Billing News Jun 2021



HHS Commits $4.8b to COVID-19 Testing for the Uninsured

  • June 8, 2021

The new funding is a slice of Biden's $1.9 trillion American Rescue Plan approved in March. The economic stimulus package has helped spur a surge in enrollment in Affordable Care Act plans during a special signup period now underway and also provides relief for rural hospitals hit hard by the pandemic, Medicaid...

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CDC Says Vaccinated People Can Largely Skip Testing, Shares New Breakthrough Case Count

  • June 8, 2021

The CDC updated its COVID-19 testing guidance for vaccinated people last week and shared a new tally on the small number of people who've been hospitalized or died from the virus after being fully vaccinated.  On May 17, the agency said fully vaccinated people with no symptoms do not need to get tested for COVID-19, even if they were exposed...

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Heligenics, Jackson Lab Partner to Study Breast Cancer Gene Variants

  • June 8, 2021

Under the terms of the deal, Heligenics will apply its GigaAssay, a massively parallelized platform for assaying molecular functions of single cells in culture, to ERBB2 variants. The resulting data will be included in the Jackson Laboratory's JAX Clinical Knowledgebase, a web-based resource for interpreting cancer genomic profiles. The...

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Cigna to Keep Paying the Professional Component of Clinical Pathology Services

  • June 8, 2021

On April 12, 2021 Cigna issued an update to their Modifier 26 Professional Component policy, stating codes inappropriately billed with the 26 modifier will be denied effective 7/11/2021. This would eliminate reimbursement for Professional Component Clinical Laboratory billing from the Cigna fee schedule. News of this updated policy being...

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Genetic and Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer

  • June 3, 2021

On April 16, 2021 the description section was updated and the rationale section was updated in the coding section: Deleted CPT- 81479 Added CPT- 81542, 0047U, 0228U, and 86316 References Updated 05-07-2021 Description section updated In Policy section Added Item A.10

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CMS’ Rule Granting Speedy Coverage to FDA-Designated ‘Breakthrough’ Devices Delayed Again

  • June 3, 2021

CMS delayed the start date of its rule that would provide expedited Medicare coverage for products the FDA deems "breakthrough devices" from May 15 to Dec. 15. CMS wants more time to examine concerns expressed about the rule, including that devices may gain coverage despite limited evidence of their use among seniors.

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MolDx Local Coverage Determination (LCD) And Medical Coverage Database (MCD) Parts A and B Article Updates

  • June 3, 2021

The comment period for the following A/B MAC LCDs will begin on May 20, 2021, and will end on July 3, 2021: MolDX: Next-Generation Sequencing Lab-Developed Tests for Inherited Cancer Syndromes DL38966 MolDX: Melanoma Risk Stratification Molecular Testing DL37725  MolDX: Biomarkers to Risk-Stratify Patients at Increased Risk for...

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Biden Signs Executive Order to Improve Cybersecurity: 4 Details

  • June 3, 2021

"Today, the cost of insecure technology is borne at the end by the victims in incident response — in incident response and cleanup, and small businesses, schools, hospitals, and local governments bear the brunt of these costs," a senior administration official said in a May 12 press briefing. The executive order will address cybersecurity in...

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