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CHANGE NOTIFICATION TO REIMBURSEMENT POLICIES

Thu, 2013-02-28 09:55

For claims with for dates of service on or after May 20, 2013, Travel allowance services for collection of a Lab Specimen reported with HCPCS codes P9603 and P9604 are not eligible for separate reimbursement even when reported with modifier 59. The Laboratory and Venipuncture Services reimbursement policy will also be updated to reflect this change.

Frequency reimbursement policy for qualitative drug screening

Tue, 2012-11-27 09:19

The Frequency Policy was updated to document that procedure codes G0431 and G0434 for qualitative drug screening are eligible for one (1) unit of reimbursement per date of service. Effective with claims processed on or after November 11, 2012, Modifier 91 (repeat clinical diagnostic laboratory test) will no longer override the quantity limit. This change is consistent with CMS medically unlikely edits.

New Colorado Direct Billing Legislation

Tue, 2012-06-26 17:00

In March, Colorado Gov. John Hickenlooper (D) signed direct billing legislation (HB 1221) into law. Effective January 1, 2013 the legislation requires patients are billed for anatomic pathology services only by the physician performing or supervising the service.

Delay in Implementation of New Provider Rates for FY 2011-12

Thu, 2011-07-28 17:00

Fiscal Year 2011-12 provider rates will be reduced beginning July 1, 2011 to help balance the state budget. This reduction was announced in the June 2011 Provider Bulletin. Although the effective date is July 1, 2011, we need to wait for an official approval from CMS, to implement the change. The new rates for services delivered on or after July 1, 2011 will be retroactively applied once approval is granted. Until approval is received, providers will be paid at the FY 2010-11 rates.

Delay in Implementation of New Provider Rates for FY 2011-12

Thu, 2011-07-28 17:00

Fiscal Year 2011-12 provider rates will be reduced beginning July 1, 2011 to help balance the state budget. This reduction was announced in the June 2011 Provider Bulletin. Although the effective date is July 1, 2011, we need to wait for an official approval from CMS, to implement the change. The new rates for services delivered on or after July 1, 2011 will be retroactively applied once approval is granted. Until approval is received, providers will be paid at the FY 2010-11 rates.

Orders for Diagnostic Testing

Wed, 2009-12-02 10:33

TrailBlazer Health Enterprises® - Carrier/FI for Colorado, New Mexico, Oklahoma, Texas and Virginia.

Due to the recent increase in the number of errors identified during the Comprehensive Error Rate Testing (CERT) contractor audit for the lack of physician orders for diagnostic tests, TrailBlazer recommends that providers sign all orders for testing and/or progress notes showing the intent for testing to be completed.

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