As a result, the Medical Society of New Jersey (MSNJ) has filed a compliance dispute against Horizon alleging multiple violations of the national class-action settlement agreement concerning these modifiers. The Horizon BCBSNJ memo announced that this change will become effective on May 17, 2010, and will recognize services submitted with a variety of modifiers as “nonstandard” and “not...
Units of Service validation editing for procedure codes submitted from professional providers (837P or 1500 Health Insurance Claim Form) begins on the evening of December 15, 2009. Although Blue Cross and Blue Shield of Minnesota and Blue Plus are not following Medicare’s Medically Unlikely Edits (MUE), this is similar to MUEs where the verbiage of the procedure code dictates the number of units...
850,000 physicians urged to be on lookout for signs of identity theft.
The final appeal in the Blue Cross Blue Shield Settlement was dismissed on June 12, 2009 and as such, the settlement has been finalized. The settlement administrator mailed the settlement checks to class members on July 22, 2009.
On June 25, 2009 Horizon Blue Cross Blue Shield of New Jersey filed a civil suit against Biodiagnostic Laboratory Services of Parsippany, N.J. for allegedly submitting more than $14 million in fraudulent health insurance claims to Horizon between 2005 and June 2009.
This document addresses serum tumor markers in the management of cancerous conditions. Serum tumor markers are molecules or substances that are produced by the tumor itself or by the body in response to the presence of a cancerous or non-cancerous condition. These markers can be detected and quantified in the serum. Single measurements of serum tumor markers may be used to aid diagnosis and...
Medicare Kansas has retired the following LCD / HER-2/NEU GENE AMPLIFICATION AND OVEREXPRESSION TESTS effective 4/13/2005. The procedure codes are: 88342 88367 88368 174.0 to 174.0 174.2 to 174.2 174.3 to 174.3 174.4 to 174.4 174.5 to 174.5 174.6 to 174.6 174.8 to 174.8 174.9 to 174.9 V70.1 to V70.9...