Regence - Drug Testing for Substance Use and Pain Management Effective: October 1, 2020

  • Sep 9, 2020

Change policy title of Laboratory Policy No. 68. Adding CPT codes 0011U, 0116U, P2031 to this policy as investigational. Added oral fluid and hair drug testing to policy as investigational. Effective Date: October 1, 2020

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Rescission of Guidances and Other Informal Issuances Concerning Premarket Review of Laboratory Developed Tests

  • Sep 9, 2020

The Trump Administration is committed to combating COVID-19, to ensuring that the American people are protected against future pandemics, and to keeping duplicative regulations and unnecessary policies from interfering with those efforts. Consistent with the President's direction in Executive Orders 13771 (Executive Order on Reducing Regulation and Controlling Regulatory Costs) and 13924 (...

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UHC - Genetic Testing for Neuromuscular Disorders – Policy 2020T0598B Update 9/1/2020

  • Sep 9, 2020

Revised and reformatted list of proven and medically necessary indications:  Replaced criterion for suspected congenital muscular dystrophy or myopathy requiring “evidence of diffuse muscle weakness” with “evidence of muscle weakness” Replaced criterion for suspected hereditary spastic paraplegia (HSP) or ataxia requiring “peripheral neuropathy and ataxia” with “peripheral neuropathy or...

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AMA Releases Latest CPT Updates to Align with Medicare E/M Changes, Digital Innovation

  • Sep 9, 2020

The American Medical Association (AMA) released updates to its medical codes for 2021 designed to align with a Medicare rule set to take effect in January. The updates to medicine's common language aim to reduce documentation requirements for clinicians and free physicians and care teams from clinically irrelevant administrative burdens that led to time-wasting note bloat and box...

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UHC - Preventive Care Services Update 9/1/2020

  • Sep 9, 2020

Applicable Codes Preventive Care Services Revised coverage guidelines for Hepatitis C Virus Infection Screening: Updated service description: Removed June 2013 USPSTF “B” rating Added March 2020 USPSTF “B” rating to indicate the USPSTF recommends screening for hepatitis C virus infection in adults aged 18 to 79 years o Removed list of applicable diagnosis codes Updated preventive...

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AMA Announces New CPT Codes for Coronavirus Testing

  • Sep 9, 2020

The American Medical Association (AMA) recently expanded its Current Procedural Terminology (CPT) code set to include four new CPT codes for coronavirus testing, according to a special coding guidance document. The new CPT codes are 86408 for SARS-CoV-2 neutralizing antibody screen; code 86409 for SARS-CoV-2 neutralizing antibody titer; and codes 0225U and 0226U for proprietary laboratory...

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Clinical Laboratory Improvement Amendments for Anthem

  • Sep 9, 2020

Claims that are submitted for laboratory services subject to the Clinical Laboratory Improvement Amendments (CLIA) 1988 federal statute and regulations require additional information to be considered for payment. A valid CLIA certificate identification number is required for reimbursement of clinical laboratory services reported on a CMS-1500 claim form (or its electronic equivalent) beginning...

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CMS Announces One-Year Delay in Finalizing Highly Anticipated Stark Law Reform

  • Sep 9, 2020

On August 26th, the Centers for Medicare & Medicaid Services (CMS) issued a notice extending the deadline to finalize significant proposed changes to the Physician Self-Referral Law (commonly known as the Stark Law) that were announced last year. Industry stakeholders have been pressing HHS to issue both long-awaited final rules. Although CMS announced on June 30, 2020, that it...

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