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Medicare Learning Network (MLN)

Suite of Products & Resources for Billers and Coders
Whats Inside the Suite?

MLN Homepage

Welcome to the MLN Homepage!

The MLN is your destination
for official CMS information
and resources for Health Care
Professionals.

Medicare Coverage Database

(MCD)

A how-to guide to access

information from the MCD; contains
national and local Medicare
coverage determinations, analyses,
proposed decisions, coding
analyses, and other information.

National Correct Coding

Initiative (NCCI)

A how-to guide to take advantage of

the NCCI. The NCCI helps reduce
coding errors and denials and
helps you ensure payments for
covered services.

Discover more than 80 products

edited from the comprehensive
MLN Catalog of Products
geared to provide health care
reimbursement professionals with
information about new and
changing Medicare Program
policies and procedures.

REIMBURSEMENT, CLAIMS REVIEW, AND COMPLIANCE

2012 Physician Quality Reporting System Claims Reporting

Made Simple
a. *SE1207- 2012 Physician Quality Reporting System Claims
Based Coding and Reporting Principles
Durable Medical Equipment and Supplies:

How Will the Suite Help Me?

MLN products can help you
understand how to submit claims
correctly the first time; in addition
youll strengthen your knowledge
of Medicare Program basics,
business requirements, benefits
and coverage, and federal
initiatives and incentives.

Start Learning Now

Just roll your cursor over one

of the titles; click and you are
linked to a product. You can
download information, listen to
a podcast, research an article
through MLN Matters, or even
sign up for a web-based training
course many of which offer
continuing education credits.

*Indicates an

a. Cardiac Pacemakers: Complying with Documentation

and Coverage Requirements
b. Glucose Testing Supplies: Complying with Documentation
and Coverage Requirements
c. Oxygen Therapy Supplies: Complying with Documentation
and Coverage Requirements
d. Positive Airway Pressure (PAP) Devices: Complying with
Documentation and Coverage Requirements (Podcast)
e. Power Mobility Face-to-Face Examination Checklist
(Podcast)
Complying with Medicare Signature Requirements
Inpatient Rehabilitation Therapy Services: Complying with
Documentation Requirements

MLN Matters Article

*MM7833 Calendar Year 2013 and After Payments to Home

Health Agencies That Do Not Submit Required Quality Data
ICN 904183
May 2013

Medicare Learning Network (MLN)

Suite of Products & Resources for Billers and Coders
REIMBURSEMENT, CLAIMS REVIEW, AND COMPLIANCE

PAYMENT SYSTEMS AND FEE SCHEDULES

Medicare Claim Review Programs: MR, NCCI Edits, MUEs,

CERT and RAC

How To Use the Searchable Medicare Physician Fee Schedule

MLN Provider Compliance Fast Facts Web Page

Inpatient Psychiatric Facility Prospective Payment System

Recovery Audit Program Demonstration: High-Risk

Diagnosis Related Group (DRG) Coding Vulnerabilities for
Inpatient Hospitals (Podcast)

Inpatient Rehabilitation Facility Prospective Payment System

The Medicare Overpayment Collection Process (Podcast)

Skilled Nursing Facility Prospective Payment System

PAYMENT SYSTEMS AND FEE SCHEDULES

CLAIMS SUBMISSIONCOVERAGE, BILLING AND

CODING REQUIREMENTS

Acute Care Hospital Inpatient Prospective Payment System

Ambulance Fee Schedule
Ambulatory Surgical Center Fee Schedule

Long Term Care Hospital Prospective Payment System: News

*MM7679 2012 Durable Medical Equipment, Prosthetics,

Orthotics, and Supplies (DMEPOS) Healthcare Common
Procedure Coding System (HCPCS) Code Jurisdiction
Evaluation and Management Services: Complying with
Documentation Requirements

Clinical Laboratory Fee Schedule

Global Surgery

End Stage Renal Disease Prospective Payment System

How to Use the National Correct Coding Initiative

(NCCI) Tools

Home Health Prospective Payment System

Items and Services That Are Not Covered Under the

Medicare Program

Hospice Payment System

Medicare Claims Submission Guidelines

Hospital Outpatient Prospective Payment System

Web-Based
Training
Visit here to register for
free classes.
Scroll down to section
Related Links
Select Web-Based
Training (WBT) Courses

Popular Courses:
Medicare Billing Certificate
Program for Part A and Part B
Providers

*HIPAA EDI Standards

*Medicare Fraud and Abuse

*Medicare Secondary Payer

Provisions

*Physician Quality Reporting
Initiative and Electronic
Prescribing Incentive Program
Uniform Billing (UB-04)

*World of Medicare
*Your Office in the World
of Medicare

* Continuing Education
Credits

Medicare Learning Network (MLN)

Suite of Products & Resources for Billers and Coders
CLAIMS SUBMISSIONCOVERAGE, BILLING AND
CODING REQUIREMENTS

FEDERAL INITIATIVE AND INCENTIVE PROGRAMS

*SE1128 Prohibition on Balance Billing Qualified Medicare

Beneficiaries (QMBs)

Electronic Health Records (EHR) Incentive Program

2012 Physician Quality Reporting System: Medicare
Electronic Health Record (EHR) Incentive Pilot: Quick
Reference Guide

Rehabilitation Therapy Information Resource for Medicare

Skilled Nursing Facility (SNF) Spell of Illness Quick
Reference Chart
*MM7836 Transcutaneous Electrical Nerve Stimulation
(TENS) for Chronic Low Back Pain (CLBP)
*SE1239 Updated ICD-10 Information

Web-Based
Training
Visit here to register for
free classes.
Scroll down to section
Related Links
Select Web-Based
Training (WBT) Courses

Popular Courses:

Electronic Data Interchange (EDI) Standards: Transition to

Versions 5010 and D.0
a. Checklist for Level 1 Testing Activities
b. Provider Action Checklist for a Smooth Transition

Medicare Billing Certificate

Program for Part A and Part B
Providers

*HIPAA EDI Standards

*Medicare Fraud and Abuse

*Medicare Secondary Payer

*SE1240 Partial Code Freeze Prior to ICD-10

Implementation
FEDERAL INITIATIVE AND INCENTIVE PROGRAMS

PROVIDER ENROLLMENT

Accountable Care Organizations: What Providers Need

to Know

Basics of Internet-based Provider Enrollment, Chain and

Ownership System (PECOS) for Provider and Supplier
Organizations

Clinical Laboratory Improvement Amendments (CLIA)

Electronic Prescribing (eRx) Incentive Program
a. 2012 Electronic Prescribing (eRx) Incentive Program:
Participation for the Incentive Payments Made Simple
b. 2012 Electronic Prescribing (eRx) Incentive Program:
Updates for 2012

Provisions

*Physician Quality Reporting
Initiative and Electronic
Prescribing Incentive Program
Uniform Billing (UB-04)

*World of Medicare
*Your Office in the World
of Medicare

Medicare Enrollment Guidelines for Ordering/

Referring Providers

PECOS for Physicians and Non-Physician Practitioners

* Continuing Education
Credits

Medicare Learning Network (MLN)

Suite of Products & Resources for Billers and Coders

Web-Based
Training
Visit here to register for
free classes.

PROVIDER ENROLLMENT

MEDICARE PROGRAM RESOURCES FROM THE MLN

*SE1135 Guidance on Completing the CMS-855A

Enrollment Form

Contractor Entities At A Glance: Who May Contact You

About Specific CMS Activities

Scroll down to section

Related Links

The Basics of Medicare Enrollment for Institutional

Providers

CMS Electronic Mailing Lists: Keeping Medicare Fee-ForService Providers Informed

Select Web-Based
Training (WBT) Courses

The National Provider Identifier (NPI) What You Need

to Know

Guidelines for Teaching Physicians, Interns and Residents

EXPANDED BENEFITS AND COVERED

SCREENING SERVICES

Medical Record Retention and Media Format (Podcast)

Medicare Learning Network (MLN) Preventive Services

Resources Web Page

Medicare Fraud & Abuse: Prevention, Detection, and

Reporting Facilitator Kit

Quick Reference Information: Medicare Immunization

Billing

MLN Guided Pathways to Medicare Resources

Quick Reference Information: Preventive Services

Quick Reference Information: All Medicare Providers

Popular Courses:
Medicare Billing Certificate
Program for Part A and Part B
Providers

*HIPAA EDI Standards

*Medicare Fraud and Abuse

*Medicare Secondary Payer

Provisions

*Physician Quality Reporting
Initiative and Electronic
Prescribing Incentive Program
Uniform Billing (UB-04)

Communicating With Your Medicare Patient

*World of Medicare
*Your Office in the World
of Medicare

Visit the Medicare Learning Network (MLN)

http://go.cms.gov/MLNGenInfo

Learn more. Stay connected.

Check out CMS on

* Continuing Education
Credits