Billing News Aug 2012



Overpayment Letters: Look for Blue Envelopes

  • August 31, 2012

Beginning August 13, 2012, CGS will send all overpayment letters (demand letters) in light blue envelopes. Requests for repayment of Medicare funds are time-sensitive, and they hope that this change in envelope color will help you quickly and easily identify these requests. ï CGS uses the Healthcare Integrated General Ledger Accounting...

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Blues must stop using 'most-favored nation' clauses

  • August 31, 2012

Blue Cross Blue Shield of Michigan must stop using "most-favored nation" clauses in their contracts with providers, the state insurance commissioner said in an order issued last week. The preferential hospital pricing policies, in which Blue Cross allegedly required hospitals to charge higher prices to competing insurers, also are banned for all...

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CMS confirms 1-year delay to ICD-10; new compliance date is Oct. 1, 2014

  • August 31, 2012

Physicians now have an extra year to prepare for the new ICD-10 code set as the result of a final rule issued Aug. 24 by CMS. The rule delays the compliance deadline by one year to Oct. 1, 2014. The delay is intended to give physicians more time to ready their practices for the transition to ICD-10 and conduct testing prior to the compliance...

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Benefits to Change for Clinical Pathology Consultations

  • August 31, 2012

Effective for dates of service on or after August 1, 2012, benefits for clinical pathology consultations have changed for Texas Medicaid. Clinical pathology consultations (procedure code 80500 or 80502) are a benefit of Texas Medicaid for services rendered by a consultant who is either a clinical pathologist or a geneticist. Routine conversations...

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Coverage of Oncotype DX

  • August 31, 2012

Effective September 1, 2012, the MO HealthNet Division will begin covering the multigene expression assay procedure called Oncotype DX Breast Cancer Assay. This assay predicts outcomes for patients with early stage estrogen receptor (ER)-positive, lymph node-negative breast cancer by examining the tumor at a molecular level. This information is...

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New issues posted to the DCS Recovery Audit Contractor Website

  • August 31, 2012

Diversified Collection Services (DCS) is the Recovery Audit Contractor for the states of Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont. The following issue concerning Hepatic Function Panel Testing is under review for laboratories in CT and...

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Medicare Learning Network® tips and services

  • August 31, 2012

The Medicare Learning Network® offers several ways to search and quickly find articles of interest to you: ï MLN Matters® index: A list of common keywords and phrases contained within MLN Matters® articles. Each index is organized by year with the ability to search by specific keywords and topics. Most indices link directly to the...

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Transcranial Doppler Studies, Intracranial Arteries Codes Updates

  • August 31, 2012

Effective for dates of service on or after September 1, 2012, the ICD-9-CM diagnosis range that justifies reimbursement is updated for the following CPT codes: 93886, 93888, 93890, 93892 and 93893. Source: General Medicine | August 2012 | Bulletin 458

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