Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations - Update - Revised

MLN Matters Number: SE19007 Revised
Article Release Date: September 5, 2019
Related Change Request (CR) Number: 9613; 9907
Related CR Transmittal Numbers: R1704OTN and R1783OTN

Note: CMS revised this article on September 5, 2019, to announce a delay of full implementation until April 2020.

This article conveys the activation of systematic validation edits to enforce the requirements in the Medicare Claims Processing Manual, Chapter 1, Section 170, which describes Payment Bases for Institutional Claims. These requirements are not new requirements. The Centers for Medicare & Medicaid Services (CMS) discussed these requirements in CRs 9613 and 9907, both of which were effective on January 1, 2017. MLN Matters articles for CRs 9613 and 9907 are available at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-NetworkMLN/MLNMattersArticles/Downloads/MM9613.pdf and https://www.cms.gov/Outreach-andEducation/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9907.pdf, respectively. Make sure your billing staff is aware of these instructions.

View the complete CMS Medicare Learning Network (MLN) Matters Special Edition (SE)19007.

Last Updated Sep 06, 2019