Medicare Claims Processing Manual (Pub. 100-04), Ch. 18 § 50.6
Calculating Frequency
50.6 - Calculating Frequency
(Rev. 1, 10-01-03)
A3-3616.D and E, B3-4182.4, B3-4182.5
Calculating Frequency - To determine the 11-month period, the count starts beginning with the
month after the month in which a previous test/procedure was performed.
EXAMPLE: The beneficiary received a screening prostate specific antigen test in January 2002.
Start counts beginning February 2002. The beneficiary is eligible to receive another screening
prostate specific antigen test in January 2003 (the month after 11 months have passed).
Common Working File (CWF) Edits
Beginning October 1, 2000, the following CWF edits were implemented for dates of service
January 1, 2000, and later, for prostate cancer screening tests and procedures for the following:
•
Age;
•
Frequency;
•
Sex; and
•
Valid HCPCS code.