Billing News Apr 2014



President Obama Signs the Protecting Access to Medicare Act of 2014/ICD-10 delayed until 10/1/2015

  • April 23, 2014

On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients from taking effect on April 1, 2014. This new law maintains the 0.5 percent update for such services that applied from January 1,...

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Mandatory Payment Reduction of 2% Continues through March 31, 2015, for the Medicare FFS Program — “Sequestration”

  • April 23, 2014

For the Medicare Fee-for-Service (FFS) program, claims with dates-of-service or dates-of-discharge on or after April 1, 2013, will continue to incur a 2 percent reduction in Medicare payment through March 31, 2015. The claims payment adjustment will continue to be applied to all claims after determining coinsurance, any applicable deductible, and...

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Calendar Year (CY) 2014 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment - REVISION

  • April 23, 2014

This article is based on CR 8695 which provides instructions for the revised CY 2014 clinical laboratory fee schedule, including several codes that were inadvertently left off of the previous CY 2014 fee schedule files. These codes, which were intended to be included on the original CY 2014 clinical laboratory fee schedule file, were recently...

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U.S. House seeks to change CLFS reimbursement policy in SGR legislation

  • April 23, 2014

The US House of Representatives introduced legislation that would extend the flawed sustainable growth rate (SGR) formula until April 1, 2015, but would also change the manner by which tests on the Clinical Laboratory Fee Schedule (CLFS) are reimbursed going forward. In addition to postponing the 24% pay cut to physicians for another year, the...

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Hospitals Must Report ICD Code for Outreach Patients

  • April 23, 2014

Longstanding Medicare policy recognizes that hospitals act in the capacity of an independent laboratory when they provide clinical laboratory tests to outreach (i.e., nonhospital) patients. Many hospitals today have outreach programs through which blood, urine, and related specimens are transported from physician offices, clinics, and other...

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New Waived Tests effective 7/1/2014

  • April 23, 2014

Listed below are the latest tests approved by the FDA as waived tests under CLIA. CPT codes for the following new tests must have the modifier QW to be recognized as a waived test. CPT Code Effective Date Description 87880QW July 29, 2013 Poly stat Strep A Flip Test...

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Clinical Pathology Laboratories Get a New CLIA Accreditation Choice as CMS Grants Deeming Status to A2LA

  • April 23, 2014

There’s a new CMS accrediting organization for clinical laboratories. Medicare officials granted deeming status for CLIA to the American Association for Laboratory Accreditation (A2LA). The approval marks the first time in two decades that CMS has added a new organization to accredit medical laboratories under CLIA. “We have determined...

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Individualized Quality Control Plan for CLIA Laboratory Non-Waived Testing — Registration Now Open

  • April 23, 2014

How will the new Individualized Quality Control Plan (IQCP) affect my laboratory? This MLN Connects™ National Provider Call on Monday, May 19; 2-3:30pm ET,  will educate laboratories on IQCP, the new quality control option for Clinical Laboratory Improvement Amendments (CLIA) laboratories performing non-waived testing. IQCP will provide...

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