Billing News Jun 2020



Developers of Antibody Tests for COVID-19 Now Must Seek Emergency Use Authorization

  • June 8, 2020

Developers of antibody tests for SARS-CoV-2 now must seek Emergency Use Authorization for their tests from the US Food and Drug Administration. Previously, the agency had only required that companies affirm their tests are valid and label them as unapproved, Reuters writes, noting that the agency had at that time been "under pressure to move...

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LabCorp, Quest Expand COVID-19 Antibody Testing Nationwide

  • June 8, 2020

LabCorp Monday announced its COVID-19 antibody tests will be available nationwide with no out-of-pocket costs with an order from a healthcare provider. The test will be administered at its nearly 2,000 patient service centers, more than 100 of which are at Walgreens locations, as well as doctors’ offices.​ Quest Diagnostics on...

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CDC Seeks to Limit False Positives with COVID-19 Antibody Testing, as Immunity Question Lingers

  • June 8, 2020

The Centers for Disease Control and Prevention published interim guidelines Tuesday on the use of COVID-19 antibody tests in clinical and public health laboratories.​ CDC is encouraging lab professionals to take steps to limit the risk of false positives, including by testing people twice to mitigate the imperfect specificity of...

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COVID-19: Modified Ordering Requirements for Laboratory Billing

  • June 8, 2020

During the COVID-19 Public Health Emergency, CMS is relaxing billing requirements for laboratory tests (PDF) required for a COVID-19 diagnosis. Any health care professional authorized under state law may order tests. Medicare will pay for tests without a written order from the treating physician or other practitioner: If an order is...

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COVID-19: Payment for Diagnostic Laboratory Tests

  • June 8, 2020

To help increase testing and track new cases, CMS developed two HCPCS codes that laboratories can use to bill for certain COVID-19 diagnostic tests. Health care providers and laboratories may bill Medicare and other health insurers for SARS-CoV2 tests performed on or after February 4 using: HCPCS code U0001 for tests developed by the Centers...

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Natera Cell-Free DNA Organ Transplant Test Receives Positive Coverage from Noridian

  • June 8, 2020

Medicare Administrative Contractor Noridian has issued positive coverage for its Prospera donor-derived cell-free DNA organ transplant test. In addition, Noridian is developing a generic policy for dd-cfDNA tests that will include several commercially available tests. Prospera's coverage will be under this new policy in the future, Natera said....

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MLN-SE20017 Medicare Pharmacies and Other Suppliers May Temporarily Enroll as Independent Clinical Diagnostic Laboratories to Help Address COVID-19 Testing

  • June 8, 2020

Pharmacies and other suppliers currently enrolled in Medicare may also enroll temporarily as independent clinical diagnostic laboratories during the COVID-19 public health emergency via the provider enrollment hotline. This will provide additional laboratory resources to meet the urgent need to increase COVID-19 testing capability. Pharmacies and...

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EPC letter May 14,2020 - Resubmission of Claims for COVID-19 HCPCS and CPT Codes

  • June 8, 2020

The Department of Health Care Services (DHCS) identified a claims processing issue affecting claims for Covid-19 HCPCS Code U0001, U0002 and CPT Code 87635. This issue caused claims to erroneously deny. The issue affected claims for dates of service from February 4, 2020, through April 9, 2020. No action is required on your part. The California...

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