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Pulmonary Rehabilitation (PR) Services
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Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months
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Appeals Revisions AIC Requirements
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Date Issued:
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05-07-2010
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Implementation Date:
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10-04-2010
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Effective Date:
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01-01-2010
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Source:
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CMS - Transmittal
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Source#:
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CR6960
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Category:
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Bill/Pmt SNF Inpatient
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CBSI Contact:
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Missy Tieken
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Section 6404 of the Patient Protection and Affordable Care Act (PPACA) amended the timely filing requirements to reduce the maximum time period for submission of all Medicare FFS claims to one calendar year after the date of service.
Medicare contractors shall adjust (as necessary) all relevant system edits so that:
1) claims with dates of service prior to October 1, 2009 will be subject to prePPACA timely filing rules and associated edits;
2) claims with dates of service October 1, 2009 through December 31, 2009 received after December 31, 2010 will be denied as being past the timely filing statute and;
3) claims with dates of service on or after January 1, 2010 received more than 1 calendar year beyond the date of service will be denied as being past the timely filing statute (ex: claim DOS = 3/15/10, claim must be received by COB 3/15/11).
Claims for services that require the reporting of a line item date of service, the line item date is used to determine the date of service. For other claims, the claim statement?s ?From? date is used to determine the date of service.
Section 6404 of
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http://www.cms.gov/transmittals/downloads/R697OTN.pdf
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