[Federal Register Volume 70, Number 37 (Friday, February 25, 2005)]
[Notices]
[Pages 9338-9355]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-3551]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-9025-N]


Medicare and Medicaid Programs; Quarterly Listing of Program 
Issuances--October Through December 2004

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 2004 through December 2004, relating to the 
Medicare and Medicaid programs. This notice provides information on 
national coverage determinations (NCDs) affecting specific medical and 
health care services under Medicare. Additionally, this notice 
identifies certain devices with investigational device exemption (IDE) 
numbers approved by the Food and Drug Administration (FDA) that 
potentially may be covered under Medicare. Finally, this notice also 
includes listings of all approval numbers from the Office of Management 
and Budget for collections of information in CMS regulations.
    Section 1871(c) of the Social Security Act requires that we publish 
a list of 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 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 
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 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 Eileen Davidson, Office of Clinical 
Standards and Quality, Centers for Medicare & Medicaid Services, S3-26-
10, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call 
(410) 786-6874.
    Questions concerning approval numbers for collections of 
information in Addendum VII may be addressed to Dawn Willinghan, Office 
of Strategic Operations and Regulatory Affairs, Regulations Development 
and Issuances Group, Centers for Medicare & Medicaid Services, C5-09-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call 
(410) 786-6141.
    Questions concerning all other information may be addressed to 
Margaret Teeters, Office of Strategic Operations and Regulatory 
Affairs, Regulations Development Group, Centers for Medicare & Medicaid 
Services, C5-13-18, 7500 Security Boulevard, Baltimore, MD 21244-1850, 
or you can call (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 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

[[Page 9339]]

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 six 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--

--Date published;
--Federal Register citation;
--Parts of the Code of Federal Regulations (CFR) that have changed (if 
applicable);
--Agency file code number; and
--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.

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.gpoaccess.gov/fr/index.html, 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. 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' 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, 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 9340]]

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 NCD publication 
titled ``Treatment of Obesity,'' use CMS-Pub. 100-03, Transmittal No. 
23.

(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: February 14, 2005.
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 27, 2002 (67 FR 61130); December 27, 2002 (67 FR 79109); 
March 28, 2003 (68 FR 15196); June 27, 2003 (68 FR 38359); September 
26, 2003 (68 FR 55618); December 24, 2003 (68 FR 74590); March 26, 2004 
(69 FR 15837); June 25, 2004 (69 FR 35634); September 24, 2004 (69 FR 
57312); and December 30, 2004 (69 FR 78428).

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 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
                     [October Through December 2004]
------------------------------------------------------------------------
     Transmittal No.             Manual/Subject/Publication Number
------------------------------------------------------------------------
             Medicare General Information (CMS-Pub. 100-01)
------------------------------------------------------------------------
11.......................  Manual Revision Regarding Waiver of Annual
                            Deductible and Coinsurance for Both
                            Ambulatory Surgery Center Facility, and
                            Ambulatory Surgery Center/Hospital
                            Outpatient Department Physician Services
                            Exceptions to Annual Deductible and
                            Coinsurance.
12.......................  New Policy and Refinements on Billing Non-
                            covered Charges to Fiscal Intermediaries.
                           Applications of Deductible and Coinsurance in
                            Liability and Indemnification Situations.
13.......................  Medicare Termination of Beneficiaries With
                            End-Stage Renal Disease.
14.......................  Scheduled Release for January Updates to
                            Software Programs and Coding/Files.
--------------------------
                Medicare Benefit Policy (CMS-Pub. 100-02)
------------------------------------------------------------------------
23.......................  Revised Requirements for Chiropractic Billing
                            of Active/Corrective Treatment And
                            Maintenance Therapy Full Replacement of CR
                            3063
                           Chiropractor's Services.
                           Necessity of Treatment.
                           Treatment Parameters.
24.......................  Revision of Sec.   300.5.1, Chapter 15 of the
                            Medicare Benefit Policy Manual to Include
                            22x Type of Bill for Diabetes Self-
                            Management Training.
                           Special Claims Processing Instructions for
                            Fiscal Intermediary.
25.......................  Implementation of Coverage of Religious
                            Nonmedical Health Care.
                           Institution Items and Services Furnished in
                            the Home, Medicare Modernization Act Section
                            706.
                           Coverage of Religious Nonmedical Health Care
                            Institution Items and Services Furnished in
                            the Home.
                           Coverage and Payment of Durable Medical
                            Equipment aUnder the Religious Nonmedical
                            Health Care Institution Home Benefit.
                           Coverage and Payment of Home Visits Under the
                            Religious Nonmedical Health Care Institution
                            Home Benefit.
26.......................  Inclusion of Forteo as a Covered Osteoporosis
                            Drug and Clarification of Manual.
                           Instructions Regarding Osteoporosis Drugs.
                           Medical Supplies (Except for Drugs and
                            Biologicals Other Than Covered Osteoporosis
                            Drugs) and the Use of Durable Medical
                            Equipment.
                           Covered Osteoporosis Drugs.
27.......................  New End-Stage Renal Disease Composite Payment
                            Rates Effective January 1, 2005.
28.......................  Hospice Pre-Election Evaluation and
                            Counseling Services.
                           Documentation.
                           Payment.
--------------------------
       Medicare National Coverage Determinations (CMS-Pub. 100-03)
------------------------------------------------------------------------
22.......................  This Transmittal has been rescinded and
                            replaced with Transmittal 25.
23.......................  Treatment of Obesity.
24.......................  Dementia and Neurodegenerative Diseases.
25.......................  Percutaneous Transluminal Angioplasty.
26.......................  Electrocardiographic Services.
--------------------------
              Medicare Claims Processing (CMS-Pub. 100-04)
------------------------------------------------------------------------
305......................  Disabling the Common Working File 57x3
                            Consistency Error Code.
306......................  Full Replacement of CR 3415, 3rd Update to
                            the 2004 Medicare Physician Fee Database.
307......................  This Transmittal has been rescinded and
                            replaced with Transmittal 314.

[[Page 9341]]

 
308......................  Two New Medicare Summary Notice (MSN)
                            Messages for Parenteral Pumps-DMERC Only.
                           Durable Medical Equipment.
309......................  Fiscal Year 2005 Inpatient Prospective
                            Payment System, Long Term Care.
                           Hospital and Other Bill Processing Changes
                            Related to the Inpatient.
                           Prospective Payment System Final Rule.
310......................  Billing Requirements for Positron Emission
                            Tomography Scans for Dementia and
                            Neurodegenerative Diseases.
                           Billing Instructions.
                           Positron Emission Tomography Scan Qualifying
                            Conditions and Healthcare.
                           Common Procedure Coding System Code Chart.
                           Coverage for Positron Emission Tomography
                            Scans for Dementia and Neurodegenerative
                            Disease.
311......................  Instructions for Completion of Form CMS-1450.
                           Health Insurance Portability and
                            Accountability Act Health Care and
                            Coordination of Benefits.
                           Coordination of Benefits.
                           General Instructions for Completion of Form
                            CMS--1450 for Billing.
312......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to confidentiality of
                            instruction.
313......................  Remittance Advice Remark Code and Claim
                            Adjustment Reason Code Update.
314......................  Percutaneous Transluminal Angioplasty.
315......................  Temporary Change in Carrier Jurisdictional
                            Pricing Rules for Purchased Diagnostic
                            Services.
316......................  Clarification of Messages in Chapter 1,
                            Section 10.1.1.1 to Match Official Listing
                            on the WPC-Electronic Data Interchange Web
                            Site.
                           Claims Processing Instructions for Payment
                            Jurisdiction for Claims Received on or After
                            April 1, 2004.
317......................  Clarification to Chapter 26 of the Internet
                            Only Manual.
                           Patient and Insured Information.
                           Provider of Service or Supplier Information.
318......................  Clarification of CR 3176--Payment Amounts for
                            End-Stage Renal Disease Drug.
                           Administration Supplies: Healthcare Common
                            Procedure Coding System A4657 and A4913.
319......................  Comprehensive Outpatient Rehabilitation
                            Facility/Outpatient Physical Therapy.
                           Edit for Billing Inappropriate Supplies.
320......................  Reminder Notice of the Implementation of the
                            Ambulance Transition.
                           Schedule.
321......................  Instructions for Downloading the Medicare Zip
                            Code File.
322......................  Release Medlearn Article for Change Request
                            CR 2813 End-Stage Renal Disease
                            Reimbursement for Automated Multi-Channel
                            Chemistry Test(s).
323......................  Update Regarding the Use of American Dental
                            Association's (ADA) Current Dental
                            Terminology Codes on Medicare Contractor's
                            Web Sites and Other Electronic Media.
                           Displaying Material With Content Development
                            Team Codes.
                           Use of Content Development Team Nomenclature
                            and Descriptors.
                           American Dental Association Copyright Notice.
                           Point and Click License, and Shrink Wrap
                            License.
                           Samples of Content Development Team
                            Nomenclature and Descriptors.
324......................  Quarterly Update to Correct Coding Initiative
                            (CCI) edits, Version 11.0, Effective January
                            1, 2005.
325......................  New Waived Tests--January 1, 2005.
326......................  Invalid Diagnosis Code Editing--Second Phase.
327......................  This Transmittal has been rescinded and
                            replaced with Transmittal 374.
328......................  2005 Annual Update for Skilled Nursing
                            Facility Consolidated Billing for the Common
                            Working File and Medicare Carriers.
329......................  Durable Medical Equipment Regional Carrier
                            Only--Payment to Providers/Suppliers
                            Qualified To Bill Medicare for Prosthetics
                            and Certain Custom-Fabricated Orthotics.
                           Provider Billing for Prosthetics and Orthotic
                            Services.
330......................  Durable Medical Equipment Carrier--
                            Beneficiary Submitted Claims, Process First
                            Claim.
                           General Billing for DME, Prosthetics,
                            Orthotic Devices, and Supplies.
331......................  Durable Medical Equipment Carrier--
                            Beneficiary Submitted Claims, Process First
                            Claim.
332......................  New Policy and Refinements on Billing
                            Noncovered Charges to Fiscal Intermediaries.
                           Provider Billing of Noncovered Charges to
                            Fiscal Intermediaries.
                           General Information on Institutional
                            Noncovered Charges Prior to Billing.
                           Provider-Liable Fully Noncovered Outpatient
                            Claims.
                           Summary of All Types of Institutional No
                            Payment Claims.
                           General Operational Information on
                            Institutional Noncovered Charges.
                           Noncovered Charges on Institutional Demand
                            Bills.
                           Traditional Demand Bills.
                           Summary of Methods for Institutional Demand
                            Billing.
                           Line-Item Modifiers Related to Reporting of
                            Noncovered Charges When Covered and
                            Noncovered Services Are on the Same
                            Institutional Claim.
                           Clarifying Institutional Instructions for
                            Outpatient Therapies Billed As Noncovered,
                            on Other Than Hold Harmless Prospective
                            Payment System Claims, and for Critical
                            Access Hospitals Billing the Same Health
                            Common.
                           Procedure Coding System Requiring Specific
                            Time Increments.
                           Instructions for Noncovered Charges on
                            Institutional Ambulance Claims.
                           Clarification on Notice Requirements Related
                            to Billing Noncovered Charges for
                            ``Bundled'' Institutional Benefits:
                            Laboratory and Rural Health Clinic/Federally
                            Qualified Health Clinic.
333......................  Issued to a specific audience, not posted to
                            the Internet/Intranet due to the
                            confidentiality of instruction.
334......................  Payment of Beneficiary Submitted Flu Claims
                            and Flu Claims Submitted by Non-Enrolled
                            Providers.
335......................  This Transmittal has been rescinded and
                            replaced with Transmittal 400.

[[Page 9342]]

 
336......................  Indian Health Service or Tribal Hospitals
                            including Critical Access Hospital.
                           Payment Methodology for Inpatient Social
                            Admissions and Outpatient Services Occurring
                            During Concurrent Stays.
                           Indian Health Service/Tribal Hospital
                            Inpatient Social Admits.
337......................  Change in Hospital Type of Bill for Billing
                            Diagnostic and Screening Mammographies.
                           Mammography Services.
                           Computer-Aided Detection Add-On Codes.
                           Billing Requirements--Fiscal Intermediary
                            Claims.
                           Rural Health Clinic/Federally Qualified
                            Health Center Claims With Dates of Service
                            Prior to January 1, 2002.
                           Rural Health Clinic/Federally Qualified
                            Health Center Claims With Dates of Service
                            on or After January 1, 2002.
                           Fiscal Intermediary Requirements for
                            Nondigital Screening Mammographies.
                           Mammograms Performed With New Technologies.
338......................  Removal of the Skilled Nursing Facility No
                            Pay File.
339......................  Issued to a specific audience, not posted to
                            the Internet/Intranet due to the Sensitivity
                            of Instruction.
340......................  Annual Update of Healthcare Common Procedure
                            Coding System Codes Used for Home Health
                            Consolidated Billing Enforcement.
341......................  Implementation of the Medicare Physician Fee
                            Schedule (MPFS) National Abstract File for
                            Purchased Diagnostic Tests and
                            Interpretations.
                           Payment Jurisdiction Among Local Carriers for
                            Services Paid Under the Physician Fee
                            Schedule and Anesthesia Services.
                           Payment Jurisdiction for Purchased Services.
                           Payment to Physician or Other Supplier for
                            Purchased Diagnostic Tests--Claims Submitted
                            to Carriers.
                           Payment to Supplier of Diagnostic Tests for
                            Purchased Interpretations.
                           Abstract File for Purchased Diagnostic Tests/
                            Interpretations.
342......................  Change to the Common Working File Skilled
                            Nursing Facility Consolidated.
                           Edits for Ambulance Transports to or From a
                            Diagnostic or Therapeutic Site Ambulance
                            Services.
                           Skilled Nursing Facility Billing.
343......................  Clarification: Modifiers for Transportation
                            of Portable X-rays.
                           Transportation Component.
344......................  Update of Healthcare Common Procedure Coding
                            System Codes and File Names, Descriptions
                            and Instructions for Retrieving the 2005
                            Ambulatory Surgery.
                           Center Healthcare Common Procedure Coding
                            System Deletions and Master Listing.
345......................  This Transmittal is rescinded and replaced
                            with Transmittal 353.
346......................  This Transmittal is rescinded and replaced
                            with Transmittal 352.
347......................  Inpatient Rehabilitation Facility
                            Classification Requirements.
                           Medicare Inpatient Rehabilitation Facility
                            Classification Requirements.
                           Criteria That Must Be Met By Inpatient
                            Rehabilitation Hospitals.
                           Verification Process To Be Used To Determine
                            if the Inpatient Rehabilitation.
                           Facility Met the Classification Criteria.
                           Verification of Compliance Using
                            International Classification of Disease 9th
                            Edition Clinical Modification and Impairment
                            Group Codes.
348......................  January 2005 Quarterly Average Sales Price
                            (ASP) Medicare Part B Drug Pricing File,
                            Effective January 1, 2005.
349......................  This Transmittal is rescinded and replaced
                            with Transmittal 359.
350......................  Editing for Part B Carriers and Durable
                            Medical Equipment Regional Carriers for
                            Duplicate Claims in Process at the Same
                            Time.
351......................  Editing of Hospitals and Skilled Nursing
                            Facilities Part B Inpatient Services.
352......................  Three Places After the Decimal Point for
                            Application Service Provider Drug File.
353......................  Durable Medical Equipment Regional Carrier--
                            Revision to CR 2631.
                           Requirements for Durable Medical Equipment
                            Regional Carrier Claims.
                           Claims Processing Instructions for Payment
                            Jurisdiction for Claims Received on or After
                            April 1, 2004--Durable Medical Equipment
                            Regional Carrier Only.
354......................  DMERC--Beneficiary Submitted Claims, Process
                            First Claim.
355......................  This Transmittal has been rescinded and
                            replaced with Transmittal 375.
356......................  This Transmittal has been rescinded and
                            replaced with Transmittal 376.
357......................  Implementation of Coverage of Religious
                            Nonmedical Health Care Institution.
                           Items and Services Furnished in the Home, MMA
                            section 706.
                           Noncovered Charges on Outpatient Bills.
                           Billing and Payment of Religious Nonmedical
                            Health Care Institution Items and Services
                            Furnished in the Home.
                           Inclusion of Forteo As a Covered Osteoporosis
                            Drug and Clarification of Manual
                            Instructions Regarding Osteoporosis Drugs.
                           Osteoporosis Injections as Home Health Agency
                            Benefit.
358......................  This Transmittal replaces Transmittal 349.
359......................  Annual Update of Healthcare Common Procedure
                            Coding System Codes for Skilled Nursing
                            Facility Consolidated Billing.
360......................  Medicare Modernization Act Drug Pricing
                            Update--Payment Limit for
                            J0207.(Amifostine).
361......................  Update to the Prospective Payment System for
                            Home Health Agencies for Calendar Year 2005.
                           Annual Updates to the Home Health Pricer.
362......................  2005 Annual Update for Clinical Laboratory
                            Fee Schedule and Laboratory Services Subject
                            to Reasonable Charge Payment.
363......................  Common Working File Editing for the Initial
                            Preventive Physical Examination.
364......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to the confidentiality
                            of instruction.
365......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to the confidentiality
                            of instruction.
366......................  This Transmittal has been rescinded and
                            replaced with Transmittal 425.
367......................  Instructions for Completion of Form CMS-1450.
368......................  Fee Schedule Update for 2005 for Durable
                            Medical Equipment, Prosthetics, Orthotics,
                            and Supplies.
369......................  New Case-Mix Adjusted End-Stage Renal Disease
                            (ESRD) Composite.

[[Page 9343]]

 
                           Payment Rates and New Composite Rate
                            Exceptions Window for Pediatric.
                           ESRD Facilities.
                           Outpatient Provider Specific File.
                           Calculation of Case Mix Adjusted Composite
                            Rate.
                           Required Information for In-Facility Claims
                            Paid Under the Composite Rate.
370......................  Updated Billing Instructions for Rural Health
                            Clinics and Federally Qualified.
                           Health Centers.
                           General Billing Requirements.
                           Special Federally Qualified Health Centers
                            Requirements.
                           Reporting of Preventive Services in the
                            Federally Qualified Health Centers.
                           Benefit by Independent Federally Qualified
                            Health Centers.
                           Reporting of Specific Healthcare Common
                            Procedure Coding System Codes for Hospital-
                            based Federally Qualified Health Centers.
                           General Billing Requirements for Preventive
                            Services.
                           Bills Submitted to Fiscal Intermediary.
                           Special Instructions for Independent and
                            Provider-Based Rural Health Clinics/
                            Federally Qualified Health Centers.
                           Claims Submitted to Intermediaries for Mass
                            Immunizations of Influenza and
                           Pneumococcal Pneumonia Vaccine
                           Payment for Computer Add-on Diagnostic and
                            Screening Mammograms for Fiscal Intermediary
                            and Carriers.
                           Rural Health Centers/Federally Qualified
                            Health Centers Claims With Dates of Service
                            Prior to January 1, 2002.
                           Rural Health Centers/Federally Qualified
                            Health Centers Claims With Dates of Service
                            on or After January 1, 2002.
                           Healthcare Common Procedure Coding Codes for
                            Billing.
                           Additional Coding Applicable to Claims
                            Submitted to Fiscal Intermediary.
                           Special Billing Instructions for Rural Health
                            Centers and Federally Qualified.
                           Health Centers.
                           Electrical Stimulation.
                           Electromagnetic Therapy.
371......................  Payment for Referred Laboratory Automated
                            Multi-Channel Chemistry Tests.
                           Claims Processing Requirements for Panel and
                            Profile Tests.
                           History Display.
372......................  New End-Stage Renal Disease Composite Payment
                            Rates Effective Lanuary 1, 2005.
                           Publication of Composite Rates.
                           Determining Individual Facility Composite
                            Rate.
                           Required Information for In-Facility Claims
                            Paid Under the Composite Rate.
                           Epoetin Alfa.
                           Epoetin Alfa Facility Billing Requirement
                            Using UB-92/Form CMS-1450.
                           Payment Amount for Epoetin Alfa.
                           Epoetin Alfa Provided in the Hospital
                            Outpatient Departments.
                           Darbepoetin Alfa for End-Stage Renal Disease
                            Patients.
373......................  Clarification to IOM Chapter 17, Section 80.4
                            Regarding Claims for Blood Clotting Factors.
                           Billing for Blood Clotting Factors.
374......................  This Transmittal has been rescinded and
                            replaced with 388.
375......................  This Transmittal has been rescinded and
                            replaced with 389.
376......................  Hospital Outpatient Prospective Payment
                            System: Misclassified Drugs and Biologicals,
                            Ganciclovir Long Act Implant, Beg Live
                            Intravesical Vac, and Gallium ga 67;
                            Adjustments Due to Misclassification.
377......................  Full Replacement of CR 3308, Fiscal
                            Intermediary Shared System Changes To Allow
                            for Provider Liability Days on Skilled
                            Nursing Facility and Swing Bed Facility
                            Inpatient Bills.
                           Billing Skilled Nursing Facility Prospective
                            Payment System Services.
                           Provider Liability Instructions.
378......................  Low Osmolar Contrast Material/Laboratory
                            Tests/Payment for Inpatient Servces.
                           Furnished by a Critical Access Hospital.
                           Payment for Inpatient Services Furnished by a
                            Critical Access Hospital.
                           Standard Method--Cost Based Facility
                            Services, With Billing of Carrier for
                            Professional Services.
                           Clinical Diagnostic Laboratory Tests
                            Furnished by Critical Access Hospitals.
379......................  Changes to the Laboratory National Coverage
                            Determination Edit Software for January
                            2005.
380......................  Revisions and Corrections to Chapter 29 of
                            the IOM, Claims Processing Manual--Appeals.
                           CMS Decisions Subject to the Administrative
                            Appeals Process.
                           Who May Appeal.
                           Provider or Supplier Appeals When the
                            Beneficiary Is Deceased.
                           Where To Appeal and Initial Determinations.
                           Social Security Office.
                           Part A Fiscal Intermediary.
                           Providers Right To Appeal Certain Initial
                            Determinations.
                           Part B Carrier (or Fiscal Intermediary Acting
                            As a Carrier).
                           Quality Improvement Organization.
                           Time Limits for Filing Appeals.
                           Amount in Controversy Requirements.
                           Limitation on Liability.
                           Part A Appeals Procedures.
                           Finding Good Cause for Late Filing of Part A
                            Redetermination.
                           General.

[[Page 9344]]

 
                           Establishment of Time Limits for Filing.
                           Conditions Which Establish Good Cause.
                           Procedures To Establish Good Cause.
                           Examples of Situations Where Good Cause
                            Exists.
                           Where Good Cause Is Not Found.
                           Redetermination of a Part A Payment
                            Determination.
                           Place and Manner of Filing Requests for
                            Redeterminations and What Constitutes a
                            Request for Redetermination.
                           Evaluating the Evidence and Making the
                            Redetermination.
                           Preparing the Determination.
                           Completing the Determination.
                           Notice of Further Appeal Rights.
                           Preventing Duplicate Payment in Reversal
                            Cases.
                           Effectuating Favorable Final Appellate
                            Decisions That a Beneficiary Is ``Confined
                            To Home''--Regional Home Health
                            Intermediaries Only.
                           Model Medicare Redetermination Notice.
                           Request for Hearing Under Part A.
                           Right to Representation Under Part A.
                           Reconsiderations, Hearings, and Appeals Where
                            a Quality Improvement.
                           Organization Has Review Responsibility.
                           Reconsiderations.
                           Hearings.
                           Appeals of Institutional Supplementary
                            Medical Insurance (Part B) Claim Decisions.
                           Appeals by Hospitals of Diagnosis Related
                            Group Assignments Under Prospective Payment
                            System--Review of Initial Diagnosis Related
                            Group Assignments.
                           Part B Appeals Procedures for Fiscal
                            Intermediaries and Administrative Law Judge
                            Instructions for Fiscal Intermediaries
                            Redetermination and Hearing Officer (HO)
                            Hearing Supplemental Medical Insurance.
                           Redetermination.
                           What Constitutes a Request for
                            Redetermination & Handling Beneficiary
                            Inquiries.
                           Elements of a Redetermination.
                           Requests for Hearing.
                           Preparation for the Hearing.
                           In-Person and Telephone Hearing Procedures.
                           Request for Hearing Before an Administrative
                            Law Judge.
                           Scope and Effect of Office of Hearings &
                            Appeals, Social Security.
                           Administration Administrative Law Judge
                            Decisions Under Part A.
                           Determining the Amount in Controversy for
                            Administrative Law Judge Hearing.
                           Requests Filed With Social Security
                            Administration.
                           Requests Filed With the Fiscal Intermediary.
                           Action on Incoming Requests for
                            Administrative Law Judge Hearing.
                           Requests for Claim File (Sent by Hearing
                            Office).
                           Examination of Claim File.
                           Prehearing Case Redetermination.
                           Routing the Administrative Law Judge Hearing
                            Claim File.
                           Effectuating Decisions.
                           Effectuating Favorable Final Appellate
                            Decisions That a Beneficiary Is ``Confined
                            To Home''--Regional Home Health
                            Intermediaries Only.Effectuation of Reversal
                            of Decision Where There Was Subsequent
                            Utilization of Benefits in the Same Benefit
                            Period.
                           Effect of Court Decisions.
                           Standard Exhibits Referred to in Sections
                            40.5-50.7.
                           Part B Appeals Procedures--Carriers.
                           Initial Determinations.
                           Steps in the Appeals Process: Overview.
                           Fiscal Intermediary and Carrier
                            Correspondence With Beneficiaries or Other
                            Parties Regarding Appeals.
                           Appointment of Representative--Introduction.
                           Who May Be a Representative.
                           How To Make and Revoke an Appointment.
                           Rights and Responsibilities of a
                            Representative.
                           Timeliness of an Appeal Request and
                            Completeness of Appointment.
                           Incapacitation of Death of Beneficiary.
                           Disclosure of Individually Identifiable
                            Beneficiary Information to Amount in
                            Controversy--General Requirements.
                           Additional Considerations for Calculation of
                            the Amount in Controversy.
                           Aggregation of Claims to Meet the Amount in
                            Controversy.
                           General Procedure To Establish Good Cause.
                           Good Cause Not Found for Beneficiary, or for
                            Provider, Physician, or Other Supplier.
                           General Guidelines.
                           Letter Format.
                           How To Establish Reading Level.
                           Required Elements in Appeals Correspondence.
                           Disclosure of Information to Third Parties.
                           Fraud and Abuse Investigations.
                           Medical Consultants Used.

[[Page 9345]]

 
                           Multiple Beneficiaries.
                           Redetermination--The First Level of Appeal.
                           Filing a Request for Redetermination.
                           Time Limit for Filing a Request for
                            Redetermination.
                           The Redetermination.
                           The Redetermination Determination.
                           Redetermination Determination.
                           Informing the Beneficiary and Provider
                            Communities About the Telephone.
                           Redetermination Process.
                           Redetermination Determination Letters.
                           Hearing Officer Hearing--The Second Level of
                            Appeal.
                           Time Limit for Filing a Request for a Hearing
                            Officer Hearing.
                           Request for a Hearing Officer Hearing Filed
                            Prior to a Redetermination.
                           Timely Processing Requirements.
                           Contractor Responsibilities--General.
                           Requests for Transfer of In-Person Hearing.
                           Acknowledgment of Request for a Hearing
                            Officer Hearing.
                           Case File Development.
                           In-Person Hearing.
                           Telephone Hearing.
                           Qualifications and General Responsibilities.
                           Preparation for the Hearing Officer Hearing.
                           Scheduling the Date, Time and Place of
                            Hearing.
                           Pre-Hearing Review of the Evidence.
                           Forwarding Copy of Case File Prior to
                            Telephone Hearing.
                           The Hearing Officer Hearing Decision
                            Timeliness.
                           Delaying Effectuation.
                           Hearing Officer Reply to Reopening Request.
                           Requests for Part B Administrative Law Judge
                            Hearing.
                           Forwarding Request to Social Security
                            Administration/Office of Hearings & Appeals.
                           Case File Preparation.
                           Effectuation Time Limits.
                           Requests for Case Files.
                           Part A and Part B Quality Improvement and
                            Data Analysis Activities.
                           Workload Data Analysis Program.
                           Quality Improvement Activities.
                           Submitting Summary Reports to CMS.
                           Managing Appeals Workloads.
                           Standard Operating Procedures.
                           Execution of Workload Prioritization.
                           Workload Priorities.
                           Reopening and Revision of Claim
                            Determinations and Decisions.
                           Development of Appeals.
                           How Issues May Arise.
                           Summary of Conditional Under Which a
                            Determination or Decision May Be Reopened.
                           Determining Date of Initial or Appeal
                            Determination or Decision.
                           Who May Reopen an Initial Appeal
                            Determination or Decision.
                           Actions to Permit Reopening Within the 1 Year
                            or 4 Year Period.
                           Good Cause for Reopening.
                           Definitions.
                           Unrestricted Reopening.
                           Reopening an Initial Determination.
                           Reopening a Redetermination or
                            Redetermination Determination.
                           Reopening a Hearing Officer Hearing Decision.
                           Notice of Results of Reopening.
                           Exception to Sending Notice of Revision to
                            Parties--Cases Involving Limitation of
                            Recovery for Beneficiary.
                           Refusal to Reopen Is Not an ``Initial
                            Determination''.
                           Revised Determination or Decision.
382......................  Independent Laboratory Billing for the
                            Technical Component (TC) of Physician
                            Pathology Services to Hospital Patients.
                           Payment for Pathology Services.
383......................  This revision rescinded Transmittal.
384......................  Inpatient Psychiatric Facility Prospective
                            Payment System.
385......................  January 2005 Update of the Hospital
                            Outpatient Prospective Payment System.
                           Summary of Outpatient Prospective Payment
                            System Outpatient Code Editor.
                           Data Changes and Outpatient Prospective
                            Payment System Pricer Logic.
                           Changes; Changes to Payment for Diagnostic
                            Mammography.
386......................  Hospice Pre-election Evaluation and
                            Counseling Services.
387......................  This instruction is to inform the fiscal
                            intermediaries that the January 2005.
                           Outpatient Prospective Payment System
                            Outpatient Code Editor Specifications have
                            been updated with new additions, changes,
                            and deletions.
388......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to confidentiality of
                            instruction.

[[Page 9346]]

 
389......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to confidentiality of
                            instruction.
390......................  Announcement of Medicare Rural Health Clinics
                            and Federally Qualified Health Centers
                            Payment Rate Increase--Skilled Nursing
                            Facility Consolidated.Billing As It Applies
                            to Rural Health Clinics and Federally
                            Qualified Health.Center Services.
391......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to confidentiality of
                            instruction.
392......................  The Supplemental Security Income Medicare
                            Beneficiary Data for Fiscal Year 2003 for
                            Inpatient Rehabilitation Facility
                            Prospective Payment System.
                           LIP Adjustment: The Supplemental Security
                            Income Medicare Beneficiary Data for
                            Inpatient Rehabilitation Facility Paid Under
                            Prospective Payment System.
393......................  ZThis revision is rescinded and replaced with
                            revision 401.
394......................  This revision is rescinded and replaced with
                            revision 396.
395......................  Ambulance Fee Schedule--Medical Conditions
                            List.
396......................  New Dispensing/Supply Fee Codes for Oral Anti-
                            Cancer, Oral Anti-Emetic, Immunosuppressive,
                            and Inhalation Drugs.
                           Pharmacy Supply Fee.
397......................  Durable Medical Equipment Regional Carrier /
                            Local Carriers/Statistical.
                           Analysis Durable Medical Equipment Regional
                            Carrier--Drug Pricing.
                           Limits as of January 1, 2005.
                           Payment Rules for Drugs and Biologicals.
                           Medicare Modernization Act Drug Pricing--
                            Average Sales Price.
                           Single Drug Pricer.
                           Calculation of the Payment Allowance Limit
                            for Durable Medical Equipment.
                           Regional Carriers Drugs.
                           Calculation of the Average Wholesale Price.
                           Detailed Procedures for Determining Average
                            Wholesale Prices and the Drug.Payment
                            Allowable Limits.
                           Background.
                           Review of Sources for Medicare Covered Drugs
                            and Biologicals.
                           Use of Generics.
                           Find the Strength and Dosage.
                           Restrictions.
                           Inherent Reasonableness for Drugs and
                            Biologicals.
                           Injection Services.
                           Injections Furnished to End-Stage Renal
                            Disease Beneficiaries.
398......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to confidentiality of
                            instruction.
399......................  Expansion of the Existing Interrupted Stay
                            Policy Under Long Term Care.
                           Hospital Prospective Payment System.
400......................  Incorrect Reporting of Miles Time Units
                            Services Indicator When Drugs are Billed
                            Using a National Drug Code.
                           Miles/Times/Units/Services.
                           Methodology of Coding Number of Services,
                            Miles Times Units Services.
                           Count and Miles Times Units Services
                            Indicator Fields.
401......................  2005 Part B Deductible Update to the Back
                            Page of Medicare Summary Notices.
                           Back of the Medicare Summary Notices--
                            Carriers and Intermediaries.
402......................  January Update to the Medicare Outpatient
                            Code Editor Version 20.1 for Bills from
                            Hospitals That Are Not Paid Under the
                            Outpatient Prospective Payment System.
403......................  January 2005 Update of the Hospital
                            Outpatient Prospective Payment System:
                            Billing Devices That Do Not Have
                            Transitional Pass-Through Status, and That
                            Are Not Classified As New Technology
                            Ambulatory Payment Classification Groups.
                           Requirements That Hospitals Report Device
                            Codes on Claims on Which They Report
                            Specified Procedures.
                           Edits for Claims On Which Specified
                            Procedures Are To Be Reported With Device.
                           Codes.
404......................  January 2005 Update of the Hospital
                            Outpatient Prospective Payment System:
                            Changes to Coding and Payment for Drug
                            Administration.
                           Billing and Payment for Drugs and
                            Biologicals.
                           Coding and Payment for Drug Administration.
405......................  Emergency Change to Carrier Instructions for
                            the End-Stage Renal Disease.
                           50/50 Rule Implementation.
406......................  Update to Health Care Claims Status Category
                            Codes and Health Care Claim Status Codes for
                            Use With the Health Care Claim Status
                            Request and Response ASC X12N 276/277.
407......................  Hospital Billing for Repetitive Services.
                           Inpatient Billing From Hospitals and Skilled
                            Nursing Facilities.
                           Frequency of Billing for Outpatient Services
                            to Fiscal Intermediaries.
                           Hospital and Community Mental Health Center
                            Reporting Requirements for Services
                            Performed on the Same Day.
408......................  Cardiovascular Disease Screening.
                           Healthcare Common Procedure Coding System
                            Coding for Cardiovascular Screening.
                           Carrier Billing Requirements.
                           Fiscal Intermediary Billing Requirements.
                           Diagnosis Code Reporting.
                           Medicare Summary Notices.
                           Remittance Advice Remark Codes.
                           Claims Adjustment Reason Codes.
409......................  Diabetes Screening Tests.
410......................  Medicare Health Insurance Portability &
                            Accountability Act Electronic Claims.
                           Compliance Report--Reporting Timeframe
                            Extension.
411......................  Ambulance Inflation Factor.

[[Page 9347]]

 
412......................  Skilled Nursing Facility Consolidated Billing
                            Services Furnished Under an ``Arrangement''
                            With an Outside Entity.
                           ``Under Arrangements'' Relationships.
                           Skilled Nursing Facility and Supplier
                            Responsibilities.
413......................  Medicare Part A Skilled Nursing Facility
                            Prospective Payment System Pricer.
                           Update Fiscal Year 2005 for 9 Metropolitan
                            Statistical Areas With New Wage.Index Values
                            Effective January 1, 2005.
                           Skilled Nursing Facility Prospective Payment
                            System Pricer Software.
414......................  Emergency Update to the 2005 Medicare
                            Physician Fee Schedule Database.
415......................  Temporary Change in Carrier Jurisdictional
                            Pricing Rules for Purchased Diagnostic
                            Services.
416......................  Interest Payment on Clean Claims Not Paid
                            Timely.
417......................  This revision rescinded and replaced revision
                            294.
418......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to the confidentiality
                            of instruction.
419......................  This Transmittal has been rescinded and
                            replaced with Transmittal 423.
420......................  Good Cause Waiver of Late Claim Filing
                            Payment Reduction Penalty and Monitoring of
                            Late Claims Submissions.
                           Extend Time for Good Cause.
                           Conditions Which Establish Good Cause.
                           Procedure To Establish Good Cause.
                           Good Cause Is Not Found.
                           Preparing Common Working File (CWF) Claim
                            Records for Services Subject to 10 Percent
                            Payment Reduction.
                           Monitoring Late Claims Submission Violations.
                           Sample Notification Letter.
                           Violations That Are Not Developed for
                            Referral.
421......................  Correction to January 2005 Annual Update of
                            Healthcare Common Procedure Coding.
                           System Codes Used for Skilled Nursing
                            Facility Consolidated Billing Enforcement.
422......................  Update to Fiscal Year 2005 Wage Index for
                            Inpatient Prospective Payment and Outpatient
                            Prospective Payment System Hospitals .
--------------------------
               Medicare Secondary Payer (CMS-Pub. 100-05)
------------------------------------------------------------------------
20.......................  Secondary Payer (Medicare Secondary Payer)
                            Savings Report Redesign.
                           Monthly Intermediary Report (Form CMS-1563)
                            and Monthly Carrier Report.
                           (Form CMS-1564) on Medicare Secondary Payer
                            Savings.
                           Savings Calculations.
                           Source of Savings.
                           Type of Savings.
                           Pre-payment Savings--Cost Avoid (Unpaid
                            Medicare Secondary Payer Claims).
                           Pre-payment Savings--Full Recoveries.
                           Pre-payment Savings--Partial Recoveries.
                           Post-payment Savings--Full Recoveries.
                           Post-payment Savings--Partial Recoveries.
                           Total Post-payment Savings.
                           Electronic Submission.
                           Data Entry of the Forms CMS-1563 and CMS-
                            1564.
                           System Calculations for Forms CMS-1563 and
                            CMS-1564.
21.......................  Instructions on Processing Certain Types of
                            Medicare Secondary Payer.Claims and to
                            Balance the Outbound Remittance Advice.
                           Instructions to Physicians and Suppliers on
                            How To Submit Claims to a Medicare Carrier
                            When There Are One or More Primary Payers.
22.......................  Medicare Secondary Payer Debt Referral
                            Instructions and Debt Collection Improvement
                            Act of 1996 Activities.
                           Courtesy Copy of All Medicare Secondary Payer
                            Group Health Plan-Based.
                           Recovery Demand Packages to the Employer's
                            Insurer/Third Party Administrator.
                           Insurer/Third Party Administrator Courtesy
                            Copy Letter.
                           Medicare Secondary Payer Debt Referral,
                            ``Write-Off--Closed'' Instructions and Debt
                            Collection Improvement Act of 1996
                            Activities.
                           Background.
                           Debt Selection, Verification of Debt, and
                            Updating of Interest.
                           ``Intent to Refer'' Letter and Inquiries/
                            Replies Related to Debt Improvement Act of
                            1996 Activities
                           Debt Collection System, Debt Collection
                            System Input, Debt Transmission,
                            Documentation to Treasury.
                           Actions Subsequent to Debt Collection System
                            Input.
                           Medicare Secondary Payer Debt Collection
                            Improvement Act of 1996 Tracking Report for
                            Referral/Collection.
                           Monitoring Debts Excluded From the Debt
                            Collection Improvement Act of 1996.
                           Referral Process.
                           Financial Reporting.
                           Compromise Requests and Extended Repayment
                            Agreement Requests, and Waiver of Interest
                            Requests.
                           Miscellaneous Questions and Answers.
--------------------------
             Medicare Financial Management (CMS-Pub. 100-06)
------------------------------------------------------------------------
55.......................  Reporting Appeals Redetermination Information
                            on Forms CMS-2591 and 2590.
56.......................  Revision to Balancing Requirement on Form 5,
                            Line 10, of the Contractor.
                           Reporting of Operational and Workload Data.

[[Page 9348]]

 
57.......................  Revised Reporting Requirements for Contractor
                            Reporting of Operational Workload Data
                            Health Professional Shortage Area Quarterly
                            Report.
58.......................  Issued to specific audience, not posted to
                            Internet/Intranet due to sensitivity of
                            instruction.
59.......................  Notice of New Interest Rate for Medicare
                            Overpayments and Underpayments.
60.......................  Revised Instructions on Contractor Procedures
                            for Provider Audit and the Provider
                            Statistical & Reimbursement Report.
                           Submission of Cost Report Data to CMS.
                           Desk Review Exceptions Resolution Process.
                           Definition of Field Audits.
                           Purpose of Field Audits.
                           Establishing the Objective/Scope of the Field
                            Audit.
                           Audit Confirmation Letter.
                           Entrance Conference.
                           Tests of Internal Control.
                           Designing Tests/Sampling.
                           Pre-Exit Conference.
                           Finalization of Audit Adjustments.
                           Exit Conference.
                           Medicare Cost Report and All Related
                            Documents.
                           Qualifications.
                           Internal Quality Control.
                           Final Settlement of the Cost Report.
                           Audit Responsibility When Provider Changes
                            Contractors.
                           Audits of Home Offices.
                           Standards for Issuance of an Audit Report for
                            a Home Office.
                           Provider Permanent File.
                           Contractor Responsibility in Suspected Fraud
                            or Abuse Cases.
61.......................  New Location Code Interstate Commerce
                            Commission, Status Code AR and Modified
                            Intent Letter for Unfiled Cost Reports Only.
                           Recovery of Overpayment Due to Overdue Cost
                            Report.
                           Provider Overpayment Recovery System User
                            Manual.
                           List of Status Codes.
                           Content of Demand Letters--Fiscal
                            Intermediary Serviced Providers.
--------------------------
           Medicare State Operations Manual (CMS-Pub. 100-07)
------------------------------------------------------------------------
3........................  Medicare Systems Acceptance of New Provider
                            Numbers for Federally Qualified Health
                            Centers.
4........................  Guidance to Surveyors for Long Term Care
                            Facilities.
--------------------------
5........................  Revisions to Appendix P (Survey Protocols for
                            Long Term Care Facilities) and Appendix PP
                            (Guidance to Surveyors for Long Term Care
                            Facilities).
--------------------------
              Medicare Program Integrity (CMS-Pub. 100-08)
------------------------------------------------------------------------
84.......................  This revision is rescinded and replaced by
                            revision 86.
85.......................  This revision is rescinded and replaced by
                            revision 87.
86.......................  Payment for Emergency Medical Treatment and
                            Labor Act--Mandated Screening and
                            Stabilization Services.
87.......................  Informing Beneficiaries About Which Local
                            Medical Review Policy and/or Local Coverage
                            Determination and/or National Coverage
                            Determination Is Associated With Their Claim
                            Denial.
88.......................  Timeframes for Processing 855 Enrollment
                            Applications.
                           Provider Enrollment, Chain and Ownership
                            System.
89.......................  Updating Financial Reporting Requirements for
                            Medical Review and Local Provider Education
                            and Training.
                           Medical Review and Local Provider, Education,
                            and Training.
                           Medical Review Overview.
                           Reporting Medical Review Workload and Cost
                            Information and Documentation in Contractor
                            Administrative, Budget & Financial
                            Management II.
                           Contractor Administrative, Budget & Financial
                            Management II Reporting for Medical Review
                            Activities.
                           Automated Review Workload and Cost (Activity
                            Code 21001).
                           Routine Review Workload and Cost (Activity
                            Code 21002).
                           Data Analysis Cost (Activity Code 21007).
                           Third Party Liability or Demand Bills
                            Workload and Cost (Activity Code 21010).
                           Policy Reconsideration/Revision Activities
                            (Activity Code 21206).
                           Medical Review Program Management Costs
                            (Activity Code 21207).
                           New Policy Development Activities (Activity
                            Code 21208).
                           Complex Probe Review Workload and Cost
                            (Activity Code 21220).
                           Prepay Complex Review Workload and Cost
                            (Activity Code 21221).
                           Post-pay Complex Review Workload and Cost
                            (Activity Code 21222).
                           Medicare Integrity Program Comprehensive
                            Error Rate Testing Support.
                           Medicare Integrity Program Comprehensive
                            Error Rate Testing Support.(Activity Code
                            21901).
                           Reporting Internal Staff Training.
                           Reporting Medical Review Savings in
                            Contractor Reporting of Operational &
                            Workload Data.
                           Local Provider Education and Training
                            Overview.

[[Page 9349]]

 
                           Reporting Local Provider Education and
                            Training Workload and Cost Information and
                            Documentation in Contactor Administrative,
                            Budget & Financial Management II.
                           One-on-One Provider Education a Workload and
                            Cost (Activity Code 24116).
                           Education Delivered to Group of Providers
                            Workload and Cost (Activity Code 24117).
                           Education Delivered via Electronic or Paper
                            Media Workload and Cost (Activity Code
                            24118).
90.......................  Prepayment Review of Claims for Medical
                            Review Purposes.
91.......................  Revision of Program Integrity Manual, Section
                            3.11.1.4.
                           Requesting Additional Documentation.
92.......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to Sensitivity of
                            instruction.
--------------------------
  Medicare Contractor Beneficiary and Provider Communications (CMS-Pub.
                                 100-09)
------------------------------------------------------------------------
00.......................  None.
--------------------------
                 Medicare Managed Care (CMS-Pub. 100-16)
------------------------------------------------------------------------
63.......................  Home Health Services Appeals.
64.......................  Surveys, Contracting Strategy, Grievances and
                            Appeals.
--------------------------
      Medicare Business Partners Systems Security (CMS-Pub. 100-17)
------------------------------------------------------------------------
05.......................  Consortium Contractor Management Officer and
                            CMS Project Officer.
                           The (Principal) Systems Security Officer.
                           Personnel Security/Suitability.
                           IT Systems Security Program Management.
                           System Security Plan.
                           Risk Assessment.
                           Information Technology Systems Contingency
                            Plan.
                           Annual Compliance Audit.
                           Corrective Action Management Process and
                            Plans of Action and Milestones.
                           Computer Security Incident Response.
                           Systems Security Profile.
                           Fraud Control.
                           Patch Management.
                           Security Management Resources.
                           Security Configuration Management.
                           National Institute of Standards and
                            Technology.
                           Information Security Levels.
                           Level 4: High Criticality and National
                            Security Interest.
                           Security Room.
                           Intrusion Detection System.
                           Internet Security.
--------------------------
                    Demonstrations (CMS-Pub. 100-19)
------------------------------------------------------------------------
07.......................  Expansion of Coverage for Chiropractic
                            Services Demonstration.
08.......................  This revision is rescinded and replaced with
                            Transmittal 9.
09.......................  This revision is rescinded and replaced with
                            Transmittal 10.
10.......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to sensitivity of
                            instruction.
11.......................  Medicare Coordinated Care Demonstration--
                            Override of Certain Medicare Secondary Payer
                            Edit Codes.
12.......................  Chemotherapy Demonstration Project.
13.......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to Sensitivity of
                            Instruction.
--------------------------
                 One Time Notification (CMS-Pub. 100-20)
------------------------------------------------------------------------
118......................  Shared Systems Maintainer Hours for
                            Resolution of Problem Detected As a Result
                            of Implementation of Change Request 2525 and
                            Change Request 2527.
119......................  Shared System Maintainer Hours for Resolution
                            of Problem Detected During Health Insurance
                            Portability and Accountability Act
                            Transaction Release Testing.
120......................  Override of Common Working File Edit for
                            Observation Services Exceeding 48 Hours.
121......................  Modification to Fiscal Intermediary Standard
                            System Regarding Common Working File
                            Initiated Adjustments.
122......................  Shared System and Common Working File
                            Renovation of Override Code Process and
                            Recognition of Four 2-byte Modifier Fields
                            on the Part B Query Record--For Multi-
                            Carrier System Phased Implementation
                            Approach Only.
123......................  Instructions for Pricing Treprostinil
                            (Q4077).
124......................  Common Working File Duplicate Claim Edit for
                            Referred Clinical Diagnostic and Purchased
                            Diagnostic Services.
125......................  This revision is rescinded and replaced with
                            revision 127.
126......................  Transmittal replaced by Transmittal 27 in
                            Pub. 100-02, Medicare Benefit Policy.
127......................  Instructions Applicable to the Audit of
                            Hospitals That Are Part of an Affiliated
                            Group in Relation to the ``Redistribution of
                            Unused Resident Positions,'' Section 422 of
                            the Medicare Modernization Act of 2003, P.L.
                            108-173, for Purposes of Graduate Medical
                            Education Payments.
128......................  Promoting Medicare's Preventive Benefits and
                            Services on an Annual Basis.

[[Page 9350]]

 
129......................  2005 Drug Administration Coding Revisions.
130......................  Development of a Coordination of Benefits
                            Agreement Auxiliary File and Modification of
                            the Health Insurance Portability and
                            Accountability Act 837 Coordination of
                            Benefits Flat File and National Council for
                            Prescription Drug Program File.
131......................  Coverage of Routine Costs of Clinical Trials
                            Involving Investigational Device Exemption
                            Category A Devices.
132......................  Issued to a specific audience, not posted to
                            Internet/Intranet due to Sensitivity of
                            instruction.
133......................  Shared System Maintainer Hours for Resolution
                            of Problems Detected as a Result of
                            Implementation of Change Request 2525 and
                            Change Request 2527
------------------------------------------------------------------------


                      Addendum IV.--Regulation Documents Published in the Federal Register
                                         [October Through December 2004]
----------------------------------------------------------------------------------------------------------------
                                   FR vol. 69
        Publication date           page number   CFR parts affected       File code        Title of regulation
----------------------------------------------------------------------------------------------------------------
October 6, 2004................           59929  ..................  CMS-5015-N........  Medicare Program; Care
                                                                                          Management for High-
                                                                                          Cost Beneficiaries
                                                                                          (CMHCB) Demonstration.
October 7, 2004................           60242  403, 412, 413,      CMS-1428-CN2......  Medicare Program;
                                                  418, 460, 480,                          Changes to the
                                                  482, 483, 485,                          Hospital Inpatient
                                                  489.                                    Prospective Payment
                                                                                          Systems and Fiscal
                                                                                          Year 2005 Rates;
                                                                                          Corrections.
October 7, 2004................           60158  ..................  CMS-1249-CN.......  Medicare Program;
                                                                                          Prospective Payment
                                                                                          System and
                                                                                          Consolidated Billing
                                                                                          for Skilled Nursing
                                                                                          Facilities;
                                                                                          Corrections.
October 7, 2004................           60157  ..................  CMS-1360-CN.......  Medicare Program;
                                                                                          Inpatient
                                                                                          Rehabilitation
                                                                                          Facility Prospective
                                                                                          Payment System for
                                                                                          Fiscal Year 2005;
                                                                                          Correction.
October 22, 2004...............           62124  484...............  CMS-1265-F........  Medicare Program; Home
                                                                                          Health Prospective
                                                                                          Payment System Rate
                                                                                          Update for Calendar
                                                                                          Year 2005.
October 22, 2004...............           62057  ..................  CMS-1302-N........  Medicare Program; Town
                                                                                          Hall Meeting on the
                                                                                          Medicare Provider
                                                                                          Feedback Group (MPFG)
                                                                                          November 16, 2004.
October 22, 2004...............           62056  ..................  CMS-1484-N........  Medicare Program;
                                                                                          November 22, 2004,
                                                                                          Meeting of the
                                                                                          Practicing Physicians
                                                                                          Advisory Council.
October 22, 2004...............           62055  ..................  CMS-4078-N........  Medicare Program;
                                                                                          Meeting of the
                                                                                          Advisory Panel on
                                                                                          Medicare Education--
                                                                                          November 30, 2004.
November 15, 2004..............           66922  412 and 413.......  CMS-1213-F........  Medicare Program;
                                                                                          Prospective Payment
                                                                                          System for Inpatient
                                                                                          Psychiatric
                                                                                          Facilities.
November 15, 2004..............           66918  ..................  CMS-1267-N........  Medicare Program;
                                                                                          Coverage and Payment
                                                                                          of Ambulance Services;
                                                                                          Recalibration of
                                                                                          Conversion Factor;
                                                                                          Inflation Update for
                                                                                          CY 2005.
November 15, 2004..............           66236  403, 405, 410,      CMS-1429-FC.......  Medicare Program;
                                                  411, 414, 418,                          Revisions to Payment
                                                  424, 484, and 486.                      Policies Under the
                                                                                          Physician Fee Schedule
                                                                                          for Calendar Year
                                                                                          2005.
November 15, 2004..............           65682  419...............  CMS-1427-FC.......  Medicare Program;
                                                                                          Changes to the
                                                                                          Hospital Outpatient
                                                                                          Prospective Payment
                                                                                          System and Calendar
                                                                                          Year 2005 Payment
                                                                                          Rates.
November 26, 2004..............           69252  405 and 489.......  CMS-4004-FC.......  Medicare Program;
                                                                                          Expedited
                                                                                          Determination
                                                                                          Procedures for
                                                                                          Provider Service
                                                                                          Terminations.
November 26, 2004..............           69178  416...............  CMS-1478-P........  Medicare Program;
                                                                                          Update of Ambulatory
                                                                                          Surgical Center List
                                                                                          of Covered Procedures.
November 26, 2004..............           68944  ..................  CMS-3149-N........  Medicare Program;
                                                                                          Meeting of Medicare
                                                                                          Coverage Advisory
                                                                                          Committee--January 25,
                                                                                          2005.
November 26, 2004..............           68935  ..................  CMS-1374-GNC......  Medicare Program;
                                                                                          Criteria and Standards
                                                                                          For Evaluating
                                                                                          Intermediary, Carrier,
                                                                                          and Durable Medical
                                                                                          Equipment,
                                                                                          Prosthetics,
                                                                                          Orthotics, and
                                                                                          Supplies (DMEPOS)
                                                                                          Regional Carrier
                                                                                          Performance During
                                                                                          Fiscal Year 2005.
November 26, 2004..............           68931  ..................  CMS-2202-FN.......  Medicare and Medicaid
                                                                                          Programs; Approval of
                                                                                          Application for
                                                                                          Deeming Authority for
                                                                                          Ambulatory Surgical
                                                                                          Centers by the
                                                                                          American Association
                                                                                          for Accreditation of
                                                                                          Ambulatory Surgery
                                                                                          Facilities, Inc.
November 26, 2004..............           68931  ..................  CMS-5011-WN.......  Medicare and Medicaid
                                                                                          Programs; Notice of
                                                                                          Withdrawal of the
                                                                                          Solicitation of
                                                                                          Proposals for the
                                                                                          Private, for-Profit
                                                                                          Demonstration Project
                                                                                          for the Program of All-
                                                                                          Inclusive Care for the
                                                                                          Elderly (PACE).

[[Page 9351]]

 
November 26, 2004..............           68815  447...............  CMS-2175-F........  Medicaid Program; Time
                                                                                          Limitation on
                                                                                          Recordkeeping
                                                                                          Requirements Under the
                                                                                          Drug Rebate Program.
November 30, 2004..............           69686  484...............  CMS-1265-CN2......  Medicare Program; Home
                                                                                          Health Prospective
                                                                                          Payment System Rate
                                                                                          Update for Calendar
                                                                                          Year 2005; Correction.
November 30, 2004..............           69536  403, 412, 413,      CMS-1428-N........  Medicare Program;
                                                  418, 460, 480,                          Changes to the
                                                  482, 483, 485,                          Hospital Inpatient
                                                  and 489.                                Prospective Payment
                                                                                          Systems and Fiscal
                                                                                          Year 2005 Rates;
                                                                                          Extension for the
                                                                                          Hospital Applications
                                                                                          To Receive Increases
                                                                                          in Full Time
                                                                                          Equivalent Resident
                                                                                          Caps for Graduate
                                                                                          Medical Education
                                                                                          Payment.
December 23, 2004..............           76947  ..................  CMS-5036-N........  Medicare Program;
                                                                                          Solicitation for
                                                                                          Proposals for the
                                                                                          Cancer Prevention and
                                                                                          Treatment
                                                                                          Demonstration for
                                                                                          Ethnic and Racial
                                                                                          Minorities.
December 30, 2004..............           78720  26 CFR Parts 54     CMS-2151-F........  HIPAA Program; Final
                                                  and 602, 29 CFR                         Regulations for Health
                                                  Part 2590, 45 CFR                       Coverage Portability
                                                  Parts 144 and 146.                      for Group Health Plans
                                                                                          and Group Health
                                                                                          Insurance Issuers
                                                                                          Under HIPPA Titles I
                                                                                          and IV.
December 30, 2004..............           78800  26 CFR Part 54, 29  CMS-2158-P........  HIPAA Program; Notice
                                                  CFR Part 2590, 45                       of Proposed Rulemaking
                                                  CFR Part 146.                           for Health Coverage
                                                                                          Portability: Tolling
                                                                                          Certain Time Periods
                                                                                          and Interaction With
                                                                                          the Family and Medical
                                                                                          Leave Act Under HIPAA
                                                                                          Titles I and IV.
December 30, 2004..............           78825  26 CFR Part 54, 29  CMS-2150-NC.......  HIPAA Program; Request
                                                  CFR Part 2590, 45                       for Information on
                                                  CFR Part 146.                           Benefit-Specific
                                                                                          Waiting Periods Under
                                                                                          HIPAA Titles I and IV.
December 30, 2004..............           78526  403, 412, 413,      CMS-1428-F2.......  Medicare Program;
                                                  418, 460, 480,                          Changes to the
                                                  482, 483, 485,                          Hospital Inpatient
                                                  and 489.                                Prospective Payment
                                                                                          Systems and Fiscal
                                                                                          2005 Rates; Correcting
                                                                                          Amendment.
December 30, 2004..............           78466  ..................  CMS-1292-N........  Medicare Program; Town
                                                                                          Hall Meeting on the
                                                                                          Fiscal Year 2006
                                                                                          Applications for New
                                                                                          Medical Services and
                                                                                          Technologies Add-on
                                                                                          Payments Under the
                                                                                          Hospital Inpatient
                                                                                          Prospective Payment
                                                                                          Systems Scheduled for
                                                                                          February 23, 2005.
December 30, 2004..............           78464  ..................  CMS-1285-N........  Medicare Program;
                                                                                          Meeting of the
                                                                                          Advisory Panel on
                                                                                          Ambulatory Payment
                                                                                          Classification (APC)
                                                                                          Groups (Panel)--
                                                                                          February 23, 24, and
                                                                                          25, 2005 and Re-
                                                                                          chartering of APC
                                                                                          Panel on November 8,
                                                                                          2004.
December 30, 2004..............           78445  ..................  CMS-1249-CN2......  Medicare Program;
                                                                                          Prospective Payment
                                                                                          System and
                                                                                          Consolidated Billing
                                                                                          for Skilled Nursing
                                                                                          Facilities;
                                                                                          Corrections.
December 30, 2004..............           78444  ..................  CMS-4077-FN.......  Medicare Program;
                                                                                          Approval of the
                                                                                          National Committee for
                                                                                          Quality Assurance
                                                                                          Deeming Authority for
                                                                                          Medicare Advantage
                                                                                          Local Preferred
                                                                                          Provider
                                                                                          Organizations.
December 30, 2004..............           78442  ..................  CMS-9026-N........  Medicare Program;
                                                                                          Timeline for
                                                                                          Publication of
                                                                                          Medicare Final
                                                                                          Regulations After
                                                                                          Proposed or Interim
                                                                                          Final Regulations.
December 30, 2004..............           78428  ..................  CMS-9042-N........  Medicare and Medicaid
                                                                                          Program; Quarterly
                                                                                          Listing of Program
                                                                                          Issuances--July 2004
                                                                                          Through September
                                                                                          2004.
December 30, 2004..............           78426  ..................  CMS-2490-N........  CLIA Program; Continued
                                                                                          Approval of the
                                                                                          American Association
                                                                                          of Blood Banks for
                                                                                          Deeming Authority.
December 30, 2004..............           78336  422...............  CMS-4041-IFC......  Medicare Program;
                                                                                          Modifications to
                                                                                          Managed Care Rules.
December 30, 2004..............           78315  419...............  CMS-1427-CN.......  Medicare Program;
                                                                                          Changes to the
                                                                                          Hospital Outpatient
                                                                                          Prospective Payment
                                                                                          System and Calendar
                                                                                          Year 2005 Payment
                                                                                          Rates; Wage Index
                                                                                          Tables and
                                                                                          Corrections.
----------------------------------------------------------------------------------------------------------------


[[Page 9352]]

Addendum V--National Coverage Determinations

[October Through December 2004]

    A national coverage determination (NCD) is a determination by the 
Secretary with respect to whether or not a particular item or service 
is covered nationally under Title XVIII of the Social Security Act, but 
does not include a determination of what code, if any, is assigned to a 
particular item or service covered under this title, or determination 
with respect to the amount of payment made for a particular item or 
service so covered. We include below all of the NCDs that were issued 
during the quarter covered by this notice. The entries below include 
information concerning completed decisions as well as sections on 
program and decision memoranda, which also announce pending decisions 
or, in some cases, explain why it was not appropriate to issue an NCD. 
We identify completed decisions by the section of the NCDM in which the 
decision appears, the title, the date the publication was issued, and 
the effective date of the decision. Information on completed decisions 
as well as pending decisions has also been posted on the CMS Web site 
at http://cms.hhs.gov/coverage.

                                        National Coverage Determinations
                                         [October Through December 2004]
----------------------------------------------------------------------------------------------------------------
                                                NCDM                                                  Effective
                   Title                      section             TN            Issue date      date
----------------------------------------------------------------------------------------------------------------
Treatment of Obesity......................         40.5  R23NCD.......................     10/01/04     10/01/04
Changes to the Laboratory NCD Edit                  N/A  R38CP........................     11/26/04     01/03/05
 Software for January 2005.
Dementia and Neurodegenerative Diseases...     220.6.13  R24NCD.......................     10/01/04     09/15/04
Percutaneous Transluminal Angioplasty.....         20.7  R25NCD.......................     10/15/04     10/12/04
Electrocardiographic Services.............        20.15  R26NCD.......................     12/10/04     08/26/04
----------------------------------------------------------------------------------------------------------------

Addendum VI--FDA-Approved Category B IDEs

    Under the Food, Drug, and Cosmetic Act (21 U.S.C. 360c) devices 
fall into one of three classes. To assist CMS under this categorization 
process, the FDA assigns one of two categories to each FDA-approved 
IDE. Category A refers to experimental IDEs, and Category B refers to 
non-experimental IDEs. 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 list includes all Category B IDEs approved by FDA 
during the 4th quarter, October Through December 2004.
G010041
G020001
G020105
G040026
G040081
G040086
G040090
G040115
G040117
G040133
G040135
G040136
G040157
G040163
G040164
G040165
G040169
G040170
G040171
G040173
G040174
G040175
G040177
G040178
G040179
G040180
G040181
G040182
G040183
G040185
G040187
G040188
G040189
G040193
G040197
G040199
G040201
G040202
G040207
G040210
G040211
G040212
G040213
G040215
G040216
G911803

Addendum VII--Approval Numbers for Collections of Information

    Below we list all approval numbers for collections of information 
in the referenced sections of CMS regulations in Title 42; Title 45, 
Subchapter C; and Title 20 of the Code of Federal Regulations, which 
have been approved by the Office of Management and Budget:

------------------------------------------------------------------------
                                         Approved CFR Sections in Title
                                       42, Title 45, and Title 20 (Note:
                                       Sections in Title 45 are preceded
           OMB Control No.               by ``45 CFR,'' and sections in
                                         Title 20 are preceded by ``20
                                                     CFR'')
------------------------------------------------------------------------
0938-0008............................  414.40, 424.32, 424.44
0938-0022............................  413.20, 413.24, 413.106
0938-0023............................  424.103
0938-0025............................  406.28, 407.27
0938-0027............................  486.100-486.110
0938-0033............................  405.807
0938-0035............................  407.40
0938-0037............................  413.20, 413.24
0938-0041............................  408.6, 408.22
0938-0042............................  410.40, 424.124
0938-0045............................  405.711
0938-0046............................  405.2133
0938-0050............................  413.20, 413.24, 431.151,
                                        435.1009, 440.220, 440.250,
                                        442.1, 442.10-442.16, 442.30,
                                        442.40, 442.42,
0938-0062............................  442.100-442.119, 483.400-483.480,
                                        488.332, 488.400, 498.3-498.5
0938-0065............................  485.701-485.729
0938-0074............................  491.1-491.11

[[Page 9353]]

 
0938-0080............................  406.7, 406.13
0938-0086............................  420.200-420.206, 455.100-455.106
0938-0101............................  430.30
0938-0102............................  413.20, 413.24
0938-0107............................  413.20, 413.24
0938-0146............................  431.800-431.865
0938-0147............................  431.800-431.865 493.1405,
                                        493.1411, 493.1417, 493.1423,
                                        493.1443, 493.1449, 493.1455,
                                        493.1461
0938-0151............................  493.1469, 493.1483, 493.1489
0938-0155............................  405.2470
0938-0170............................  493.1269-493.1285
0938-0193............................  430.10-430.20, 440.167
0938-0202............................  413.17, 413.20
0938-0214............................  411.25, 489.2, 489.20
0938-0236............................  413.20, 413.24
0938-0242............................  442.30, 488.26
0938-0245............................  407.10, 407.11
0938-0246............................  431.800-431.865
0938-0251............................  406.7
0938-0266............................  416.41, 416.47, 416.48, 416.83
0938-0267............................  410.65, 485.56, 485.58, 485.60,
                                        485.64, 485.66
0938-0269............................  412.116, 412.632, 413.64,
                                        413.350, 484.245
0938-0270............................  405.376
0938-0272............................  440.180, 441.300-441.305
0938-0273............................  485.701-485.729
0938-0279............................  424.5
0938-0287............................  447.31
0938-0296............................  413.170, 413.184
0938-0301............................  413.20, 413.24
0938-0302............................  418.22, 418.24, 418.28, 418.56,
                                        418.58, 418.70, 418.74, 418.83,
                                        418.96, 418.100
0938-0313............................  489.11, 489.20, 482.12, 482.13,
                                        482.21, 482.22, 482.27, 482.30,
                                        482.41, 482.43, 482.45, 482.53,
                                        482.56
0938-0328............................  482.57, 482.60, 482.61, 482.62,
                                        482.66, 485.618, 485.631
0938-0334............................  491.9, 491.10
0938-0338............................  486.104, 486.106, 486.110
0938-0354............................  441.60
0938-0355............................  442.30, 488.26
0938-0357............................  409.40-409.50, 410.36, 410.170,
                                        411.4--411.15, 421.100, 424.22,
                                        484.18, 489.21
0938-0358............................  412.20-412.30
0938-0359............................  412.40-412.52
0938-0360............................  488.60
0938-0365............................  484.10, 484.11, 484.12, 484.14,
                                        484.16, 484.18, 484.20, 484.36,
                                        484.48, 484.52
0938-0372............................  414.330
0938-0378............................  482.60-482.62
0938-0379............................  442.30, 488.26
0938-0382............................  442.30, 488.26
0938-0386............................  405.2100-405.2171
0938-0391............................  488.18, 488.26, 488.28
0938-0426............................  476.104, 476.105, 476.116,
                                        476.134
0938-0429............................  447.53
0938-0443............................  473.18, 473.34, 473.36, 473.42
0938-0444............................  1004.40, 1004.50, 1004.60,
                                        1004.70
0938-0445............................  412.44, 412.46, 431.630, 456.654,
                                        466.71, 466.73, 466.74, 466.78
0938-0447............................  405.2133
0938-0448............................  405.2133, 45 CFR Parts 5, 5b; 20
                                        CFR Parts 401, 422E
0938-0449............................  440.180, 441.300-441.310
0938-0454............................  424.20
0938-0456............................  412.105
0938-0463............................  413.20, 413.24, 413.106
0938-0467............................  431.17, 431.306, 435.910,
                                        435.920, 435.940-435.960
0938-0469............................  417.126, 422.502, 422.516
0938-0470............................  417.143, 417.800-417.840, 422.6
0938-0477............................  412.92
0938-0484............................  424.123
0938-0501............................  406.15
0938-0502............................  433.138
0938-0512............................  486.304, 486.306, 486.307
0938-0526............................  475.102, 475.103, 475.104,
                                        475.105, 475.106
0938-0534............................  410.338, 424.5
0938-0544............................  493.1-493.2001
0938-0564............................  411.32
0938-0565............................  411.20-411.206
0938-0566............................  411.404, 411.406, 411.408
0938-0573............................  412.230, 412.256
0938-0578............................  447.534

[[Page 9354]]

 
0938-0581............................  493.1-493.2001
0938-0599............................  493.1-493.2001
0938-0600............................  405.371, 405.378, 413.20
0938-0610............................  417.436, 417.801, 422.128,
                                        430.12, 431.20, 431.107, 434.28,
                                        483.10, 484.10, 489.102,
                                        493.801, 493.803, 493.1232,
                                        493.1233, 493.1234, 493.1235,
                                        493.1236, 493.1239, 493.1241,
                                        493.1242, 493.1249, 493.1251,
                                        493.1252, 493.1253, 493.1254,
                                        493.1255, 493.1256, 493.1261,
                                        493.1262, 493.1263, 493.1269,
                                        493.1273, 493.1274, 493.1278
0938-0612............................  493.1283, 493.1289, 493.1291,
                                        493.1299
0938-0618............................  433.68, 433.74, 447.272
0938-0653............................  493.1771, 493.1773, 493.1777
0938-0657............................  405.2110, 405.2112
0938-0658............................  405.2110, 405.2112
0938-0667............................  482.12, 488.18, 489.20, 489.24
0938-0679............................  410.38
0938-0685............................  410.32, 410.71, 413.17, 424.57,
                                        424.73, 424.80, 440.30, 484.12
0938-0686............................  493.551-493.557
0938-0688............................  486.304, 486.306, 486.307,
                                        486.310, 486.316, 486.318,
                                        486.325
0938-0690............................  488.4-488.9, 488.201
0938-0691............................  412.106
0938-0692............................  466.78, 489.20, 489.27
0938-0701............................  422.152
0938-0702............................  45 CFR 146.111, 146.115, 146.117,
                                        146.150, 146.152, 146.160,
                                        146.180
0938-0703............................  45 CFR 148.120, 148.124, 148.126,
                                        148.128
0938-0714............................  411.370-411.389
0938-0717............................  424.57
0938-0721............................  410.33
0938-0723............................  421.300-421.318
0938-0730............................  405.410, 405.430, 405.435,
                                        405.440, 405.445, 405.455,
                                        410.61, 415.110, 424.24
0938-0732............................  417.126, 417.470
0938-0734............................  45 CFR Part 5b
0938-0739............................  413.337, 413.343, 424.32, 483.20
0938-0742............................  422.300-422.312
0938-0749............................  424.57
0938-0753............................  422.000-422.700
0938-0754............................  441.151, 441.152
0938-0758............................  413.20, 413.24
0938-0760............................  Part 484 Subpart E, 484.55
0938-0761............................  484.11, 484.20, 422.1-422.10,
                                        422.50-422.80, 422.100-422.132,
                                        422.300-422.312, 422.400-
0938-0763............................  422.404, 422.560-422.622
0938-0770............................  410.2
0938-0778............................  422.64, 422.111
0938-0779............................  417.126, 417.470, 422.64, 422.210
0938-0781............................  411.404-411.406, 484.10
0938-0786............................  438.352, 438.360, 438.362,
                                        438.364
0938-0787............................  406.28, 407.27, 460.12, 460.22,
                                        460.26, 460.30, 460.32, 460.52,
                                        460.60, 460.70, 460.71, 460.72,
                                        460.74, 460.80, 460.82, 460.98,
                                        460.100, 460.102, 460.104,
                                        460.106, 460.110, 460.112,
                                        460.116, 460.118, 460.120,
                                        460.122, 460.124, 460.132,
                                        460.152, 460.154, 460.156,
                                        460.160, 460.164, 460.168,
                                        460.172, 460.190, 460.196,
                                        460.200, 460.202, 460.204,
0938-0790............................  460.208, 460.210
0938-0792............................  491.8, 491.11
0938-0798............................  413.24, 413.65, 419.42
0938-0802............................  419.43
0938-0818............................  410.141, 410.142, 410.143,
                                        410.144, 410.145, 410.146,
                                        414.63
0938-0829............................  422.568
0938-0832............................  Parts 489 and 491
0938-0833............................  483.350-483.376, 431.636, 457.50,
                                        457.60, 457.70, 457.340,
                                        457.350, 457.431, 457.440,
                                        457.525, 457.560, 457.570,
                                        457.740, 457.750, 457.810,
                                        457.940, 457.945, 457.965,
                                        457.985,
0938-0841............................  457.1005, 457.1015, 457.1180
0938-0842............................  412.23, 412.604, 412.606,
                                        412.608, 412.610, 412.61a4,
                                        412.618, 412.626, 413.64
0938-0846............................  411.352-411.361
0938-0857............................  Part 419
0938-0860............................  Part 419
0938-0866............................  45 CFR Part 162
0938-0872............................  413.337, 483.20
0938-0873............................  422.152
0938-0874............................  45 CFR Parts 160 and 162
0938-0878............................  Part 422 Subpart F & G
0938-0883............................  45 CFR Parts 160 and 164
0938-0884............................  405.940
0938-0887............................  45 CFR 148.316, 148.318, 148.320
0938-0897............................  412.22, 412.533
0938-0907............................  412.230, 412.304, 413.65
0938-0910............................  422.620, 422.624, 422.626
0938-0911............................  426.400, 426.500
0938-0916............................  483.16, 438.6, 438.8, 438.10,
                                        438.12, 438.50, 438.56, 438.102,
                                        438.114, 438.202, 438.206,
                                        438.207, 438.240, 438.242,
                                        438.402, 438.404, 438.406,
                                        438.408, 438.410, 438.414

[[Page 9355]]

 
0938-0920............................  438.416, 438.710, 438.722,
                                        438.724, 438.810
0938-0921............................  414.804
------------------------------------------------------------------------

[FR Doc. 05-3551 Filed 2-24-05; 8:45 am]
BILLING CODE 4120-01-P