[Federal Register Volume 68, Number 60 (Friday, March 28, 2003)]
[Notices]
[Pages 15196-15206]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-7063]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-9016-N]


Medicare and Medicaid Programs; Quarterly Listing of Program 
Issuances--October 2002 Through December 2002

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 October 2002 through December 2002, relating to the 
Medicare and Medicaid programs. This notice also provides information 
on national coverage determinations affecting specific medical and 
health care services under Medicare. Additionally, this notice 
identifies certain devices with investigational device exemption 
numbers approved by the Food and Drug Administration that potentially 
may be covered under Medicare.
    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, we are also including all Medicaid 
issuances and Medicare and Medicaid substantive and interpretive 
regulations (proposed and final) published during this timeframe.

FOR FURTHER INFORMATION CONTACT: It is possible that an interested 
party may have a specific information need and not be able to determine 
from the listed information whether the issuance or regulation would 
fulfill that need. Consequently, we are providing information 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 items in Addendum III may be addressed to 
Karen Bowman, Office of Strategic Operations and Regulatory Affairs, 
Centers for Medicare & Medicaid Services, C5-16-03, 7500 Security 
Boulevard, Baltimore, MD 21244-1850, (410) 786-5252.
    Questions concerning national coverage determinations should be 
directed to Shana Olshan, Office of Clinical Standards and Quality, 
Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security 
Boulevard, Baltimore, MD 21244-1850, (410) 786-3122.
    Questions concerning Investigational Device Exemptions items in 
Addendum VI may be addressed to Sharon Hippler, Office of Clinical 
Standards and Quality, Centers for Medicare & Medicaid Services, C5-13-
27, 7500 Security Boulevard, Baltimore, MD 21244-1850, (410) 786-4633.
    Questions concerning all other information may be addressed to 
Margie Teeters, Office of Strategic Operations and Regulatory Affairs, 
Regulations Development and Issuances Group, Centers for Medicare & 
Medicaid Services, C5-13-18, 7500 Security Boulevard, Baltimore, MD 
21244-1850, (410) 786-4678.

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 
these 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, fiscal intermediaries and 
carriers 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, we are continuing our 
practice of including Medicare substantive and interpretive regulations 
(proposed and final) published during the 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, national coverage determinations, and Food and Drug 
Administration-approved investigational device exemptions published 
during the timeframe 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

[[Page 15197]]

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 Coverage Issues Manual may wish to review 
the August 21, 1989 publication (54 FR 34555). Those interested in the 
procedures used in making national coverage determinations may review 
the April 27, 1999 publication (64 FR 22619). In this publication, the 
1989 proposed rule affecting national coverage procedures and decisions 
(54 FR 4302) was withdrawn, and the procedures for national coverage 
determinations established.
    To aid the reader, we have organized and divided this current 
listing into six addenda:
    [sbull] Addendum I lists the publication dates of the most recent 
quarterly listings of program issuances.
    [sbull] Addendum II identifies previous Federal Register documents 
that contain a description of all previously published CMS Medicare and 
Medicaid manuals and memoranda.
    [sbull] 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 instruction or many. Often, it is 
necessary to use information in a transmittal in conjunction with 
information currently in the manuals.
    [sbull] Addendum IV lists all substantive and interpretive Medicare 
and Medicaid regulations and general notices published in the Federal 
Register during the quarters covered by this notice. For each item we 
list the--
    [sbull] Date published;
    [sbull] Federal Register citation;
    [sbull] Parts of the Code of Federal Regulations (CFR) that have 
changed (if applicable);
    [sbull] Agency file code number; and
    [sbull] Title of the regulation.
    [sbull] Addendum V includes completed national coverage 
determinations from the quarter covered by this notice. Completed 
decisions are identified by title, a brief description, effective date, 
and section in the appropriate Federal publication.
    [sbull] Addendum VI includes listings of the Food and Drug 
Administration-approved investigational device exemption 
categorizations, using the investigational device exemption numbers the 
Food and Drug Administration 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 
investigational device exemption number.

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: http://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 http://www.access.gpo.gov/nara/index.html, by using local WAIS client 
software, or by telnet to swais.access.gpo.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. 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 http://cms.hhs.gov/rulings.

D. CMS's 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:
    [sbull] Titles XI, XVIII, and XIX of the Act.
    [sbull] CMS-related regulations.
    [sbull] CMS manuals and monthly revisions.
    [sbull] CMS program memoranda.
    The titles of the Compilation of the Social Security Laws are 
current as of January 1, 1999. (Updated titles of the Social Security 
Laws are available on the Internet at http://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

[[Page 15198]]

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.
    Superintendent of Documents numbers for each CMS publication are 
shown in Addendum III, along with the CMS publication and transmittal 
numbers. To help FDLs locate the materials, use the Superintendent of 
Documents number, plus the transmittal number. For example, to find the 
Part 3--Claims Process, (CMS Pub. 13-3) transmittal entitled ``Hearing 
Aide Exclusion,'' use the Superintendent of Documents No. HE 22.8/6 and 
the transmittal number 1868.

(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: March 18, 2003.
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.

August 11, 1998 (63 FR 42857)
September 16, 1998 (63 FR 49598)
December 9, 1998 (63 FR 67899)
May 11, 1999 (64 FR 25351)
November 2, 1999 (64 FR 59185)
December 7, 1999 (64 FR 68357)
January 10, 2000 (65 FR 1400)
May 30, 2000 (65 FR 34481)
June 28, 2002 (67 FR 43762)
September 27, 2002 (67 FR 61130)
December 27, 2002 (67 FR 79109)

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 Medicare 
Coverage Issues Manual was published on August 21, 1989, at 54 FR 
34555. (Please note that in this publication the 1989 proposed rule 
referred to, concerning the criteria for national coverage 
determinations, was withdrawn (64 FR 22619)). A brief description of 
the various Medicaid manuals and memoranda that we maintain was 
published on October 16, 1992 (57 FR 47468).

        Addendum III.--Medicare and Medicaid Manual Instructions
                  [October 2002 Through December 2002]
------------------------------------------------------------------------
 Transmittal  No.                 Manual/Subject/Publication number
------------------------------------------------------------------------
                           Intermediary Manual
                         Part 3--Claims Process
                             (CMS Pub. 13-3)
               (Superintendent of Documents No. HE 22.8/6)
------------------------------------------------------------------------
1863                [sbull]  Prospective Payment System Pricer Program
                    .......  Provider-Specific Payment Data
                    .......  Provider-Specific Data Record Layout and
                              Description
1864                [sbull]  Mammography Screening
                    .......  Diagnostic and Screening Mammography
                              Performed With New Technologies
1865                [sbull]  Overpayments for Provider Services--General
1866                [sbull]  Pneumococcal Pneumonia, Influenza Virus and
                              Hepatitis B Vaccines
1867                [sbull]  Immunosuppressive Drugs Furnished to
                              Transplant Patients
1868                [sbull]  Hearing Aide Exclusion
1869                [sbull]  Payment for Services Furnished by a
                              Critical Access Hospital
1870                [sbull]  Payment for Services Furnished by a
                              Critical Access Hospital
1871                [sbull]  Heart Transplants
-------------------
                             Carriers Manual
                         Part 3--Claims Process
                             (CMS Pub. 14-3)
               (Superintendent of Documents No. HE 22.8/7)
------------------------------------------------------------------------
1772                [sbull]  Type of Service
1773                [sbull]  Durable Medical Equipment Regional Carriers
                              Only--Appeals of Duplicate Claims
                    .......  Introduction to the Appeals Process
1774                [sbull]  Home Dialysis Patients' Options for Billing
                    .......  Payment for Method II Home Dialysis
                              Supplies When the Beneficiary is an
                              Inpatient
1775                [sbull]  Identifying a Screening Mammography Claim
                              and a Diagnostic Mammography Claim
                    .......  Diagnostic and Screening Mammography
                              Performed With New Technologies
1776                [sbull]  Evaluation and Management Services Codes--
                              General
1777                [sbull]  Overpayments--General
1778                [sbull]  Healthcare Common Procedure Coding System
                              Coding
1779                [sbull]  Coding Physician Specialty
                    .......  Coding Type of Supplier and Non-Physician
                              Practitioners
1780                [sbull]  Supervising Physicians in Teaching Settings
1781                [sbull]  Hearing Aid Exclusion
1782                [sbull]  Mandatory Assignment and Other Requirements
                              for Home Dialysis Supplies and Equipment
                              Paid Under Method II
1783                [sbull]  Type of Service
1784                [sbull]  Recovery Where Fraud Is Suspected
-------------------

[[Page 15199]]

 
                             Carriers Manual
                     Part 4--Professional Relations
                             (CMS Pub. 14-4)
              (Superintendent of Documents No. HE 22.8/7-4)
------------------------------------------------------------------------
27                  [sbull]  Surrogate Unique Physician Identification
                              Number
-------------------
                            Program Memoranda
                      Intermediaries (CMS Pub. 60A)
              (Superintendent of Documents No. HE 22.8/6-5)
------------------------------------------------------------------------
A-02-094            [sbull]  Annual Desk Review Program for Hospital
                              Wage Data: Cost Reporting Periods
                              Beginning on or after October 1, 1999,
                              Through September 30, 2000 (Fiscal Year
                              2004 Wage Index)
A-02-095            [sbull]  Production Dates for the Provider
                              Statistical and Reimbursement Report and
                              Extension of Due Date for Filing Provider
                              Cost Reports for Providers Having Their
                              Claims Processed by the Arkansas Part A
                              Standard System and Request for Wage Data
                              for the FY 2004 Wage Index
A-02-096            [sbull]  Payment of Skilled Nursing Facility Claims
                              for Beneficiaries Disenrolling from
                              Terminating Medicare+Choice Plans Who Have
                              Not Met the 3-Day Hospital Stay
                              Requirement
A-02-097            [sbull]  Special Handling of New ``K'' Codes K0556,
                              K0557, K0558, and K0559
A-02-098            [sbull]  Changes in Transitional Outpatient Payment
                              for 2003
A-02-099            [sbull]  Scheduled Release for January Updates to
                              Software Programs and Pricing/Coding Files
A-02-100            [sbull]  Installation of Version 27.4 of the
                              Provider Statistical and Reimbursement
                              Report
A-02-101            [sbull]  Changes to the Prospective Payment System
                              and Consolidated Billing for Skilled
                              Nursing Facilities--Update as Published in
                              the Federal Register, Fiscal Year 2001 (66
                              FR 39572, July 31, 2001), and Transmittal
                              A-01-144, December 20, 2001 Hospice Wage
                              Index Fiscal Year 2003, as published in
                              the Federal Register (67 FR 56092, August
                              30, 2002) Update to the Prospective
                              Payment System for Home Health Agencies
                              for FY 2003; as Published in the Federal
                              Register, (67 FR 43616, June 28, 2002)
A-02-102            [sbull]  Medicare Certified Hospices--Clarification
                              of Acceptable Parameters for Some
                              Contractual Arrangements
A-02-103            [sbull]  New Electronic Remittance Advice Coding for
                              Home Health Prospective Payment System
                              Adjustments
A-02-104            [sbull]  Provider Education Article: Home Health
                              Agencies Responsibilities Regarding
                              Patient Notification
A-02-105            [sbull]  Removal of Common Working File Edit on Non-
                              Covered Hospice Claims
A-02-106            [sbull]  Provider Education Article: Hospitals
                              Responsibilities Re: Patient Notification
                              at Discharge Planning and Home Health
                              Consolidated Billing
A-02-107            [sbull]  Revisions to Common Working File Editing to
                              Accommodate Home Health Partial Episode
                              Payment Claims and Rescheduling of Payment
                              Adjustment Utility
A-02-108            [sbull]  Multiple Patient Ambulance Transport
A-02-109            [sbull]  Cost Based Payment for Certified Registered
                              Nurse Anesthetists' Services Furnished by
                              Outpatient Prospective Payment System
                              Hospitals
A-02-110            [sbull]  Financially Required Changes for the Fiscal
                              Intermediary Standard System Paid Claim
                              File
A-02-111            [sbull]  October 2002 Update to the Hospital
                              Outpatient Prospective Payment System--
                              Correction--This instruction replaces PM A-
                              02-076 (CR 2298) issued on August 7, 2002.
A-02-112            [sbull]  Program Integrity Management Reporting
                              System for Part A--Phase1
A-02-113            [sbull]  Transmittal A-02-113 Has Been Rescinded
A-02-114            [sbull]  Revisions to the Outpatient Prospective
                              Payment System Pricer Software and
                              Outpatient Code Editor for Blood
                              Deductible and Technical Charges
A-02-115            [sbull]  Medical Nutrition Therapy Services for
                              Beneficiaries With Diabetes or Renal
                              Disease--POLICY CHANGE
A-02-116            [sbull]  Long Term Care Hospital Prospective Payment
                              System: Requirements for Provider
                              Education and Training
A-02-117            [sbull]  Correction to Updated Instruction on
                              Receipt and Processing on Non-Covered
                              Charges on Other Than Part A Inpatient
                              Claims (Transmittal A-02-071)
A-02-118            [sbull]  Annual Update of Healthcare Common
                              Procedure Coding System Codes for Skilled
                              Nursing Facility Consolidated Billing
                              Enforcement, Updated Skilled Nursing
                              Facility Help File
A-02-119            [sbull]  0001 Revenue Line Direction for the Health
                              Insurance Portability and Accountability
                              Act Institutional 837 Health Care Claim
A-02-120            [sbull]  Change in Requirements for Medicare Payment
                              for Low Osmolar Contrast Material Under
                              the Outpatient Prospective Payment System
A-02-121            [sbull]  Skilled Nursing Facility Adjustment
                              Billing: Adjustments to Health Insurance
                              Prospective Payment System Codes Resulting
                              From Minimum Data Set Corrections
A-02-122            [sbull]  Notice Regarding Cost-to-Charge Ratios and
                              Inpatient Outlier Payments
A-02-123            [sbull]  Hospital Billing for Immunosuppressive
                              Drugs Furnished to Transplant Patients--
                              ACTION
A-02-124            [sbull]  Necessary Changes to Implement Special Add-
                              On Payments for New Technologies
A-02-125            [sbull]  Installation of Version 29.0 of the
                              Provider Statistical and Reimbursement
                              Reporting System
A-02-126            [sbull]  Instructions Regarding Hospital Outlier
                              Payments
A-02-127            [sbull]  Indian Health Service Hospital Payment
                              Rates for Calendar Year 2002
-------------------
                           Program Memorandum
                                Carriers
                             (CMS Pub. 60B)
              (Superintendent of Documents No. HE 22.8/6-5)
------------------------------------------------------------------------
B-01-062            [sbull]  Payment to Registered Dietitians for
                              Diabetes Outpatient Self-Management
                              Training Services

[[Page 15200]]

 
B-02-063            [sbull]  Annual Updating of ICD -9-CM Codes Must Be
                              Date of Services Driven
B-02-064            [sbull]  Viable Information Processing System
                              Implementation to Process ICD-9-CM Codes
                              Using Date of Service and Not Date of
                              Receipt
B-02-065            [sbull]  Durable Medical Equipment Regional Carriers-
                              Establishment Common Working File Override
                              for Legitimate Duplicate Claims
B-02-066            [sbull]  Ambulance Services: Maintaining Point-of-
                              Pickup Zip Code
B-02-067            [sbull]  Revision to Messages for Skilled Nursing
                              Facility Consolidated Billing and
                              Implementation of Common Working File
                              Edits for Clinical Social Workers for
                              Skilled Nursing Facility Consolidated
                              Billing
B-02-068            [sbull]  Revised X12N 4010 837 Professional Flat
                              File
B-02-069            [sbull]  Messages for Use With Drug Claims
B-02-070            [sbull]  Reporting of Admission Date and Additional
                              Edit Requirements for the X12N 837
                              (Version 4010) Coordination of Benefits
                              Transaction
B-02-071            [sbull]  Use of the National Drug Code for Drug
                              Claims at the Durable Medical Equipment
                              Regional Carriers
B-02-072            [sbull]  Calendar Year 2003 Participation Enrollment
                              and Medicare Participating Physicians and
                              Supplies Directory Procedures
B-02-073            [sbull]  Durable Medical Equipment Regional Carriers-
                              Establishment Common Working File Override
                              for Legitimate Duplicate Claims
B-02-074            [sbull]  Clarification on System Changes in Change
                              Request 2299
B-02-075            [sbull]  Carrier Review of Payment Amounts for
                              Portable X-Ray Transportation Services
                              (HCPCS code R0070)--Request
B-02-076            [sbull]  Annual Update for Skilled Nursing Facility
                              Consolidated Billing for the Common
                              Working File and Medicare Carriers
B-02-077            [sbull]  Program Integrity Management Reporting
                              System for Part B
B-02-078            [sbull]  Medical Review Progressive Corrective
                              Action--ACTION
B-02-079            [sbull]  Contractor Reporting of Operational and
                              Workload Data for Electronic Data
                              Interchange and Manual Transactions
B-02-080            [sbull]  Medicare Status Code System Standard System
                              Financial Data Report Requirements for the
                              Production Performance Monitoring System,
                              Pulse System
B-02-081            [sbull]  Migrate Medicare Carrier Provider/Supplier
                              Enrollment Data From the Existing Carrier
                              Provider Enrollment System into the
                              Provider Enrollment Chain Ownership System
B-02-082            [sbull]  Migrate Medicare Carrier Provider/Supplier
                              Enrollment Data From the Existing Carrier
                              Provider Enrollment System into the
                              Provider Enrollment Chain Ownership System
                              and Shut Down All Provider Enrollment
                              Functions in Percutaneous Electrical Nerve
                              Stimulation
B-02-083            [sbull]  Create Import/Export Functionality Between
                              the Unique Provider Identification Number
                              System and the Provider Enrollment Chain
                              Ownership System
B-02-084            [sbull]  Create Import/Export Functionality Between
                              the Medicare Claims System and the
                              Provider Enrollment Chain Ownership System
B-02-085            [sbull]  Process All Medicare Part B Provider
                              Enrollments in the Provider Enrollment
                              Chain Ownership System. Modify the
                              Medicare Claims System to Incorporate All
                              Claim Payment and Provider Correspondence
                              Functionality That Is Included in the
                              Provider Enrollment System But Will Not Be
                              a Part of Provider Enrollment System. Shut
                              Down All Provider Enrollment Functions in
                              Provider Enrollment System
B-02-086            [sbull]  Create Import/Export Functionality Between
                              the Viable Medicare System and the
                              Provider Enrollment Chain Ownership System
B-02-087            [sbull]  Skilled Nursing Facility Consolidated
                              Billing--New Requirements for Claims for
                              Durable Medical Equipment, Prosthetics,
                              Orthotics, and Supplies
B-02-088            [sbull]  Changes to Correct Coding Edits, Version
                              9.1, Effective April 1, 2003
B-02-089            [sbull]  Further Instructions Regarding the
                              Reasonable Charge Update for 2003 for
                              Splints and Casts
B-02-090            [sbull]  Implementation of the National Council for
                              Prescription Drug Programs (NCPDP)
                              Telecommunications Standard Version 5.1
                              and the Equivalent Batch Standard Version
                              1.1 for Retail Pharmacy Drug Transactions--
                              CORRECTION
B-02-091            [sbull]  Provider Education Article: Requirements
                              for Payment of Medicare Claims for Foot
                              and Nail Care Services
B-02-092            [sbull]  Electromagnetic Stimulation
-------------------
 Program Memoranda
  Intermediaries/
     Carriers
 (CMS Pub. 60A/B)
(Superintendent of
 Documents No. HE
     22.8/6-5)
-------------------
AB-02-134           [sbull]  Questions and Answers Related to
                              Implementation of National Coverage
                              Determinations for Clinical Diagnostic
                              Laboratory Services
AB-02-135           [sbull]  System Networking Electronic Correspondence
                              Referral System 1.3 User and Installation
                              Guides for Testing and Production
AB-02-136           [sbull]  Reasonable Charge Update for 2003 for
                              Splints, Casts, Dialysis Supplies,
                              Dialysis Equipment, Therapeutic Shoes, and
                              Certain Intraocular Lenses
AB-02-137           [sbull]  Annual Update of Healthcare Common
                              Procedure Coding System Codes Used for
                              Home Health Consolidated Billing
                              Enforcement
AB-02-138           [sbull]  Instructions for Fiscal Intermediary
                              Standard System and Multi-Carrier System
                              Healthcare Integrated General Ledger
                              Accounting System Changes
AB-02-139           [sbull]  Additional Guidance for Applying the
                              Medicare Self-Administered Drug Exclusion
AB-02-140           [sbull]  Data Center Testing and Production--
                              Electronic Correspondence Referral System
                              User Manual 5.1 and Quick Reference Guide
                              Replacement
AB-02-141           [sbull]  Charging Fees to Providers for Medicare
                              Education and Training Activities-Program
                              Management
AB-02-142           [sbull]  Remittance Advice Coding Update
AB-02-143           [sbull]  Provider Education Article: Psychotropic
                              Drug Use in Skilled Nursing Facilities
AB-02-144           [sbull]  Virginia Cardiac Surgery Initiative
                              Demonstration

[[Page 15201]]

 
AB-02-145           [sbull]  Electronic Patient Records Via Non-Internet
                              Means
AB-02-146           [sbull]  Revision to the Healthcare Provider
                              Taxonomy Codes Crosswalk
AB-02-147           [sbull]  Promoting Influenza Vaccinations
AB-02-148           [sbull]  Remittance Advice Message for Ambulance
                              Services
AB-02-149           [sbull]  Update to the Mammography Quality Standard
                              Act File Record Layout for the Food and
                              Drug Administration Certified Digital
                              Mammography Centers
AB-02-150           [sbull]  Payment of Physician and Nonphysician
                              Services for Certain Indian Providers
AB-02-151           [sbull]  Clarification Regarding Non-physician
                              Practitioners Billing on Behalf of a
                              Diabetes Outpatient Self-Management
                              Training Services Program and the Common
                              Working File Edits for Diabetes Outpatient
                              Self-Management Training Services &
                              Medical Nutrition Therapy. (Note: APASS
                              has received a waiver for this Change
                              Request
AB-02-152           [sbull]  Fee Schedule Update for 2003 for Durable
                              Medical Equipment, Prosthetics, Orthotics,
                              and Supplies
AB-02-153           [sbull]  Claims Processing Instructions for the
                              Medicare Disease Management Demonstration
AB-02-154           [sbull]  New Waived Tests--September 27, 2002
AB-02-155           [sbull]  Beneficiary Notification of Denials Based
                              on Local Medical Review Policy
AB-02-156           [sbull]  Coverage and Billing for Neuromuscular
                              Electrical Stimulation
AB-02-157           [sbull]  Codes Billable by Skilled Nursing
                              Facilities and Suppliers for Skilled
                              Nursing Facility Residents--Notice of New
                              File Available via CMS Mainframe
                              Telecommunication System
AB-02-158           [sbull]  Common Working File, Fiscal Intermediary,
                              and Carrier Edits and Policy Clarification
                              for Peripheral Neuropathy With Loss of
                              Protective Sensation in People With
                              Diabetes
AB-02-159           [sbull]  Medicare Deductible and Premium Rates for
                              Calendar Year 2003
AB-02-160           [sbull]  Medicare Telehealth Update
AB-02-161           [sbull]  Coverage and Billing Requirements for
                              Electrical Stimulation for the Treatment
                              of Wounds
AB-02-162           [sbull]  Deported Medicare Beneficiaries
AB-02-163           [sbull]  2003 Clinical Laboratory Fee Schedule and
                              Laboratory Services Subject to Reasonable
                              Charge Payment Method
AB-02-164           [sbull]  Carrier, Durable Medical Equipment Regional
                              Carrier, Intermediary and Regional Home
                              Health Intermediary Processing
                              Requirements for Claims Edited by Common
                              Working File for Medicare Beneficiaries in
                              State or Local Custody Under a Penal
                              Authority
AB-02-165           [sbull]  Levocarnitine for Use in the Treatment of
                              Carnitine Deficiency in End Stage Renal
                              Disease Patients
AB-02-166           [sbull]  Editing of the Healthcare Provider Taxonomy
                              Codes and Use of the Healthcare Provider
                              Taxonomy Codes Crosswalk
AB-02-167           [sbull]  Notice of Interest Rate for Medicare
                              Overpayments and Underpayments
AB-02-168           [sbull]  Advance Beneficiary Notice and Durable
                              Medical Equipment Prosthetics, Orthotics &
                              Supplies Refund Requirements--Corrections
                              to PM AB-02-114
AB-02-169           [sbull]  Notice Requirement Related to Local Medical
                              Review Policies
AB-02-170           [sbull]  File Descriptions and Instructions for
                              Retrieving the 2003 Ambulatory Surgical
                              Center Healthcare Common Procedure Code
                              Additions and Deletions
AB-02-171           [sbull]  X12N Health Care Eligibility Benefit
                              Inquiry/Response (270/271) Transaction
                              Security and Connectivity Instructions
AB-02-172           [sbull]  Next Generation Desktop Data Center
                              Connectivity--Security Information
                              Clarification to Change Request 2079 (AB-
                              02-073) Dated May 16, 2002
AB-02-173           [sbull]  Ambulance Fee Schedule Updates for 2003
AB-02-174           [sbull]  Single Drug Pricer
AB-02-175           [sbull]  Revisions to Common Working File Edits for
                              Skilled Nursing Facility Consolidated
                              Billing to Permit Payment for Certain
                              Diagnostic Services Furnished to
                              Beneficiaries Receiving Treatment for End
                              Stage Renal Disease at an Independent or
                              Provider-Based Dialysis Facility
AB-02-176           [sbull]  Prior Approval Requirement for Data Center
                              and Front End Movement
AB-02-177           [sbull]  Independent Laboratory Billing for the
                              Technical Component of Physician Pathology
                              Services to Hospital Patients
AB-02-178           [sbull]  Clarification of the Comprehensive Error
                              Rate Testing Program Contractor Resolution
                              Process
AB-02-179           [sbull]  Complaint Screening
AB-02-180           [sbull]  Coverage and Billing for Home Prothrombin
                              Time International Normalized Ratio
                              Monitoring for Anticoagulation Management
AB-02-181           [sbull]  Medicare Physician Fee Schedule Update and
                              the 2003 Participation Enrollment Process
AB-03-182           [sbull]  Coverage and Billing of Sacral Nerve
                              Stimulation
AB-02-183           [sbull]  Coverage of Hyperbaric Oxygen Therapy for
                              the Treatment of Diabetic Wounds of the
                              Lower Extremities
AB-02-184           [sbull]  Provider Notification of Denials Based on
                              Local Medical Review Policy
AB-02-185           [sbull]  Deletion of Q Codes and Reactivation of CPT
                              Codes for Hepatitis B Vaccine
-------------------
                  Provider Reimbursement Manual--Part 1
                             (CMS Pub. 15-1)
                Superintendent of Documents No. HE 22.8/4
------------------------------------------------------------------------
423                 [sbull]  Regional Medicare Swing-Bed Rates
-------------------
                             Hospital Manual
                              (CMS Pub. 10)
               (Superintendent of Documents No. HE 22.8/2)
------------------------------------------------------------------------
791                 [sbull]  Billing for Mammography Screening
                    .......  Diagnostic Mammography
                    .......  Diagnostic and Screening Mammograms
                              Performed with New Technologies
792                 [sbull]  Pneumococcal Pneumonia, Influenza Virus,
                              and Hepatitis B Vaccines
793                 [sbull]  Payment for Services Furnished by a
                              Critical Access Hospital

[[Page 15202]]

 
794                 [sbull]  Payment for Services Furnished by a
                              Critical Access Hospital
795                 [sbull]  Heart Transplants
                     Skilled Nursing Facility Manual
                             (CMS--Pub. 12)
               Superintendent of Documents No. HE 22. 8/3
------------------------------------------------------------------------
375                 [sbull]  Coverage and Patient Classification
-------------------
                         Coverage Issues Manual
                              (CMS--Pub. 6)
               Superintendent of Documents No. HE 22. 8/14
------------------------------------------------------------------------
160                 [sbull]  Neuromuscular Electrical Stimulation for
                              Use by Spinal Cord Injured Patients for
                              Walking
161                 [sbull]  Electrical Stimulation for the Treatment of
                              Wounds
                    .......  Durable Medical Equipment--Reference List
162                 [sbull]  Photosensitive Drugs
                    .......  Levocarnitine for Use in the Treatment of
                              Carnitine Deficiency in End Stage Renal
                              Disease Patients
163                 [sbull]  Home Blood Glucose Monitors
164                 [sbull]  Hyperbaric Oxygen Therapy
165                 [sbull]  Heart Transplants.
-------------------
                          Financial Management
                            (CMS--Pub. 100-6)
------------------------------------------------------------------------
12                  [sbull]  Bankruptcy
                    .......  Glossary of Acronyms
                    .......  Basic Bankruptcy Terms and Definitions
                    .......  Bankruptcy is Litigation
                    .......  Types of Bankruptcies
                    .......  Filing Bankruptcy Draws a Line in the Sand
                    .......  Bankruptcy Affects Nearly All Medicare
                              Operations
                    .......  Recoupment and Set-off Time is of the
                              Essence
                    .......  Definitions
                    .......  Contractor's Establishment of Relationships
                              to Ensure Effective Actions Regarding
                              Providers in Bankruptcy
                    .......  Contractor Staff Must Establish
                              Relationships to Ensure That the Regional
                              Office and Regional Counsel Receive Prompt
                              Notice of Provider Bankruptcies, So That
                              Medicare Can Take Quick Action Contractors
                              Must Recognize and Advise Regional Office
                              Staff About Potential Provider
                              Bankruptcies
                    .......  Contractor Staff Will Establish a
                              Relationship With the Regional Office That
                              has Jurisdiction Over the Bankruptcy
                              Regional Office Jurisdiction Generally
                              Parallels the Bankruptcy Court Where Case
                              is Filed
                    .......  Contractor and Regional Office Bankruptcy
                              Point of Contact Staff Member
                    .......  Actions to Take When a Provider Files for
                              Bankruptcy
                    .......  Establish Effective Lines of Communication
                              With Partners
                    .......  Respond to Regional Office Requests for
                              Information
                    .......  Immediate Contractor Directives From the
                              Regional Office
                    .......  Tracking Debts/Contract Officer
                              Communications
                    .......  Chain Bankruptcies
                    .......  Chain Providers
                    .......  Single Providers Serviced by a National
                              Contractor
                    .......  Affirmative Recovery Actions
                    .......  Working With the Regional Office and
                              Regional Counsel's Office
                    .......  Assumption of the Medicare Provider
                              Agreement
                    .......  Settlement Agreements or Stipulations
                    .......  Recoupment
                    .......  Administrative Freeze/Set-off
                    .......  Preparing and Filing Proof of Claim
                    .......  Closure of Bankruptcy Cases and Treatment
                              of Overpayment Reporting
                    .......  Systems at End of Bankruptcy
                    .......  Closing the Bankruptcy Case
                    .......  Debt Located at the Debt Collection Center
                              or Department of the Treasury
                    .......  Managing Bankruptcy Debt at the Contractor
                              Location
-------------------
                        Peer Review Organization
                           (CMS--Pub. 100-10)
              Superintendent of Documents No. HE 22.8/8-15
------------------------------------------------------------------------
89                  [sbull]  Citations and Authority
                    .......  Identification of Potential Violations
                    .......  Meeting With a Practitioner or Other Person
                    .......  Quality Improvement Organization Finding of
                              a Violation
                    .......  Quality Improvement Organization Action on
                              Final Finding of a Violation

[[Page 15203]]

 
                    .......  Quality Improvement Organization Report to
                              the Office of Inspector General
                    .......  Imposition and Notification of Sanctions
                    .......  Effect of an Exclusion Sanction on Medicare
                              Payment and Services
                    .......  Reinstatement After Exclusion
                    .......  Appeal Rights of the Excluded Practitioner
                              or Other Person
-------------------
                     End Stage Renal Disease Network
                           (CMS--Pub. 100-14)
------------------------------------------------------------------------
14                  [sbull]  Authority
                    .......  Network's Role Prior to Initiating Sanction
                              Recommendation
                    .......  Project Officer Role in Sanction Procedures
                    .......  Duration and Removal of Alternative
                              Sanction
                    .......  Definitions for the End Stage Renal Disease
                              Complaint and Grievance Process
                    .......  End Stage Renal Disease Complaints and
                              Grievance
                    .......  Role of Network in Handling a Complaint/
                              Grievance
                    .......  End Stage Renal Disease Complaints and
                              Grievance Process
                    .......  Facility Awareness of the Complaint/
                              Grievance Process
                    .......  Use of Facility Complaint/Grievance Process
                    .......  Determination of Your Involvement
                    .......  Receiving a Complaint/Grievance
                    .......  Request of Grievance in Writing
                    .......  Referring Complaints and Grievances
                    .......  Written Acknowledgement of Grievances
                    .......  Investigation of Complaints and Grievances
                    .......  Life-Threatening Situations
                    .......  Challenging Patient Situations
                    .......  Advocating for Patient Rights
                    .......  Addressing a Complaint or Grievance
                    .......  Follow-up of a Grievance
                    .......  Conclusion of a Grievance Investigation
                    .......  Report and Letter to the Grievant
                    .......  Potential Outcomes of Complaint/Grievance
                              Process
                    .......  Improvement Plans
                    .......  Content of Improvement Plans
                    .......  Time Periods for Review and Acceptance/
                              Rejection of Improvement Plans
                    .......  Improvement Plans Tracking System
                    .......  Conclusion of Improvement Plans
                    .......  Non-Compliance With Improvement Plans
                    .......  Confidentiality and Disclosure of
                              Information
                    .......  Identity of Complainant/Grievant
                    .......  Identity of Practitioner
                    .......  Identity of Facility
                    .......  Personal Representative
                    .......  Conflict of Interest
                    .......  End Stage Renal Disease Network Complaint
                              Process
                    .......  End Stage Renal Disease Grievance Process
                    .......  End Stage Renal Disease Inquiry Process
                    .......  Time Table for Complaints and Grievances
                    .......  Model Response Letter of Acknowledgement of
                              a Written Complaint/Grievance
                    .......  Consent to Disclose Identity--Model Form
                    .......  Designation of a Representative--Model Form
                    .......  Final Response to Grievant--Model Letter
------------------------------------------------------------------------


                       Addendum IV--Regulation Documents Published in the Federal Register
                                      [October 2002 through December 2002]
----------------------------------------------------------------------------------------------------------------
                        FR Vol. 67
  Publication date         page         CFR part(s)      File code *                Regulation title
----------------------------------------------------------------------------------------------------------------
10/01/2002..........           61496  42 CFR 413.....  ...............  Principles of Reasonable Cost
                                                                         Reimbursement; Payment for End-Stage
                                                                         Renal Disease Services; Prospectively
                                                                         Determined Payment Rates for Skilled
                                                                         Nursing Facilities: OFR Correction.
10/01/2002..........           61496  42 CFR 460.....  CMS-1201-IFC...  Medicare and Medicaid Programs; Programs
                                                                         of All-inclusive Care for the Elderly
                                                                         (PACE); Program Revisions.
10/01/2002..........           61632  ...............  CMS-2160-N.....  State Children's Health Insurance
                                                                         Program; Final Allotments to States,
                                                                         the District of Columbia, and U.S.
                                                                         Territories and Commonwealths for
                                                                         Fiscal Year 2003.

[[Page 15204]]

 
10/02/2002..........           61805  42 CFR 482.....  CMS-3018-N.....  Medicare and Medicaid Programs; Hospital
                                                                         Conditions of Participation:
                                                                         Clarification of the Regulatory
                                                                         Flexibility Analysis for Patients'
                                                                         Rights.
10/02/2002..........           61808  42 CFR 482,      CMS-3160-FC....  Medicare and Medicaid Programs;
                                       483, 484.                         Conditions of Participation:
                                                                         Immunization Standards for Hospitals,
                                                                         Long-Term Care Facilities, and Home
                                                                         Health Agencies.
10/02/2002..........           61956  42 CFR 457.....  CMS-2127-F.....  State Children's Health Insurance
                                                                         Program; Eligibility for Prenatal Care
                                                                         and Other Health Services for Unborn
                                                                         Children.
10/07/2002..........           62478  ...............  CMS-4050-NR....  Medicare Program; Changes in Medicare
                                                                         Appeals Procedures Based on Section 521
                                                                         of the Medicare, Medicaid, and SCHIP
                                                                         Benefits Improvement and Protection Act
                                                                         of 2000.
10/11/2002..........           63434  ...............  CMS-3109-N.....  Medicare Program; Town Hall Meeting on
                                                                         the Hospital ``1-Hour'' Rule Related to
                                                                         the Use of Restraint and Seclusion.
10/16/2002..........           63966  ...............  CMS-1201-IFC...  Medicare and Medicaid Programs; Programs
                                                                         of All-inclusive Care for the Elderly
                                                                         (PACE); Program Revisions: OFR
                                                                         Correction.
10/21/2002..........           64641  ...............  CMS-8013-N.....  Medicare Program; Inpatient Hospital
                                                                         Deductible and Hospital and Extended
                                                                         Care Services Coinsurance Amounts for
                                                                         2003.
10/21/2002..........           64643  ...............  CMS-8014-N.....  Medicare Program; Monthly Actuarial
                                                                         Rates and Monthly Supplementary Medical
                                                                         Insurance Premium Rate Beginning
                                                                         January 1, 2003.
10/21/2002..........           64649  ...............  CMS-8015-N.....  Medicare Program; Part A Premiums for
                                                                         2003 for the Uninsured Aged and for
                                                                         Certain Disabled Individuals Who Have
                                                                         Exhausted Other Entitlement.
10/25/2002..........           65504  42 CFR 431 and   CMS-2104-F2....  Medicaid Program; Medicaid Managed Care:
                                       438.                              New Provisions Correcting Amendment.
10/25/2002..........           65582  ...............  CMS-2087-FN....  Medicaid Program; State Allotments for
                                                                         Payment of Medicare Part B Premiums for
                                                                         Qualifying Individuals: Federal Fiscal
                                                                         Year 2001.
10/25/2002..........           65585  ...............  CMS-2159-N.....  Medicare, Medicaid, and CLIA Programs;
                                                                         Clinical Laboratory Improvement
                                                                         Amendments of 1988 Continuance of
                                                                         Approval of the Joint Commission on
                                                                         Accreditation of Healthcare
                                                                         Organizations (JCAHO) as an Accrediting
                                                                         Organization.
10/25/2002..........           65588  ...............  CMS-4038-N.....  Medicare Program; Meeting of the
                                                                         Advisory Panel on Medicare Education--
                                                                         November 19, 2002.
10/25/2002..........           65672  42 CFR 409,      CMS-4041-P.....  Medicare Program; Modifications to
                                       417, 422.                         Managed Care Rules.
11/01/2002..........           66642  ...............  CMS-2141-FN....  Medicare and Medicaid Programs; Approval
                                                                         of the American Osteopathic Association
                                                                         for Deeming Authority for Ambulatory
                                                                         Surgical Centers.
11/01/2002..........           66718  42 CFR 405 and   CMS-1206-FC and  Medicare Program; Changes to the
                                       419.             CMS-1179-F.      Hospital Outpatient Prospective Payment
                                                                         System and Calendar Year 2003 Payment
                                                                         Rates; and Changes to Payment
                                                                         Suspension for Unfiled Cost Reports.
11/05/2002..........           67318  42 CFR 410 and   CMS-1204-N.....  Medicare Program; Revisions to Payment
                                       414.                              Policies Under the Physician Fee
                                                                         Schedule for Calendar Year 2003, Notice
                                                                         of Delay of Final Rule.
11/15/2002..........           69146  42 CFR 405 and   CMS-1206-CN....  Medicare Program; Changes to the
                                       419.                              Hospital Outpatient Prospective Payment
                                                                         System and Calendar Year 2003 Payment
                                                                         Rates; and Changes to Payment
                                                                         Suspension for Unfiled Cost Reports;
                                                                         Correction.
11/15/2002..........           69182  42 CFR 405.....  CMS-4004-P.....  Medicare Program; Changes to the
                                                                         Medicare Claims Appeal Procedures.
11/22/2002..........           70322  42 CFR 411.....  CMS-1809-F2....  Medicare and Medicaid Programs;
                                                                         Physicians' Referrals to Health Care
                                                                         Entities With Which They Have Financial
                                                                         Relationships: Extension of Partial
                                                                         Delay of Effective Date.
11/22/2002..........           70358  42 CFR 412,      CMS-3055-P.....  Medicare Program; Photocopying
                                       413, 476, 484.                    Reimbursement Methodology.
11/22/2002..........           70363  42 CFR 418.....  CMS-1022-P.....  Medicare Program; Hospice Care
                                                                         Amendments.
11/22/2002..........           70373  42 CFR 482.....  CMS-1224-P.....  Medicare Program; Nondiscrimination in
                                                                         Posthospital Referral to Home Health
                                                                         Agencies and Other Entities.
11/22/2002..........           70435  ...............  CMS-1241-NC....  Medicare and Medicaid Programs;
                                                                         Announcement of Applications From
                                                                         Hospitals Requesting Waivers For Organ
                                                                         Procurement Service Areas.
11/22/2002..........           70437  ...............  CMS-2154-FN....  Medicare and Medicaid Programs;
                                                                         Application by the Joint Commission on
                                                                         Accreditation of Healthcare
                                                                         Organizations for Continued Deeming
                                                                         Authority for Ambulatory Surgical
                                                                         Centers.

[[Page 15205]]

 
11/22/2002..........           70439  ...............  CMS-2155-FN....  Medicare and Medicaid Programs; Approval
                                                                         of Application for Deeming Authority
                                                                         for Ambulatory Surgical Centers by the
                                                                         Accreditation Association for
                                                                         Ambulatory Health Care.
11/22/2002..........           70442  ...............  CMS-1220-N.....  Medicare Program; Fee Schedule for
                                                                         Payment of Ambulance Services' Update
                                                                         for CY 2003.
11/22/2002..........           70444  ...............  CMS-1217-N.....  Medicare Program; December 16, 2002,
                                                                         Meeting of the Practicing Physicians
                                                                         Advisory Council.
11/22/2002..........  ..............  ...............  CMS-6012-N3....  Medicare Program; Establishment of the
                                                                         Negotiated Rulemaking Committee on
                                                                         Special Payment Provisions and
                                                                         Requirements For Prosthetics and
                                                                         Certain Custom-Fabricated Orthotics:
                                                                         January 6-7 and February 10-11, 2003
                                                                         Meetings.
12/13/2002..........           76684  42 CFR 405.....  CMS-1908-IFC...  Medicare Program; Application of
                                                                         Inherent Reasonableness to All Medicare
                                                                         Part B Services (Other Than Physician
                                                                         Services).
12/27/2002..........           79107  ...............  CMS-1231-N.....  Medicare Program; Re-Chartering of the
                                                                         Advisory Panel on Ambulatory Payment
                                                                         Classification Groups and Notice of
                                                                         Meeting of the Advisory Panel--January
                                                                         21, 22, and 23, 2003.
12/27/2002..........           79109  ...............  CMS-3104-N.....  Medicare Program; Renewal and Amendment
                                                                         of the Charter of the Medicare Coverage
                                                                         Advisory Committee (MCAC).
12/27/2003..........           79109  ...............  CMS-9015-N.....  Medicare and Medicaid Programs;
                                                                         Quarterly Listing of Program Issuances--
                                                                         July-September 2002.
12/27/2003..........           79122  ...............  CMS-4055-N.....  Medicare Program; National
                                                                         Medicare+Choice Risk Adjustment Public
                                                                         Meeting--February 3, 2003.
12/27/2002..........           79123  ...............  CMS-1202-CN....  Medicare Program; Prospective Payment
                                                                         System and Consolidated Billing for
                                                                         Skilled Nursing Facilities--Correction
                                                                         Notice.
12/27/2002..........           79124  ...............  CMS-3105-N.....  Medicare Program; Meeting of the
                                                                         Medicare Coverage Advisory Committee--
                                                                         February 12, 2003.
12/27/2002..........           79125  ...............  CMS-1234-N.....  Medicare Program; February 10, 2003,
                                                                         Meeting of the Practicing Physicians
                                                                         Advisory Council.
12/31/2002..........           79966  42 CFR 410,      CMS-1204-FC....  Medicare Program; Revisions to Payment
                                       414, 485.                         Policies Under the Physician Fee
                                                                         Schedule for Calendar Year 2003 and
                                                                         Inclusion of Registered Nurses in the
                                                                         Personnel Provision of the Critical
                                                                         Access Hospital Emergency Services
                                                                         Requirement for Frontier Areas and
                                                                         Remote Locations.
----------------------------------------------------------------------------------------------------------------

Addendum V--National Coverage Determinations [October 2002 through 
December 2002]

    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 became effective 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 impending decisions or, in some cases, explain 
why it was not appropriate to issue an NCD. We identify completed 
decisions by title, effective date, and section of the publication 
where the decision can be found. Also, please note that in some 
cases more than one NCD was made affecting a single procedure. 
Information on completed decisions as well as pending decisions has 
also been posted on the CMS Web site at http://cms.hhs.gov/coverage.

                                National Coverage Decisions for Quarterly Notices
                                      [Coverage Issues Manual--CMS Pub. 06]
----------------------------------------------------------------------------------------------------------------
                 Section                                 Title                          Effective date
----------------------------------------------------------------------------------------------------------------
35-10....................................  Hyperbaric Oxygen Therapy.......  April 1, 2003.
35-87....................................  Heart Transplants...............  April 1, 2003.
60-11....................................  Home Blood Glucose Monitors.....  not applicable.
----------------------------------------------------------------------------------------------------------------

Addendum VI--Categorization of Food and Drug Administration-Allowed 
Investigational Device Exemptions

    Under the Food, Drug, and Cosmetic Act (21 U.S.C. 360c), devices 
fall into one of three classes. Also, under the new categorization 
process to assist CMS, the Food and Drug Administration assigns each 
device with a Food and Drug Administration-approved investigational 
device exemption to one of two categories. Category A refers to 
experimental/investigational device exemptions, and Category B 
refers to nonexperimental/investigational device exemptions. To 
obtain more information about the classes or categories, please 
refer to the Federal Register notice published on April 21, 1997 (62 
FR 19328).
    The following information presents the device number and 
category (A or B) for the third quarter, July through September 
2002. (We inadvertently failed to include this information in our 
December 27, 2002, quarterly issuances notice).

       Investigational Device Exemption Numbers, 3rd Quarter 2002
------------------------------------------------------------------------
                    IDE                                Category
------------------------------------------------------------------------
G000137....................................  B
G002018....................................  B
G010155....................................  B

[[Page 15206]]

 
G010192....................................  B
G010193....................................  B
G010235....................................  B
G010260....................................  B
G010261....................................  B
G010270....................................  A
G010355....................................  B
G020043....................................  B
G020067....................................  B
G020081....................................  B
G020086....................................  B
G020088....................................  B
G020102....................................  B
G020104....................................  B
G020118....................................  B
G020128....................................  B
G020129....................................  B
G020134....................................  B
G020138....................................  B
G020140....................................  B
G020141....................................  B
G020142....................................  B
G020143....................................  B
G020144....................................  B
G020145....................................  B
G020147....................................  B
G020148....................................  B
G020151....................................  B
G020155....................................  B
G020156....................................  B
G020157....................................  B
G020158....................................  B
G020159....................................  B
G020163....................................  A
G020164....................................  B
G020166....................................  B
G020170....................................  B
G020171....................................  B
G020172....................................  B
G020173....................................  B
G020175....................................  B
G020176....................................  B
G020178....................................  B
G020179....................................  B
G020183....................................  B
G020186....................................  B
G020187....................................  B
G020188....................................  B
G020189....................................  A
G020191....................................  B
G020192....................................  B
G020194....................................  B
G020196....................................  B
G020199....................................  B
G020203....................................  B
G020204....................................  B
G020206....................................  B
G020208....................................  B
G020209....................................  B
G020214....................................  B
G020215....................................  B
G020216....................................  B
G020218....................................  B
G090193....................................  B
G910133....................................  B
------------------------------------------------------------------------

    The following information presents the device number and 
category (A or B) for the fourth quarter, October through December 
2002.

       Investigational Device Exemption Numbers, 4th Quarter 2002
------------------------------------------------------------------------
                    IDE                                Category
------------------------------------------------------------------------
G010035....................................  B
G010268....................................  B
G020020....................................  B
G020035....................................  B
G020053....................................  B
G020064....................................  B
G020160....................................  B
G020182....................................  B
G020185....................................  A
G020193....................................  B
G020211....................................  B
G020223....................................  B
G020224....................................  B
G020227....................................  B
G020228....................................  B
G020229....................................  B
G020230....................................  A
G020232....................................  B
G020233....................................  B
G020234....................................  A
G020238....................................  B
G020241....................................  A
G020244....................................  B
G020249....................................  B
G020250....................................  B
G020254....................................  B
G020255....................................  B
G020258....................................  B
G020260....................................  B
G020263....................................  B
G020269....................................  B
G020270....................................  B
G020271....................................  A
G020272....................................  B
G020275....................................  B
G020276....................................  B
G020277....................................  B
G020281....................................  B
G020283....................................  B
G020284....................................  B
G020285....................................  A
G020287....................................  B
G020288....................................  B
G020289....................................  B
G020291....................................  B
G020295....................................  B
G020296....................................  B
G020297....................................  B
G020300....................................  B
G020303....................................  B
G020304....................................  B
G020309....................................  B
G990155....................................  B
------------------------------------------------------------------------

[FR Doc. 03-7063 Filed 3-27-03; 8:45 am]
BILLING CODE 4120-01-P