  Revision to Certification for Hospital
                                   Services Covered by the Supplementary
                                   Medical Insurance Program as it
                                   Pertains to Ambulance Services.
                                   Certification for Hospital Services
                                   Covered by the Supplementary Medical
                                   Insurance Program.
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                Medicare Benefit Policy (CMS-Pub. 100-02)
------------------------------------------------------------------------
75..............................  Nurse Practitioner Services and
                                   Clinical Nurse Specialist Services
                                   Qualifications for NPs;
                                   Qualifications for CNSs.
76..............................  This Transmittal is rescinded and
                                   replaced by Transmittal 77.
77..............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Sensitivity of Instruction.
78..............................  Unlabeled Use for Anti-Cancer Drugs:
                                   Medical Literature Used to Determine
                                   Medically Accepted Indications for
                                   Drugs and Biologicals Used in Anti-
                                   Cancer Treatment; Unlabeled Use for
                                   Anti-Cancer Drugs.
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       Medicare National Coverage Determination (CMS-Pub. 100-03)
------------------------------------------------------------------------
72..............................  Ultrasound Diagnostic Procedures.
73..............................  This Transmittal is rescinded and
                                   replaced by Transmittal 76.
74..............................  Medicare Clinical Trial Policy;
                                   Routine Costs in Clinical Trials
                                   (Effective July 9, 2007).
75..............................  Lumbar Artificial Disc Replacement.
76..............................  Ultrasound Diagnostic Procedure.
77..............................  Percutaneous Transluminal Angioplasty.
------------------------------------------------------------------------
              Medicare Claims Processing (CMS-Pub. 100-04)
------------------------------------------------------------------------
1281............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Sensitivity of Instruction.
1282............................  Medicare Contractors Use of the
                                   Coordination of Benefits Agreement
                                   Problem Inquiry Request Form To
                                   Identify and Send Coordination of
                                   Benefits Agreement Related Issues to
                                   the Coordination of Benefits
                                   Contractor Consolidation of the
                                   Claims Crossover Process.
1283............................  National Provider Identifier Required
                                   to Enroll in Electronic Data
                                   Interchange; Update of
                                   Telecommunication and Transmission
                                   Protocols for Electronic Data;
                                   Interchange and Deletion of Obsolete
                                   Reference to Medicaid Subrogation
                                   Claims; Electronic Data Interchange
                                   Enrollment; New Enrollments and
                                   Maintenance of Existing Enrollments;
                                   Telecommunication and Transmission
                                   Protocols.
1284............................  Chapter 24 Update and EFT Format
                                   Standardization Electronic Funds
                                   Transfer; Identification of Those
                                   Providers to be Reviewed.
1285............................  Renal Dialysis Facility Line Item
                                   Billing Requirement for Epoetin Alfa
                                   Submitted on End-Stage Renal Disease
                                   Claims; Required Information for In-
                                   Facility Claims Paid Under the
                                   Composite Rate; Epoetin Alfa Facility
                                   Billing Requirements; Payment Amount
                                   for Epoetin Alfa; Self Administered
                                   EPO Supply; Darbepoetin Alfa
                                   (Aranesp) Facility Billing
                                   Requirements.
1286............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Confidentiality of Instruction.
1287............................  Instructions for Downloading the
                                   Medicare ZIP Code Files--January
                                   2008.
1288............................  Update to the Place of Service Code
                                   Set To Add a Code for Prison/
                                   Correctional Facility--VMS Only.
1289............................  Additional Common Working File Editing
                                   for Skilled Nursing Facility
                                   Consolidated Billing; A/B Crossover
                                   Edits; Edit for Ambulance Services;
                                   Edit for Clinical Social Workers.
1290............................  Clarification of Skilled Nursing
                                   Facility Billing Requirements for
                                   Beneficiaries Enrolled in Medicare
                                   Advantage Plans; Medicare Billing
                                   Requirements for Beneficiaries
                                   Enrolled in Medicare Advantage Plans.
1291............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Confidentiality of Instruction.
1292............................  Payment for Hospice Care Based on
                                   Location Where Care is Furnished.
1293............................  This Transmittal is rescinded and will
                                   not be replaced at this time.
1294............................  Revision of the Fiscal Intermediary
                                   Standard System to Forward Payment
                                   Ambulatory Payment Classification to
                                   the Common Working File.
1295............................  Laboratory and Radiology: Adjustment
                                   to Common Working File Duplicate
                                   Claim Edit for the Technical
                                   Component of Radiology and Pathology
                                   Laboratory Services Provided to
                                   Hospital Patients.
1296............................  Modifications to the National
                                   Coordination of Benefits Agreement
                                   Crossover Process; Consolidated
                                   Claims Crossover Process;
                                   Consolidation of the Claims Crossover
                                   Process; Coordination of Benefits
                                   Agreement Detailed Error Report
                                   Notification Process; Coordination of
                                   Benefits Agreement Full Claim File
                                   Repair Process.
1297............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Sensitivity of Instruction.
1298............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Confidentiality of Instruction 1299
                                   Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Confidentiality of Instruction 1300
                                   Healthcare Provider Taxonomy Codes
                                   Update October 2007
1301............................  Revised Information on Positron
                                   Emission Tomography Scan Coding;
                                   Appropriate CPT Codes Effective for
                                   Positron Emission Tomography Scans
                                   for Services Performed on or After
                                   January 28, 2005; Tracer Codes
                                   Required for Positron Emission
                                   Tomography Scans; Medicare Summary
                                   Notice; Remittance Advice Message.
1302............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Confidentiality of Instruction.
1303............................  Modification of Part B Flat File for
                                   Electronic Remittance Advice--
                                   Transaction 835.

[[Page 73994]]

 
1304............................  Reporting of Additional Data to
                                   Describe Services on Hospice Claims;
                                   Levels of Care; Data Required on
                                   Claim to Fiscal Intermediary.
1305............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Confidentiality of Instruction.
1306............................  Medicare Part A Skilled Nursing
                                   Facility Prospective Payment System
                                   Pricer Update for FY 2008.
1307............................  Modification to the National
                                   Monitoring Policy for Erythropoietic
                                   Stimulating Agents for End-Stage
                                   Renal Disease Patients Treated in
                                   Renal Dialysis Facilities; Epoetin
                                   Alfa; Darbepoetin Alfa (Aranesp) for
                                   End-Stage Renal Disease patients.
1308............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Sensitivity of Instruction.
1309............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Confidentiality of Instruction.
1310............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Confidentiality of Instruction.
1311............................  Capturing Days on Which Medicare
                                   Beneficiaries are Entitled to
                                   Medicare; Advantage in the Medicare/
                                   Supplemental Security Income
                                   Fraction; Additional Payment Amounts
                                   for Hospitals with Disproportionate
                                   Share of Low-Income Patients; Low
                                   Income Patient Adjustment: The
                                   Supplemental Security; Income/
                                   Medicare Beneficiary Data for
                                   Inpatient Rehabilitation Facilities
                                   Paid Under the Prospective Payment
                                   System.
1312............................  Timeliness Standards for Processing
                                   Other-Than-Clean Claims.
1313............................  Response to Competitive Acquisition
                                   for Part B Drugs and Biologicals
                                   Claims When the Common Working File
                                   69XD Error Code is Received;
                                   Submission of Claims With the
                                   Modifier JW, ``Drug Amount Discarded/
                                   Not Administered to Any Patient''.
1314............................  Claim Status Category Code and Claim
                                   Status Code Update.
1315............................  Clarification of Percutaneous
                                   Transluminal Angioplasty Billing
                                   Requirements Issued in CR 3811;
                                   Carotid Artery Stenting With Embolic
                                   Protection Coverage.
1316............................  This Transmittal is rescinded and
                                   replaced by Transmittal 1324.
1317............................  2008 Annual Update of Healthcare
                                   Common Procedure Coding System Codes
                                   for Skilled Nursing Facility;
                                   Consolidated Billing for the Common
                                   Working File Medicare Carriers and
                                   Fiscal Intermediaries.
1318............................  This Transmittal is rescinded and
                                   replaced by Transmittal 1333.
1319............................  Date of Service for Laboratory
                                   Specimens.
1320............................  2008 Annual Update for the Health
                                   Professional Shortage Area Bonus
                                   Payment.
1321............................  Sunset of the Physician Scarcity Bonus
                                   Payment; Billing and Payment in a
                                   Physician Scarcity Area; Zip Code
                                   Files; Physician Rendering Anesthesia
                                   in a Hospital Outpatient Setting;
                                   Billing and Payment in a Physician
                                   Scarcity Area.
1322............................  Indian Health Service Hospital Payment
                                   Rates for Calendar Year 2007.
1323............................  Inpatient Rehabilitation Facility
                                   Annual Update: Prospective Payment
                                   System Pricer Changes for FY 2008.
1324............................  Anesthesia Services Furnished by the
                                   Same Physician Providing the Medical
                                   and Surgical Service; General Payment
                                   for Anesthesiology Services.
1325............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Sensitivity of Instruction.
1326............................  Update to the 2007 Medicare Physician
                                   Fee Schedule Database.
1327............................  Schedule for Completing the Calendar
                                   Year (CY) 2008 Fee Schedule Updates
                                   and the Participating Physician
                                   Enrollment Process--(For
                                   Informational Purposes Only).
1328............................  Delete References to Reporting of the
                                   National Provider Identifier on or
                                   after May 23, 2007, and Revise
                                   References to a ``When Required''
                                   Date Carrier Data Element
                                   Requirements; Conditional Data
                                   Element Requirements for Carriers and
                                   DMERCs; Carrier Specific Requirements
                                   for Certain Specialties/Services.
1329............................  Modification to the Timeliness
                                   Requirements for Contractors
                                   Forwarding Reconsideration Requests
                                   Submitted to the Wrong Contractor
                                   Filing a Request for a
                                   Reconsideration.
1330............................  Quarterly Update to Correct Coding
                                   Initiative Edits, Version 13.3,
                                   Effective October 1, 2007.
1331............................  Issued to a specific audience. Not
                                   posted to Internet/Intranet due to
                                   Confidentiality of Instruction.
1332............................  Transitioning the Mandatory Medigap
                                   (``Claim-Based'') Crossover Process
                                   to the Coordination of Benefits
                                   Contractor; Claims Crossover
                                   Disposition Indicators; Coordination
                                   of Benefits Agreement (COBA) Medigap
                                   Claim-Based Crossover Process;
                                   Completion of the Claim Form; Form
                                   CMS-1500 (ANSI X12N 837 Coordination
                                   of Benefits (version 4010)).
1333............................  Ambulance: New Remark Code for Denying
                                   Separately Billed Services General
                                   Coverage and Payment Policies.
1334............................  October 2007 Quarterly Average Sales
                                   Price (ASP) Medicare Part B Drug
                                   Pricing Files and Revisions to Prior
                                   Quarterly Pricing Files.
1335............................  Updating the Internet Only Manual to
                                   Include Language or National
                                   Provider; Identifier When Required;
                                   Payment Under Reciprocal Billing
                                   Arrangements--Claims Submitted to
                                   Carriers; Physicians Payment Under
                                   Locum Tenens Arrangements--Claims
                                   Submitted to Carriers; Billing
                                   Procedures for Entities Qualified To
                                   Receive Payment on Basis of
                                   Reassignment--for Carrier Processed
                                   Claims; Billing Procedures for
                                   Entities Qualified To Receive Payment
                                   on Basis of Reassignment--for Carrier
                                   Processed Claims; Carrier
                                   Participation and Billing
                                   Limitations.
1336............................  October 2007 Update of the Hospital
                                   Outpatient Prospective Payment
                                   System; Summary of Payment Policy
                                   Changes; Billing for Devices Eligible
                                   for Transitional Pass-Through
                                   Payments and Items Classified in
                                   ``New Technology'' APCs; Categories
                                   for Use in Coding Devices Eligible
                                   for Transitional Pass-Through
                                   Payments Under the Hospital OPPS;
                                   Roles of Hospitals, Manufacturers,
                                   and CMS in Billing for Transitional
                                   Pass-Through Items; Devices Eligible
                                   for Transitional Pass-Through
                                   Payments; General Coding and Billing
                                   Instructions and Explanations;
                                   Services Eligible for New Technology
                                   Ambulatory Payment Class Assignment
                                   and Payments.
1337............................  Revisions to 9-Digit ZIP Code List
                                   Provided in Change Request 5208.
1338............................  Issued to a specific audience, not
                                   posted to Internet/Intranet due to
                                   Sensitivity of Instruction.
1339............................  Magnetic Resonance Imaging Procedures.
1340............................  Lumbar Artificial Disc Replacement;
                                   General; Carrier Billing
                                   Requirements; Fiscal Billing
                                   Requirements; Reasons for Denial and
                                   Medicare Summary Notice Claim
                                   Adjustment Reason; Code Messages and
                                   Remittance Advice Remark Code;
                                   Advanced Beneficiary Notice and
                                   Hospital Issued Notice of Noncoverage
                                   Information.
1341............................  New Web Site for Approved Transplant
                                   Centers; Billing Transplant Services;
                                   Kidney Transplants--General; Billing
                                   for Kidney Transplants and
                                   Acquisition Services; Heart
                                   Transplants; Liver Transplants;
                                   Billing for Liver Transplants and
                                   Acquisition Services; Pancreas
                                   Transplants Kidney Transplants;
                                   Pancreas Transplant Alone; Intestinal
                                   and Multi-Visceral Transplants; Renal
                                   Transplantation and Related Services.
1342............................  October 2007 Integrated Outpatient
                                   Code Editor (I/OCE) Specifications
                                   Version 8.3.

[[Page 73995]]

 
1343............................  Stage 3 NPI Changes for Transaction
                                   835 and Standard Paper Remittance;
                                   Advice; Background; Remittance
                                   Balancing; Medicare Standard
                                   Electronic PC Print Software for
                                   Institutional Providers; Part A (A/B
                                   Macs/FIs/RHHIs) SPR Format; Part B (A/
                                   B Mac/Carrier/DMERC/DME MAC) SPR
                                   Format; Part A (A/B MAC/FI/RHHI) SPR
                                   Crosswalk to the 835; 22/50/50.4/Part
                                   B (A/B Mac/Carrier/DMERC/DME MAC) SPR
                                   Crosswalk to the 835.
1344............................  Reasonable Charge Update for 2008 for
                                   Splints, Casts, Dialysis Supplies,
                                   Dialysis Equipment, and Certain
                                   Intraocular Lenses.
1345............................  Remittance Advice Remark Code and
                                   Claim Adjustment Reason Code Update.
1346............................  New Waived Tests.
1347............................  MSN Message: Revised 38.13; General
                                   Information; Seccion De Informacion
                                   General.
------------------------------------------------------------------------
               Medicare Secondary Payer (CMS-Pub. 100-05)
------------------------------------------------------------------------
00..............................  None.
------------------------------------------------------------------------
             Medicare Financial Management (CMS-Pub. 100-06)
------------------------------------------------------------------------
 126............................  Manual Revision Re: Medicare Summary
                                   Notice Workload Reporting; Body of
                                   Report; Part C--Miscellaneous Claims
                                   Data.
127.............................  Instructions for Documenting Scoping
                                   Decision of Provider's Internal
                                   Controls; Revisions to Continuing
                                   Education and Training and Revision
                                   Regarding Time Frame for Settling
                                   Cost Reports; Tests of Internal
                                   Control; Qualifications; Final
                                   Settlement of the Cost Report.
128.............................  Revisions to Instructions On Chapter
                                   1--Budget Preparation--Intermediaries
                                   and Carriers and Chapter 2--Budget
                                   Execution of the Medicare Financial
                                   Management (CMS Pub. 100-06); List of
                                   Acronyms; Budget Preparation Check
                                   List for Program Management and
                                   Medicare Integrity Program;
                                   Instructions for Using the System for
                                   Tracking Audit and Reimbursement
                                   Servicing Contractor; Transmittal and
                                   Due Dates; Exhibit of Variances
                                   Analysis; Variance Analysis;
                                   Transmittal and Due Dates; Budget
                                   Execution Checklist for Program
                                   Management and Medicare Integrity
                                   Program.
129.............................  Notice of New Interest Rate for
                                   Medicare Overpayments and
                                   Underpayments--4th Quarter FY 2007.
130.............................  Revisions of the CROWD Report; Monthly
                                   Statistical Report on Intermediary
                                   and Carrier Part A and Part B Appeals
                                   Activity Form (CMS-2592); General;
                                   Section I--Redeterminations; Section
                                   II--Qualified Independent Contractor
                                   Reconsiderations; Section III--
                                   Administrative Law Judge Results;
                                   Section IV--Medicare Appeals Council
                                   Effectuations; Clerical Error
                                   Reopenings; Validation of Reports.
131.............................  Participating Physicians Report--
                                   Deletion of Requirement to Forward a
                                   Memorandum to CMS Detailing
                                   Adjustments to Form F Column 1 (PAR
                                   Prior) (from previous enrollment
                                   period).
------------------------------------------------------------------------
           Medicare State Operations Manual (CMS-Pub. 100-07)
------------------------------------------------------------------------
 26.............................  Revised Appendix P and Appendix PP--
                                   New Tag F373.
27..............................  Revisions to Appendix PP--Guidance to
                                   Surveyors for Long Term Care
                                   Facilities.
28..............................  Revisions to Appendix D--Guidance to
                                   Surveyors for Portable X-ray.
------------------------------------------------------------------------
              Medicare Program Integrity (CMS-Pub. 100-08)
------------------------------------------------------------------------
215.............................  Implementation of Durable Medical
                                   Equipment Medicare Administrative
                                   Contractor Access to Viable
                                   Information Processing Systems
                                   Medicare Shared System; Medical
                                   Review Functions at DME MACs.
216.............................  Implementation of New Compliance
                                   Standards for Independent Diagnostic
                                   Testing Facilities; Independent
                                   Diagnostic Testing Facility
                                   Attachment; Independent Diagnostic
                                   Testing Facility Standards; Multi-
                                   State Independent Diagnostic Testing
                                   Facility Entities; Interpreting
                                   Physician; Technicians; Supervising
                                   Physicians; Desk and Site Reviews;
                                   Special Procedures and Supplier
                                   Types.
217.............................  Provider Enrollment Fraud Detection
                                   Program for High Risk Areas;
                                   Submission of Proposed Implementation
                                   Plan for High Risk Areas.
218.............................  Provider Enrollment Manual Update;
                                   Introduction to Provider Enrollment;
                                   Definitions; CMS-855 Medicare
                                   Enrollment Applications; Timeframes
                                   for Initial Applications; Timeframes
                                   for Changes of Information; General
                                   Timeliness Principles; Returning the
                                   Application; Basic Information
                                   (Section 1 of the CMS-855); Employer
                                   Identification Numbers and Legal
                                   Business Names; Licenses and
                                   Certifications; Correspondence
                                   Address; Accreditation; Section 2 of
                                   the CMS-855A; Section 2 of the CMS-
                                   855B; Section 2 of the CMS-855I;
                                   Adverse Legal Actions/Convictions;
                                   Practice Location Information;
                                   Section 4 of the CMS-855A; Section 4
                                   of the CMS-855B; Section 4 of the CMS-
                                   855I; Contact Person; Home Health
                                   Agencies; Provider Enrollment
                                   Inquiries.
219.............................  Nurse Practitioner Services and
                                   Clinical Nurse Specialist Services.
220.............................  Various Medical Review Clarifications;
                                   Annual MR Strategy; Verifying
                                   Potential Error and Setting
                                   Priorities; Overview of Prepayment
                                   and Postpayment Review for Medical
                                   Review Purposes; Documentation
                                   Specifications for Areas Selected for
                                   Prepayment or Postpayment Medical
                                   Review; Medical Review Denial
                                   Notices; Automated Prepayment
                                   Review;Postpayment Review of Claims
                                   for Medical Review Purposes; Provider
                                   Notification and Feedback; Provider
                                   Types and Subtypes; Medicare
                                   Integrity Program CERT (Activity Code
                                   21901).
221.............................  Administrative Appeals for Provider
                                   Enrollment Administrative Appeals.
222.............................  Discontinuance of the Unique Physician
                                   Identification Number Registry.
------------------------------------------------------------------------

[[Page 73996]]

 
 Provider Notification and Feedback Medicare Contractor Beneficiary and
                Provider Communications (CMS-Pub. 100-09)
------------------------------------------------------------------------
20..............................  Institute Of Medicine Pub. 100-09,
                                   Chapter 3--Provider Inquiries and
                                   Chapter 6--Provider Customer Service
                                   Program Updates; Availability of
                                   Telephone Services; Automated
                                   Services--Interactive Voice Response;
                                   Toll Free Network Services;
                                   Publication of Toll Free Numbers;
                                   Call Handling Requirements; Customer
                                   Service Assessment and Management
                                   System Reporting Requirements; CSR
                                   Qualifications; Staff Development and
                                   Training; Fraud and Abuse;
                                   Performance Improvements Provider
                                   Contact Center User Group;
                                   Performance Improvements; Contractor
                                   Guidelines for High Quality Responses
                                   to Telephone Inquiries; Quality Call
                                   Monitoring Program; Quality Call
                                   Monitoring Calibration; Quality Call
                                   Monitoring Performance Standards;
                                   Written Inquiries; Contractor
                                   Guidelines for High Quality Responses
                                   to Written Inquiries; Quality Written
                                   Correspondence Monitoring Program;
                                   Quality Written Correspondence
                                   Monitoring Calibration; Quality
                                   Written Correspondence Monitoring
                                   Performance Standards; Walk-In
                                   Inquiries; Guidelines for High
                                   Quality Walk-In Service; Surveys;
                                   Customer Service Operations Surveys;
                                   Provider Satisfaction Surveys;
                                   Contractor Activities Related to the
                                   Medicare Provider Satisfaction
                                   Survey; Provider Inquiry Reporting
                                   Standardization; Provider Transaction
                                   Access Number; Inquiry
                                   Types;Telephone Inquiries; Contractor
                                   Discretion Concerning Interactive
                                   Voice Response Information; Written
                                   Inquiries; Special Inquiry Topics;
                                   Overlapping Claims; Pending Claims;
                                   Requests for Information Available on
                                   the Interactive Voice Response;
                                   Requests for Information Available on
                                   the Remittance Advice Notice;
                                   Deceased Beneficiaries; Disclosure
                                   Desk Reference for Provider Contact
                                   Centers; Authentication of Provider
                                   Elements for Customer Service
                                   Representative Inquiries;
                                   Authentication of Provider Elements
                                   for Interactive Voice Response
                                   Inquiries; Authentication of Provider
                                   Elements for Written Inquiries;
                                   Authentication of Beneficiary
                                   Elements; POE Goals; Error Rate
                                   Reduction Data; Error Rate Reduction
                                   Plan; Refunds/Credits for
                                   Cancellation of Events; Availability
                                   Requirements; Quality Call Monitoring
                                   Program; Telephone Responses; Quality
                                   Written Correspondence Monitoring
                                   Program; Complex Beneficiary
                                   Inquiries; Interactive Voice Response
                                   System; Call Completion; Average
                                   Speed of Answer; Quality Call
                                   Monitoring Performance Standards;
                                   Quality Written Correspondence
                                   Monitoring Performance Standards;
                                   General Inquiries Timeliness;
                                   Customer Service Assessment and
                                   Management System Reporting
                                   Requirements; Provider Transaction
                                   Access Number; Inquiry Types;
                                   Telephone Inquiries; Contractor
                                   Discretion Concerning Interactive
                                   Voice Response Information; Written
                                   Inquiries; Special Inquiry Topics;
                                   Pending Claims; Requests for
                                   Information Available on the
                                   Interactive Voice Response; Requests
                                   for Information Available on the
                                   Remittance Advice Notice; Deceased
                                   Beneficiaries; Disclosure Desk
                                   Reference for Provider Contact
                                   Centers; Authentication of Provider
                                   Elements for Interactive Voice
                                   Response Inquiries; Authentication of
                                   Provider Elements for Written
                                   Inquiries; Authentication of
                                   Beneficiary Elements; Inquiry
                                   Standardized Categories.
------------------------------------------------------------------------
                 Medicare Managed Care (CMS-Pub. 100-16)
------------------------------------------------------------------------
88..............................  Revisions to Chapter 13, ``Medicare
                                   Managed Care Beneficiary Grievances,
                                   Organization Determinations, and
                                   Appeals Applicable to Medicare
                                   Advantage Plans, Cost Plans, and
                                   Health Care Prepayment Plans
                                   (collectively referred to as Medicare
                                   Health Plans)''; Definition of Terms/
                                   Grievance; Responsibilities of the
                                   Medicare Health Plan; Procedures for
                                   Handling a Grievance; Org