Annual Update Process

110.4.1 - Annual Update Process (Rev. 2802, Issued: 10-25-13, Effective: 01-01-14, Implementation: 01-06-14) Barring any delay in the Medicare Physician Fee Schedule, CMS will provide the new code files to CWF by November 1. Should this date change, CWF will be notified through the appropriate mechanism. All future updates will be submitted via a Recurring Update Notification form. These Recurring Update Notifications also describe how the changes will be implemented. CWF will be provided with 4 coding files (Physician Services, Professional Component of Physician Services to be Submitted with the 26 Modifier, Ambulance, and Therapy) that are effective based on dates of service January 1 through December 31 for that year. New files shall be provided for each calendar year. Quarterly updates to the four files will continue as usual. A/B MACs (B)/DME MACs must continue to respond to rejects and unsolicited responses received from CWF per current methodology. A/B MACs (B)/DME MACs must reopen and reprocess any claims brought to their attention for services that prior to this update were mistakenly considered to be subject to consolidated billing and therefore, not separately payable. A/B MACs (B)/DME MACs need not search claims history to identify these claims. Prior to January 1 of each year, new codes files will be posted to the CMS Web site at. https://www.cms.gov/Medicare/Billing/SNFConsolidatedBilling/. Should this date change, A/B MACs (B)/DME MACs will be notified through the appropriate mechanism. Coding changes throughout the year may also be made as necessary through a quarterly update process. As soon as the new code files are posted to the CMS Web site, through their Web sites and list serves, A/B MACs (B)/DME MACs must notify physician, non-physician practitioners, and suppliers of the availability of the files.