Billing News Apr 2022



CMS Releases Frequently Asked Questions Regarding the No Surprises Act

  • April 20, 2022

In April 2022 CMS provided answers to several frequently asked questions on issues regarding the No Surprises Act.   In the FAQs for providers about the No Surprises rules, CMS provides clarification on exceptions to the requirements under the No Surprises Act and questions regarding the independent dispute resolution process.   Q2:...

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FAQs About Consolidated Appropriations Act, 2021 Implementation – Good Faith Estimates (GFE) For Uninsured (Or Self-Pay) Individuals – Part 2

  • April 12, 2022

The FAQs have been prepared by the Department of Health and Human Services (HHS) to address the provision of GFEs for uninsured (or self-pay) individuals, as described in Public Health Service Act (PHS Act) section 2799B-6 and implementing regulations at 45 CFR 149.610. Q5: Is a provider or facility required to provide a GFE to uninsured (or self...

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CPT PLA Codes Approved by the CPT Editorial Panel

  • April 8, 2022

Updated April 1, 2022 New PLA Codes Description Effective Date 0306U ONC MRD NEXT-GNRJ TRGT SEQ ALYS CLL-FR DNA 1ST 4/1/2022 0307U ONC MRD NEXT-GNRJ TRGT SEQ ALYS CLL-FR DNA SBSQ 4/1/2022 0308U CRD CAD ALYS 3 PRTN PLSM ALG RSK OBSTRUCTIVE CAD 4/1/2022 0309U CRD CV...

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Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting & Reporting Data for the Private Payor Rate-Based Payment System

  • April 8, 2022

MLN Matters Number: SE19006 Revised. CMS Note: We revised this Article to note that for CDLTs that aren’t ADLTs, the data reporting is delayed by 1 year and must now be reported from January 1, 2023-March 31, 2023 (previously January 1, 2022-March 31, 2022). We’ve changed all references to the 2022 data reporting period to 2023. You’ll find...

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Another COVID Booster for Age 50 or Older

  • April 8, 2022

The Associated Press, among other news outlets, reported on Tuesday that the US Food and Drug Administration approved another does of the Pfizer or Moderna COVID-19 booster for people age 50 and older in an effort to provide extra protection for the most vulnerable in the event of a new SARS-CoV-2 spike. The FDA had previously cleared fourth (and...

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NIH’s All of Us Research Program Releases First Genomic Dataset of Nearly 100,000 Whole Genome Sequences

  • April 8, 2022

Nearly 100,000 highly diverse whole genome sequences are now available through the National Institutes of Health's All of Us Research Program. About 50% of the data is from individuals who identify with racial or ethnic groups that have historically been underrepresented in research. This data will enable researchers to address yet...

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Medi-Cal - Adjustment of Erroneously Paid Radiology Claims

  • April 8, 2022

The Department of Health Care Services (DHCS) identified a claims processing issue affecting certain radiology claims for CPT® code 78832 and HCPCS code G0279. This issue caused some claims to erroneously pay. The issue affected claims for dates of service from January 1, 2020, through December 2, 2021. No action is required on your part. The...

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Job Done: Scientists Fill in Missing Gaps to Complete Map of Human Genome

  • April 8, 2022

The Human Genome Project produced the most complete map of human genetics ever assembled in 2003 — but that map still held many uncharted territories. It did not contain about 8% of the human genome, representing crucial regions and large gaps that have remained hidden from scientists. Now, an ambitious team of researchers has gone back and...

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