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Live Event November 9, 2022 - Schoolcraft College, LivoniaDetails >
May 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
• TPE Reviews on 96365 & 96413 Reported by MSHO Members!
• Also, Medicare Hot Links to 2022 Final Rules and the WPS Fee Schedules Details >• Evaluation and Management (E/M) Services Ask-the-Contractor Teleconference (ACT) Recording Available until May 6
• On Demand Training
• YouTube Training Opportunities! Details >
Recent Oncology Related Articles• 2021 MIPS Cost Performance Category Reweighted to 0% for Groups and Individuals
• Patient Eligibility Information for Additional Services — Now Available
• HCPCS Application Summaries & Coding Decisions: Drugs and Biologicals
• Launch of the Cross-Cutting Initiatives
• What’s the Comprehensive Error Rate Testing Program?
• Advanced Practice Registered Nurses, Anesthesiologist Assistants, & Physician Assistants — Revised
• ICD-10 Diagnosis Codes: Comment by May 9
• Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.RAC AUDITS CONTINUE - All related to waste - not using the smallest vial available or not using the JW modifier!
Be Careful and Double Check To Be Sure You Are Doing It Correctly!
Also, Newest approved issues listed on RAC website Details >This edition includes an article on:• PHE Renewed for 90 Days - What does this mean to your clinic? Details >
Recent Oncology Related News• Resubmit rejected claims to Medicare for patients with Medicare Supplemental coverage from group 71736, UAW Retirees of The Budd Company Health and Welfare Trust
•Training available for Availity® EFT enrollment and Remittance Viewer
• Nyvepria™ and Rybrevant™ to require prior authorization for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans starting May 16
• Kimmtrak® and Tivdak® to require prior authorization for most members starting May 23
• Empaveli® and Actemra® to require prior authorization for Blue Cross URMBT non-Medicare members, starting June 1
• DanyelzaTM, Margenza® and SaphneloTM to require prior authorization for URMBT members with Blue Cross non Medicare plans starting June 30
• Inflectra® and Avsola® are the preferred infliximab products for pediatric commercial members starting July 1
• We’re designating preferred and nonpreferred IV iron therapy replacement drugs for Medicare Advantage members starting August 8 Details >Publications• The Record
• BCN Provider News Details >BCBSM System Still Not Fixed - Keep Sending Us Your Denials!BCBSM is Manually Processing Denials QUICKLY! Details >
Last Reviewed/Updated 5/4/22Review the reported payer reimbursement issues including:
• WPS Medicare requirement for infusion monitoring documentation every 15 minutes
• BCBSM issues with Pemfexy, Phesgo, and Denials for Auth Exceeds Allowed Details >Recent Oncology Related NewsMedicaid Updates Include:
• MSA Bulletin Updates - Coverage of Routine Patient Costs for Items and Services Associated with Participation in a Qualifying Clinical Trial
• Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network News Details >• Change to referring/ordering/attending editing for Medicaid claims
• Appeal vs. claims inquiry: Steps for faster claims resolution Details >Featuring this month: Medicare Advantage PlansDetails >
Kite's Yescarta® (axicabtagene ciloleucel) Novartis' Vijoice® (alpelisib) Details > 
May 2022, Frequently Asked Questions• Physician Orders and Nursing Compliance
• Hydration for 31 Minutes
• E/M 95/97 Guidelines vs 2021 Guidelines
• Concurrent Coding Confusion
MSHO MEMBERS - You can access and search previous FAQs! Just use the search field on the bottom right corner of the MSHO website! Details > |
