On April 9 the Centers for Medicare & Medicaid Services (CMS) announced contract suppliers for the Round 2 and National Mail Order programs of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program.

Humana has published an updated coverage determination for adult sleep studies. The new policy details the payer’s stance on coverage of PAP NAPs - the daytime, abbreviated cardio-respiratory sleep studies to acclimated patients to positive airway pressure (PAP) therapy.

In October 2012 the AASM published the AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications Version 2.0. All AASM accredited sleep centers will be required to follow the new manual by October 1, 2013.

Effective May 1, 2013 the Centers for Medicare & Medicaid Services (CMS) will implement edits that will result in claims denial if the ordering or referring provider is not enrolled in Medicare. To prevent denials, claims submitted on or after May 1 must include the name and national provider identifier (NPI) of the practitioner who ordered or referred the service.

This week, the practice management section of the AASM website was expanded to include new frequently asked questions (FAQs) about coding and billing. New FAQ categories include out of center sleep testing and actigraphy. For updated content, please visit the AASM Practice Management website.

Last week, the AASM announced a new Coding Education Program (A-CEP) for sleep center coding and billing staff.

The Medicare Learning Network issued a March 8, 2013, announcement to address mandatory payment reductions in the Medicare Fee-for-Service (FFS) program due to sequestration. In general, Medicare FFS claims with dates-of-service or dates-of-discharge on or after April 1, 2013, will incur a 2 percent reduction in Medicare payment.

The National Commission on Physician Payment Reform published a report on Mar 4 outlining recommendations for changing how physicians are paid.

The Affordable Care Act (ACA) requires Medicare to develop validation mechanisms for the relative value units (RVUs) assigned to services paid under the physician fee schedule.

According to a study published in HealthAffairs on Mar 4, just 27 percent of practices achieved a positive return on investment five years after implementation of electronic health record (EHR) systems.