Billing News Dec 2021



CMS 2022 National Correct Coding Initiative (NCCI) Policy Manual Released

  • December 29, 2021

CMS has released the 2022 Medicare NCCI policy manual with an effective date of 1/1/2022. There are relatively minor changes for pathology and laboratory services found in Chapter 10 of the manual. All updates to policies are noted in red font.  One item of note is a discussion regarding billing for reflex testing and those tests that...

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PAMA Related Cuts and Reporting Delayed

  • December 16, 2021

The “Protecting Medicare and American Farmers from Sequester Cuts Act” which was passed in December halted numerous 2022 Medicare Cuts including PAMA-related cuts to the clinical lab fee schedule and delayed PAMA reporting another year.    Next CLFS Data Reporting Period for Clinical Diagnostic Laboratory Tests - DELAYED. On December...

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New Legislation to Halt the 2022 Medicare Payment Cuts

  • December 10, 2021

Congress has passed the Protecting Medicare & American Farmers from Sequester Cuts Act which will delay the majority of pending Medicare payment cuts to physicians previously scheduled for January 1, 2022. The house approved the legislation on December 7 followed by the Senate approval on December 9th.   Highlights of the legislation...

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Providers, Lobbyists Sue to Change No Surprises Act Arbitration Process

  • December 10, 2021

American Medical Association and American Hospital Association filed suit to stay, pending judicial review, or for summary judgment if administration agrees. Decision requested prior to March 1, 2022, when arbitration process is set to begin. Plantiffs not attempting to halt act, but only change interpretation which directs arbitrators to lean...

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Congress Reaches Bipartisan Deal to Blunt Medicare Cuts

  • December 8, 2021

Congress has passed legislation introduced by Democrats to delay the majority of pending Medicare payment cuts. If allowed, the cuts would broadly impact healthcare providers. The Senate is expected to vote on this matter later in the week. Passage by the Senate is required for the bill to become law.  Bill highlights:  Delays 4%...

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FDA Reclassifies Certain Hepatitis C Diagnostic Tests, Blood Lancets

  • December 6, 2021

The US Food and Drug Administration announced on Friday that it has issued two final orders reclassifying certain hepatitis C diagnostic tests from Class III to Class II. Additionally, it reclassified blood lancet devices from Class I to Class II and Class III. The change applies to nucleic acid-based hepatitis C ribonucleic acid devices intended...

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CMS Drops 3 Final Payment Rules: 12 Things to Know

  • December 6, 2021

Physician Fee Schedule rule Top takeaways from the annual update in the Medicare Program; CY 2022 Payment Policies under the Physician Fee Schedule rules are: The conversion factor used to determine provider reimbursement will drop to $33.59 in 2022 from $34.89 this year as a temporary payment boost provided by the Consolidated Appropriations...

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Next CLFS Data Reporting Period for Clinical Diagnostic Laboratory Tests

  • December 6, 2021

The next CLFS Data Reporting Period for Clinical Diagnostic Laboratory Tests (CDLTs) is January 1, 2022 through March 31, 2022 and is based on the original data collection period of January 1, 2019 through June 30, 2019. After the next data reporting period, there is a three-year data reporting cycle for CDLTs that are not ADLTs, (that is 2025...

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