Billing News Feb 2019



Guidance on Coding and Billing Date of Service on Professional Claims - Reissued

  • February 12, 2019

MLN Matters Number: SE17023 Reissued Article Release Date: January 24, 2019 Note: This article was reissued on January 24, 2019, to clarify information Radiology Services Typically, radiology services have two separate components: a professional and a technical component. These services will have a PC/TC indicator of “1” on the Medicare...

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Compliance Alert: New Private-Pay Opioid Law Puts All Drug Addiction & Rehab Labs at Risk of Federal Prosecution

  • February 12, 2019

The Law of Unintended Consequences Letting the feds prosecute kickbacks involving private payers is a big departure and, arguably, an encroachment on the prosecutorial powers of the states which have their own kickback laws. So, the EKRA exception was supposed to be a narrow measure to deal with the opioid crisis. The problem is that EKRA’s...

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Beyond HIPAA: Beyond HIPAA: How The Health Insurance Industry Needs to Change their Approach to Data Privacy in Light of the CCPA and Other Incoming Data Regulations

  • February 12, 2019

US healthcare insurers have been operating under the auspices of the Health Insurance Portability and Accountability Act (HIPAA) since it was signed into law in 1996. A lot of hard work has gone into HIPAA compliance, but the data privacy problem has just gotten larger. Approximately 143 million patient health records are thought to have been...

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International Team Calls for More Open, Unrestricted Genomic Data Sharing

  • February 12, 2019

Members of an international team led by investigators in Switzerland, Germany, and the US are calling for increased access to genomics data, including data that has ostensibly been made public but remains difficult or slow to access. For a policy forum paper published online today in Science, Ioannidis and his colleagues explored some of the...

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NCCN Updates Prostate Cancer Early Detection Guidelines With Biomarker Information

  • February 12, 2019

The National Comprehensive Cancer Network has updated its guidelines on early detection of prostate cancer to include more specific language about how often men with BRCA mutations should be screened and the potential utility of certain biomarkers for determining high-grade cancer risk.  The updated guidelines now specify that "it is...

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Amendments to Massachusetts Data Breach Law Impose New Requirements

  • February 12, 2019

Effective April 11, 2019, new amendments to Massachusetts’s Data Breach Notification Act go into effect. The amendments impose additional requirements on covered companies that sustain a data breach involving personal data of Massachusetts residents.

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MolDX Local Coverage Determination (LCD) Updates

  • February 12, 2019

The MolDX: Breast Cancer IndexTM (BCI) Gene Expression Test L37794 A/B MAC LCD(s) will begin their notice period January 24, 2019. The notice period will end on March 10, 2019. Any revisions made will become effective on March 11, 2019.

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MolDX Local Coverage Determination (LCD) Updates

  • February 12, 2019

The following A/B MAC LCD(s) were revised: MolDX: EndoPredict Breast Cancer Gene Expression Test – L37264 MolDX: DecisionDx-UM (Uveal Melanoma) - L37033 Lab: Coenzyme Q10 (CoQ10) – L37022

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