Billing Transplant Services

90 - Billing Transplant Services (Rev. 1571; Issued: 08-07-08; Effective Date: 08-01-08; Implementation Date: 08-15- 08) Medicare covers the following organ transplants: kidney, heart, lung, heart/lung, liver, pancreas, pancreas/kidney, and intestinal/multi-visceral. Medicare also covers stem cell transplants for certain conditions. On March 30, 2007, the Department of Health and Human Services (DHHS) established a regulation authorizing the survey and certification of organ transplant programs. The Centers for Medicare & Medicaid Services (CMS) is the Federal agency responsible for monitoring compliance with the Medicare conditions of participation. All hospital transplant programs covered by the regulation (does not include stem cell transplants), whether currently approved by CMS or seeking initial approval, must submit a request for approval under the new regulations to CMS by December 26, 2007 (180 days from the effective date of the regulation.) http://www.cms.hhs.gov/CertificationandComplianc/20_Transplant.asp#TopOfPage Transplant hospitals should review the above Web site and send applications to the following address: Centers for Medicare and Medicaid Services Survey and Certification Group 7500 Security Blvd. Mailstop: S2-12-25 Baltimore, MD 21244 The A/B MACs (A) may choose to review claims if data analysis deems it a priority.