Billing News Jul 2021



Newly Proposed Pathology Clinical Consult CPT Codes

  • July 26, 2021

In a recent Valuation of pathology consultant service codes, the College of American Pathologists (CAP) identified that 80500 and 80502 were potentially misvalued. In light of this discrepancy, the CAP contacted the AMA CPT Editorial Panel, who then worked with CMS, to further define clinical pathology consultations with more specificity. As such...

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UHC Announces Laboratory Test Registration Requirement Delayed

  • July 9, 2021

United Healthcare (UHC) has once again announced a delay in the implementation of its clinical and pathology Laboratory Test Registry until further notice. COVID-19 and the ongoing public health emergency (PHE) are cited as the driver of the delay. The July 1, 2021 announcement on the UHC provider website, points out that this indefinite delay...

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UHC Laboratory test registration requirement delayed

  • July 7, 2021

Due to COVID-19, we have delayed implementation of the Laboratory Test Registry protocol until further notice. This includes registration of non-genetic tests and placement of test codes on claims for non-genetic tests. Providers rendering genetic testing will still need to follow the molecular genetic protocols that are in place.

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BCBS- ClaimsXten to include additional professional and outpatient facility edits, starting in October

  • July 7, 2021

Starting in October 2021, ClaimsXten™ will edit additional services for professional and outpatient facility providers on Blue Cross Blue Shield of Michigan commercial claims. These new edits are part of our ongoing effort to promote correct coding and enhance our claims payment systems. If you receive one of these edits, submit a corrected claim...

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Texas Passes Bill Establishing “Wall of Shame” for Data Breaches

  • July 7, 2021

On May 31, 2021, the Texas Legislature approved House Bill 3746, which seeks to amend the Texas Business and Commerce Code § 521.053 relating to certain notifications required following a breach of security of computerized data. Notably, the bill directs the Texas attorney general to post on its website a public listing of received data security...

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Diagnostics Reform Heats Back Up with Introduction of the Verifying Accurate Leading-edge IVCT Development Act of 2021

  • July 7, 2021

The Verifying Accurate Leading-edge IVCT Development Act of 2021 (the “VALID Act of 2021,” the “VALID Act” or the “Act”) was introduced in both the House and Senate on June 24, 2021 by U.S. Reps. Diana DeGette (D-CO) and Larry Bucshon (R-IN) and U.S. Sens. Michael Bennet (D-CO) and Richard Burr (R-NC). The bipartisan Act seeks to modernize...

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HHS Issues Revisions to Provider Relief Fund Reporting Requirements

  • July 7, 2021

On June 11, 2021, Health and Human Services (HHS) announced revised reporting requirements and timelines for recipients of Provider Relief Fund (PRF) payments. The update includes expanding the amount of time providers will have to report information and extends key deadlines for spending PRF payments for those who received payments after June 30...

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Supreme Court declines to hear AHA's appeal of site-neutral payments decision

  • July 7, 2021

The Supreme Court has declined to hear an appeal of a lower court decision upholding the Department of Health and Human Services’ (HHS') site-neutral payments policy. The appeal was requested by the American Hospital Association (AHA) in February as part of a multiyear legal battle challenging HHS’ authority to bring Medicare payments...

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