Billing News Feb 2022



Texas Medical Association Victory in No Surprises Act Lawsuit

  • February 25, 2022

On February 23, a Texas federal judge ruled that the payor provider-independent dispute resolution (IDR) process established under the No Surprises Act conflicts with the text of the legislation. In 2021, the Texas Medical Association (TMA) filed a lawsuit in Texas focusing on the emphasis during the IDR process on using the qualifying payment...

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UHC - Z-Code Requirements for Palmetto Diagnostic Exchange

  • February 7, 2022

FAQ available to support molecular diagnostic testing Z-Code requirement. Frequently asked questions and answers published 1/21/2022

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Private Insurers Must Cover Follow-Up Colonoscopies

  • February 7, 2022

Private insurers are now required to cover the cost of follow-up colonoscopies after a positive stool-based test, according to updated guidance from the Biden administration cited in a press release from the American Gastroenterology Association. By adding colonoscopies following positive stool tests to that list, the updated guidance means that...

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UHC - Professional/Technical Component Policy, Professional

  • February 7, 2022

1/16/2022 Policy Version Change Policy List Changes: Professional/Technical Component Codes (PC/TC Indicator 1 Diagnostic Tests), Gap Fill Codes and ASCFS Addendum BB PC/TC Indicator 1 Codes, Codes Subject to the PC/TC Concept Without RVU Splits (table). 1/1/2022 Policy Version Change Policy Section Change: Reimbursement for Professional/...

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UnitedHealth Has Reprocessed More than 1.6m Claims for COVID-19 Vaccines

  • February 7, 2022

In a statement to Congress, Sen. Bob Casey, D-Penn., said that 99.8% of the claims were processed by Jan. 14, with the remaining 2,900 claims expected to be finalized by Feb. 1. The average adjustment per claim was $14.55 for a total of $23.9 million, according to the statement (PDF). In a Nov. 5 letter to Casey's office, UnitedHealthcare CEO...

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HHS Renews COVID-19 Public Health Emergency Order for Another 90 Days

  • February 7, 2022

Department of Health and Human Services Secretary Xavier Becerra has renewed the COVID-19 public health emergency for another 90 days, extending key flexibilities for providers still grappling with the pandemic. The public health emergency was first ordered back in January 2020 and was set to expire after Jan. 16. By renewing it another 90 days,...

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Proposed State Privacy Law Update: Jan. 31, 2022

  • February 7, 2022

New CCPA-like privacy bills with lawmakers in three states introducing bills last week: Georgia lawmakers introduced the Georgia Computer Data Privacy Act (SB 394) on January 26, 2022. The bill was assigned to the Senate Committee on Science and Technology. Hawaii lawmakers introduced three bills: HB 2051, SB 2428, and SB 2797. HB 2051 was...

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iRhythm Scores an Important Reimbursement Win

  • February 7, 2022

The regional Medicare administrative contractor Novitas Solutions has set CPT codes 93243 and 93247 at roughly $223 and $233 respectively — news first reported by analysts this morning. The rates are retroactive to Jan. 1, 2022.

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