Medicare to Cover Natera's Signatera MRD Test in Breast Cancer

  • Mar 2, 2023

Natera said Thursday that the Centers for Medicare & Medicaid Services' MolDX program has determined that the firm's Signatera molecular residual disease test has met coverage requirements for adjuvant and recurrence monitoring in patients with stage IIb or higher breast cancer.

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Open Claims Issue – Novitas: A new issue has been added regarding the processing of colorectal cancer (CRC) screening test claims.

  • Mar 2, 2023

2/2/2023 Claims are being held for processing Colorectal cancer (CRC) screening test claims, codes G0104, G0105, G0106, G0120, G0121, G0327, G0328, 81528 and 82270, with dates of service on or after January 1, will be held until April.

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Discontinuation of COVID-19 Emergency Fee-For-Service Medi-Cal Enrollment

  • Mar 2, 2023

Effective March 29,  2023, the Department of Health Care Services (DHCS) is discontinuing the provider enrollment flexibilities authorized by the Section 1135 waiver. Providers temporarily and provisionally enrolled under the amended enrollment requirements who wish to remain enrolled in fee-for-service Medi-Cal following the discontinuation of the provider enrollment flexibilities are...

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National Correct Coding Initiative: No April Update

  • Mar 2, 2023

CMS isn’t updating any National Correct Coding Initiative edit files this April. Continue using the January edit files until the July files are posted.

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Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers

  • Mar 2, 2023

Some of the flexibilities that were created during the pandemic were recently expanded by the Consolidated Appropriations Act, 2023.  Others, while critical during our initial responses to COVID-19, are no longer needed. CMS has made further updates to our CMS Emergencies Page with useful information for providers – specifically around major telehealth and individual waivers – that...

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Update - Colorectal Cancer Screening Tests (NCD 210.3)

  • Mar 2, 2023

Colorectal Cancer Screening Tests -Added information about reduced coinsurance (starting January 1, 2023) when a screening colorectal cancer procedure becomes diagnostic or therapeutic -Effective January 1, 2023, reduced the minimum age for colorectal cancer screening tests from 50 to 45 -Effective January 1, 2023, colorectal cancer screening tests include a follow-on screening colonoscopy if...

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Coding Update to NCD 210.1 Prostate Cancer Screening

  • Mar 2, 2023

IMPLEMENTATION DATE: March 3, 2023 - MAC local edits; July 3, 2023 NCD 210.1 Prostate Cancer Screening Contractors shall add CPT code 0359U as covered for this policy effective January 1, 2023. CR#13070.6

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Clinical Laboratory Fee Schedule & Laboratory Services Subject to Reasonable Charge Payment: Quarterly Update 4/1/2023

  • Mar 2, 2023

New Codes Effective April 1, 2023 Proprietary Laboratory Analysis (PLA) See the tab “New Codes” of the table attached to CR 13082.  New codes added to the national HCPCS file with an effective date of April 1, 2023. These new codes are MACpriced (where applicable) until they’re nationally priced. MACs will only price PLA codes for laboratories in their jurisdiction. The table includes the...

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