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January 3, 2011

Inpatient Hospital Web Guide, Inpatient Rehabilitation Facility PPS Fact Sheet & DMEPOS Competitive Bidding Program Repairs and Replacements Fact Sheets

Updates from the Medicare Learning Network

From the Medicare Learning Network: "Suite of Products and Resources for Inpatient Hospitals" Web Guide

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A new Educational Web Guide is now available from The Medicare Learning Network®. The "Suite of Products and Resources for Inpatient Hospitals" provides Medicare Part-A providers with an understanding of the various PPS rates and classification criterion for reimbursement to acute inpatient hospitals, home health agencies, hospice, hospital outpatient, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities. It also provides Part-A business office management professionals with accurate, timely, and easy-to-understand billing and coding products as well as information to help understand and streamline claims submissions. This product is suggested for all Part-A Medicare Fee-For-Service inpatient hospital providers and is available in downloadable format at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNEdWebGuide/MLN_Suite_of_Products_and_Resources_for_Inpatient_Hospitals.htmlExternal Website.

From the Medicare Learning Network: "Inpatient Rehabilitation Facility Prospective Payment System" Fact Sheet Now Available in Hardcopy

The revised publication titled "Inpatient Rehabilitation Facility Prospective Payment System" (August 2010) is now available in print format from the Medicare Learning Network®. This fact sheet provides information about Inpatient Rehabilitation Facility Prospective Payment System rates, classification criterion, and reasonable and necessary criteria. To place your order, visit https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNGenInfo/index.htmlExternal Website, scroll down to "Related Links Inside CMS" and select "MLN Product Ordering Page."

From theMedicare Learning Network: "DMEPOS Competitive Bidding Program Repairs and Replacements" Fact Sheet

Once the DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) Competitive Bidding Program becomes effective on Sat Jan 1, 2011, beneficiaries with Original Medicare who obtain competitively bid items in competitive bidding areas (CBAs) must obtain these items from a contract supplier for Medicare to pay, unless an exception applies. One exception occurs when an item of DMEPOS that a beneficiary already owns needs to be repaired.

The "DMEPOS Competitive Bidding Program Repairs and Replacements" Fact Sheet contains helpful information on Competitive Bidding Program rules that apply when an item of DMEPOS that is owned by a beneficiary needs to be repaired or requires replacement parts. It includes information on which items and services non-contract suppliers may provide, and which Healthcare Common Procedure Coding System (HCPCS) codes can be considered replacement parts associated with repair of base equipment. To view the fact sheet, please visit the DMEPOS Competitive Bidding Educational Resources page at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSCompetitiveBid/index.htmlExternal Website, scroll down to "Downloads," and select "DMEPOS Competitive Bidding Fact Sheets."

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