like us on facebook connect with us on linkedin connect with us on instagram May 09, 2025

Syndax

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MSHO Featured Corporate Sponsor Assistance Programs

• Autolus Assist
• Geron's REACH4RYTELO
• TerSera SupportSource

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WPS Oncology Related LCD Updates

• Revised Policies / Articles

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WPS Recent Oncology Related News

• CPT Code 99214 – CERT Errors
• Integrated Outpatient Code Editor Version 26.1
• Medicare Physician Fee Schedule Database: April Update
New!  Medicare Hot Links
• And More

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WPS Educational Offerings

New training opportunities available

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CMS-Medicare

Recent Oncology Related Articles

• Advance Notice on the Medicare Advantage
• CMS National Coverage Determination Code Changes
• National Correct Coding Initiative
• MLN Matters
• And More

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QPP MVP and CAHPS CMS Part B

• 2025 MVP Registration Open
• 2025 CAHPS for MIPS Survey Registration Open

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Recent RAC Monitor Article

This edition includes articles on

• The Legislative Plight of 340B
• The Full Revenue Cycle Team: The Backbone of Coding Integrity
• Compliance, CDI, and the False Claims Act: Connecting the Dots
• The Comprehensive CDI Report

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BCBSM/BCN

Recent Oncology Related News

• BCN Advantage Modifier JW and JZ Denials
• New Telemedicine Codes Starting July 1
• BCBSA Settlement

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BCBSM/BCN

Publications

• Blues Brief
• The Record
• BCN Provider News

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Current Payer Issue Tracking Page

• Procrit or Epoetin Class Drugs Maintenance
• BCBSM Below Cost Reimbursement

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Resolved Payer Issues

• 0885 Claims Denied With Reason Code 693
• Procrit or Epoetin Class Drugs Maintenance
• Procrit Denials (693)
• 505(b)(2) Oncology Products Being Impacted by Prior Auth

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Aetna

• April 2025 OfficeLink Update

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Cigna

• 2025 Clinical, Reimbursement, and Administrative Policy Updates

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Health Alliance Plan

• Update - Extension of Telehealth Services for Risk Adjustment
• Model of Care Required Training
• Keep Provider Information Updated in NPPES

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Humana

• Humana's Q1 2025 Newsletter 
• Q2 TRICARE Reimbursement Implementation Update
• Coming Soon: Enhanced Security for Self-Service Accounts

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Molina

Recent Oncology Related News

• Provider Bulletin

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Priority Health Update

• Update to Corrected Claims Goes Into Effect June 2
• Auto Approval for Diagnostic Imaging Procedures 73700 & 73200
• IV Fluid Shortage Update
• New and Updated Billing Policies
• And More

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United Healthcare

• Medical Policy Updates
• Reimbursement Policy Updates
• Pharmacy and Clinical Updates
• Specialty Medical Injectable Drug Program Updates 
• APIs can Save Time for Your Whole Team 

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Recent Oncology Related FDA Approvals and Expanded Indications

Bristol Myers Squibb Opdivo® (nivolumab) plus Yervoy® (ipilimumab)
AstraZeneca Imfinzi (durvalumab)
Novartis Pluvicto® (lutetium Lu 177 vipivotide tetraxetan)
Alnylam Qfitlia™ (fitusiran)
Exelixis Cabometyx® (cabozantinib)

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ASK MSHO

April 2025 Frequently Asked Questions

• Charging an XS Modifier With IVP Drug Administration Codes
• Reporting the JW Modifier
• Billing Concurrent IV Administration of Chemo and Non-Chemo Drugs

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