Billing News Aug 2019



Lynch Syndrome Mutation Study Suggests Changes to Clinical Management

  • August 5, 2019

Based on a prospective observation of more than 6,000 individuals with the gene mutations associated with Lynch syndrome, investigators have suggested that management guidelines for the condition may need to be revised based on evidence of different gene and gender-specific risks and a relatively good prognosis for the most commonly associated...

Read



Medicare Plans to Modernize Payment Grouping and Code Editor Software

  • August 5, 2019

The Centers for Medicare & Medicaid Services (CMS) is modernizing its grouping and code editor software. Medicare processes all Original Medicare institutional claims through one of three sub-systems within the Fiscal Intermediary Shared System (FISS): • The Medicare Code Editor (MCE) • The Inpatient Grouper (MS-DRG) • The Integrated...

Read



New Waived Tests Under CLIA

  • August 5, 2019

Listed below are the latest tests approved by the Food and Drug Administration (FDA) as waived tests under CLIA. The Current Procedural Terminology (CPT) codes for the following new tests must have the modifier QW to be recognized as a waived test. However, CPT codes: 81002, 81025, 82270, 82272, 82962, 83026, 84830, 85013, and 85651 do not require...

Read



The Following Medical Policies Have Been Published to the BCBSKS Website

  • August 5, 2019

Bone Mineral Density Studies Corneal Collagen Cross-Linking Deep Brain Stimulation Drug Testing in Pain Management and Substance Use Disorder Treatment Dry Needling of Myofascial Trigger Points Gene Expression Profiling for Cutaneous Melanoma Gene Expression-Based Assays for Cancers of Unknown Primary Genetic Cancer Susceptibility Panels...

Read



EPC Letter: Reprocessing of Erroneously Paid and Denied Medicare Crossover Claims

  • August 5, 2019

The Department of Health Care Services (DHCS) updated Medicare deductibles and coinsurance rates for outpatient, inpatient, and medical claims, effective retroactively for dates of service on or after January 1, 2019. Some claims processed before the rate update could have been erroneously paid or denied with Remittance Advice Details (RAD) code...

Read



The World Health Organization Updates Essential Diagnostics List

  • August 5, 2019

The World Health Organization (WHO) released its second Model List of Essential In Vitro Diagnostics to help member nations identify the most common diseases and diseases that the organization has granted global priority status. The updated list builds on the WHO's first list, released in May of 2018, which comprised 113 types of...

Read



Kroger Health Pharmacies to Offer Myriad Genetics' GeneSight in Pilot Program

  • August 5, 2019

Kroger Health has partnered with Myriad Genetics to launch a pilot program involving the GeneSight pharmacogenetic test for personalizing depression treatments. Within this pilot, 500 Kroger pharmacies in five states will provide information about GeneSight PGx testing to members who have failed one or more antidepressant treatments. These...

Read



FBI Approves Thermo Fisher NGS Forensic Profiling Solution

  • August 5, 2019

Thermo Fisher Scientific announced that the US Federal Bureau of Investigation has approved its Applied Biosystems Precision ID System mtDNA analysis solution to generate mitochondrial DNA profiles for the National DNA Index System. NDIS is the national level of the Combined DNA Index System (CODIS), a DNA profile database that contains entries...

Read