Billing News Jan 2019



MolDX: Cystatin C Measurement Final LCD - Effective February 11, 2019

  • January 8, 2019

Medicare Coverage Database (MCD) Number/Contractor Determination Number: L37618 LCD Title: MolDX: Cystatin C Measurement Effective Date: February 11, 2019 Summary of LCD: Cystatin C is a low molecular weight protein produced by all nucleated cells in the body at a constant rate. It has been proposed and investigated as an improved marker of renal...

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Anticipated Adoption of 2019 HCPCS Updates

  • January 8, 2019

The 2019 updates to the Healthcare Common Procedure Coding System (HCPCS) Level II codes are anticipated to adopt in the first quarter of 2019. This update will be effective for Medi-Cal and all specialty programs under the fee-for-service program.

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CMS Proposes Fee Increase for Labs: Four Things to Know

  • January 8, 2019

CMS issued a notice to raise fees 20 percent for laboratories certified under the Clinical Laboratory Improvement Amendments, the agency said Dec. 28. Here are four things to know: 1. Under the CLIA statue, CMS must impose user fees to offset the costs of running the CLIA program. Laboratories are required to get CLIA certification from CMS to...

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Next Generation Sequencing NCD MLN Matters Article — New

  • January 8, 2019

National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) I. SUMMARY OF CHANGES: The purpose of this Change Request (CR) is to inform contractors that effective March 16, 2018, the Centers for Medicare & Medicaid Services covers diagnostic laboratory tests using next generation sequencing when performed in a Clinical...

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Ascension’s CIO on Joining Blockchain Pilot Project

  • January 8, 2019

Ascension and Aetna are the latest alliance members. They said the alliance is looking at how blockchain technology could help ensure up-to-date healthcare provider information is available in health plan provider directories, so patients can have the most accurate information possible. Gerry Lewis, Ascension senior vice president and CIO, spoke...

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Medicare Program: Clinical Laboratory Improvement Amendments (CLIA) of 1988 Fees (CMS-3356-NC)

  • January 8, 2019

The fact sheet discusses why CMS is increasing the CLIA fees for the first time in 20 years.  Based on the agency’s financial data review, they project that a 20 percent fee increase will sustain and maintain the CLIA program through FY 2021.  CMS is required to update the program’s fee schedule because current fees are no longer...

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SABCS 2018 Features Molecular Diagnostics Research

  • January 8, 2019

At the San Antonio Breast Cancer Symposium last week, researchers presented data from many studies exploring the use of molecular technologies to make patient care more precise. They included studies exploring the ability of breast cancer recurrence molecular diagnostics to predict which patients are likely to experience a relapse and benefit...

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Every Woman Counts Cervical Cancer Screening Update

  • January 8, 2019

Effective for dates of service on or after August 20, 2018, the Every Woman Counts (EWC) program includes primary human papillomavirus (HPV) testing as a screening strategy for women 30 to 65 years of age. The program recommends using the American Society for Colposcopy and Cervical Pathology (ASCCP) and the Society of Gynecologic Oncology (SGO)...

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