We will be making adjustments to claims for counseling to prevent tobacco use 
with dates of service Saturday, January 1, 2011 through Monday, April 4, 2011.  
These adjustments will be completed by Friday, November 4, 2011.

In a previous message, we made you aware of a claims processing problem where 
claims with the following criteria were not processing correctly:

§  HCPCs G0436 and/or G0437

§  Revenue Codes 0942, 096X, 097X, or 098X

§  Dates of Service on or after Sat Jan 1, 2011

§  Diagnosis Codes 305.1 or V15.82

§  Occurrence Code 32 not present


This claims processing problem was corrected in May 2011, and we released any 
claims we were holding.  We will now be adjusting any claims that were 
processed incorrectly with the above mention criteria.  If you have any claims 
impacted by this problem, the adjustment will be reflected on your remittance 
advice.  We appreciate your patience as we correct these claims.

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Vaccination is the Best Protection Against the Flu. The Centers for Disease 
Control and Prevention (CDC) is encouraging everyone 6 months of age and older 
to get vaccinated against the seasonal flu. The risks for complications, 
hospitalizations, and deaths from the flu are higher among individuals aged 65 
years and older. Medicare pays for the seasonal flu vaccine and its 
administration for seniors and others with Medicare with no co-pay or 
deductible. And remember, vaccination is particularly important for healthcare 
workers, who may spread the flu to high risk patients. Don't forget to immunize 
yourself and your staff. Protect your patients. Protect your family. Protect 
yourself. Get the Flu Vaccination -- Not the Flu.


Remember - Influenza vaccine plus its administration are covered Part B 
benefits.  CMS has posted the 2011-2012 seasonal influenza vaccine payment 
limits at http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp.



Note that influenza vaccine is NOT a Part D-covered drug.  For information 
about Medicare's coverage of the influenza vaccine and its administration, as 
well as related educational resources for healthcare professionals and their 
staff, visit http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp.







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