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Friday, April 29 at the Somerset Inn, TroyDetails >Now That The Dust Has Settled: Billing & Coding in 2022Handouts are available and recording is coming soon! Details >
February 2022Updates that may be of interest to oncology including:
• Multiple MolDx Revised Policies Details >Part A, Part B and Part A/B NewsIncludes articles that may be of interest to oncology released in the past 2 weeks
• Also, Medicare Hot Links to 2022 Proposed Rules, 2021 Final Rules and the WPS Fee Schedules Details >Check out these upcoming training events:• Teleconferences including; Claim Denials Relating to Provider Enrollment and Infusion Documentation
• On Demand Training Including; Appeals - Understanding the Basics, ABN Basics, YouTube Training and more... Details >
Recent Oncology Related Articles• Important Reminder of Clinical Trial (NCT) Number Reporting Requirement
• Internet-Only Manual Updates (IOM) for Critical Care, Split/ Shared Evaluation and Management Visits, Teaching Physicians, and Physician Assistants
• CY2022 Telehealth Update Medicare Physician Fee Schedule
• Calendar Year (CY) 2022 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment — Revised
• Original Medicare vs. Medicare Advantage
• Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.MANY RAC AUDITS REPORTED!!! All related to waste - not using the smallest vial available or not using the JW modifier! Be Careful!!
Newest approved issues listed on RAC website:
• Positron Emission Tomography for Initial Treatment Strategy in Oncologic Conditions
• Next Generation Sequencing Medical Necessity and Documentation Requirements Details >This edition includes articles on:• Medicare Auditors Caught Double-Dipping
• Who Owns the Chart? Details >
Recent Oncology Related News• HCPCS replacement codes, effective Jan. 1, 2022, established
• Changes to the medical oncology prior authorization list for URMBT members with Blue Cross non-Medicare plans, starting Feb. 21
• NovoLogix user interface update: Old version of authorization screen to be deactivated March 1
• Starting March 1, radiology procedure code *71271 requires prior authorization for most members
• Additional drugs to require prior authorization for Blue Cross URMBT non-Medicare members, starting March 10
• In March, AIM Specialty Health® to update clinical guidelines for prostate cancer imaging
• Changes coming to preferred products for infliximab (reference product Remicade®) for Medicare Advantage members, starting April 1
• Changes coming to preferred products for pegfilgrastim (reference product Neulasta®) for commercial and Medicare Advantage members, starting April 1 Details >Publications• The Record
• BCN Provider News
• Blues Brief for Oncology Providers Details >
Last Reviewed/Updated 2/1/22Review the reported payer reimbursement issues including:
• Multiple issues TOO MANY TO MENTION HERE - PLEASE be sure to read the section!!! Details >Recent Oncology Related NewsMedicaid Updates Include:
• MSA Bulletin Updates
• Biller "B" Aware Notices
• No Zoladex Coverage for Michigan Medicaid Patients - NDC Not Rebate Eligible
Here is What You Should Do For Your Patient Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network News Details >• Anatomic Modifiers Required Starting Apr. 1, 2022
• Submitting Claims for Medicaid Members with Other Insurance Details >MSHO MEMBERS - IMPORTANT!!!
• Starting April 1st - Exchange Plans: Prior authorization requirements for radiation and chemotherapy services Details >Featuring this month: CignaTidbits regarding:
• Electronic Tools
• Policy Updates
• General News Details >
February 2022, Frequently Asked Questions• Face to Face Requirement for Split/Shared Changed
• Deductible/Copay for Telephone Visits
• High Deductible Plans Now Owe Copay/Deductible for Telehealth Visits
• Billing Hydration for an Open Line
• Timing of Signature Requirement for Verbal Orders
MSHO MEMBERS - You can access and search previous FAQs! Scroll to the bottom of the Q & As to find out how!
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