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    • August 29, 2014

    All diagnostic services require a signed physician order (or signed progress note supporting intent) and documentation of medical necessity to be payable by Medicare. An attestation statement is not acceptable for unsigned orders. If a valid order or progress note is not submitted to support the intent for the laboratory services performed, the... more

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    • September 29, 2014

    WPS Medicare revised LCD L33219 Molecular Diagnostic Testing effective Aug. 1, 2014. The revised LCD, which focuses on the clinical indications for various molecular diagnostic tests, mistakenly captured immunohistochemistry (IHC) codes G0461 and G0462 as well. Only three ICD codes (V16.0, V84.04 and V84.09) associated with history or... more

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    • June 28, 2016

    MAC J5 for Iowa, Kansas, Missouri, and Nebraska MAC J8 for Indiana and Michigan Recent claim reviews performed by the Comprehensive Error Rate Testing (CERT) contractor have noted significant error findings for complete blood count (CBC) services billed under CPT code 85025. In these cases, the service was down coded to CPT 85027 because the... more

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    • June 28, 2016

    Recent claim reviews performed by the Comprehensive Error Rate Testing (CERT) contractor have noted significant error findings for qualitative drug tests and quantitation of drugs screened (therapeutic drug assays and certain chemistry tests).  In most cases, the independent laboratories that performed and billed the services did not submit... more

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    • May 17, 2016

    MAC J5 for Iowa, Kansas, Missouri, and Nebraska MAC J8 for Indiana and Michigan WPS GHA is collaborating with the Molecular Diagnostics (MolDx) contractor concerning Molecular Diagnostic Testing (MDT). As part of this collaboration, all laboratory service providers in the Jurisdiction 5 and 8 providing MDT must register those MDT procedures/... more

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