Billing News Jun 2019



New Codes Effective July 1, 2019 - Proprietary Laboratory Analysis (PLAs)

  • June 5, 2019

The following new codes may need to be manually added to the HCPCS file by the MACs with an effective date of July 1, 2019. These new codes are also contractor-priced until they appear on the January 1, 2020 CLFS as applicable.  Note: MACs will only price PLA codes for laboratories within their jurisdiction.  CPT Code: 0084U ...

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MolDX Local Coverage Determination (LCD) Updates and LCD Article Updates: Part A and Part B - L37709

  • June 5, 2019

The Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification (NAATs) L37709 A/B MAC LCD was revised. The Billing and Coding: Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification (NAATs) A56593 A/B MAC Article was revised. Covered ICD-10 Codes Group 1: Codes added ICD-10 codes R19.7...

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Horizon, Invitae Partner to Provide Free Genetic Testing for Urea Cycle Disorder

  • June 5, 2019

Horizon Therapeutics has partnered with Invitae for its urea cycle disorder genetic (UCD) testing program, through which individuals who may have the rare genetic condition and their family members will receive testing at no charge. Within the program, Invitae will provide its Hyperammonemia Panel which assesses 58 genes involved with the enzymes...

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Agendia, Imegen Ink Distribution Deal for Breast Cancer Tests in Spain, Portugal

  • June 5, 2019

Agendia has signed an agreement with Valencia, Spain-based Imegen for the exclusive distribution of Agendia's MammaPrint and BluePrint breast cancer genomic tests in Spain and Portugal. MammaPrint measures the expression of 70 genes and classifies patients as either high risk or low risk of recurrence over a 10-year period. BluePrint is an 80-...

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Studies Outline Outcomes Associated with Cervical Cancer Screening, Triage Strategies

  • June 5, 2019

The researchers analyzed various screening strategies in 451 English- or Spanish-speaking women between the ages of 21 and 65 years old who were enrolled at San Francisco health clinics tested, taking into account the women's screening preferences, direct medical costs and the cost-effectiveness of each approach, the estimated quality of life...

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CMS Amendment Could Bring Welcome Changes to BPCI Advanced Participation Agreement

  • June 5, 2019

The Centers for Medicare & Medicaid Services (CMS) has issued an amendment to the Bundled Payments for Care Improvement (BPCI) Advanced Participation Agreement (Amendment). Changes imposed by the 18-page Amendment were largely based on stakeholder input and could streamline aspects of the program and ease burdens on both convener and non-...

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New 2019 MIPS Group Participation Guide Now Available on QPP Resource Library

  • June 5, 2019

CMS has posted a new Merit-based Incentive Payment System (MIPS) resource to the QPP Resource Library to answer questions and provide additional information on 2019 group participation in MIPS. The 2019 MIPS Group Participation Guide covers the following topics: Eligibility and participation in MIPS Group registration for CMS Web Interface...

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Federal Proposal Would Change Medical Debt Collection Rules

  • June 5, 2019

The Consumer Financial Protection Bureau has proposed a rule to protect consumers against harassment by debt collectors, including medical debt, and provide avenues to address or dispute the debt, according to Kaiser Health News. The rule would limit the number of calls debt collectors could make to reach consumers weekly; make it clear how...

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