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Welcome to the Reimbursement Bulletin
Tuesdays - Lunch and Learn Weekly Webinar Series 4/21 - 5/12Register Today for the April 21st Webinar • WPS Medicare - 2020 Updates to Chronic, Principal, and Transitional Care Management Services! Details >The must-attend community oncology conference of the year!Free for all Health Care and Practice Professionals APRIL 23-24, 2020 - Register Today! Details >
April 2020Including:
• MolDX • Billing and Coding: Bisphosphonate Drug Therapy 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 Fee Schedules and 2020 Final CMS Rules Details >Check out these upcoming training events:• Care Management Services • Locating a Local Coverage Determination (LCD) • New to Medicare - Fundamentals of Reimbursement • New to Medicare - Appeals and Overpayments • New to Medicare - Last Call for 2020 • PLUS many additional on-demand educational opportunities including E & M training opportunities! Details >
Recent Oncology Related Articles• Coronavirus Major Policy Changes • Billing for Professional Telehealth Distant Site Services During the Public Health Emergency - Revised • New ICD-10-CM diagnosis code, U07.1, for COVID-19 • Quality Payment Program and Quality Reporting Program/Value Based Purchasing Program COVID-19 Relief • Clinical Laboratory Improvement Amendments (CLIA) Guidance During COVID-19 Emergency • Quality Payment Program: 2020 Resources • Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.Latest Issues Under Review That May be Significant to Oncology... • Including - Bone Marrow Transplants, ESAs for Cancer Patients, and Therapeutic Injections! Details >
Recent Oncology Related News• We're granting a 90-day extension to claim submission time limits • We've updated the Telehealth procedure codes for COVID-19 and our telehealth guides for medical providers and for behavioral health providers • Ranitidine market withdrawal • Billing for COVID-19 drive-through testing • COVID-19 testing and treatment covered at no member cost-sharing • Blue Cross and BCN extend no-cost telehealth services to members through June 30 and include behavioral health • Telehealth overview guides available • Medicare Part B medical specialty drug prior authorization list is changing in June • We're adding site-of-care requirements for Lemtrada and Tysabri for commercial members, starting May 1 Details >Publications• The Record • BCN Provider News Details >Monthly Status ReportMany updates/corrections. Listed below is a sampling of what you will find: • 835 Recoupment isn't reflected on voucher • Evaluation and Management services claims are incorrectly being denied • J0881 and J0885 claims are being denied incorrectly • RHC claim issues • and more Details >
Last Updated 4/7/2020Review the reported payer reimbursement issues MSHO is currently addressing including the response from BCBSM regarding reimbursement by NDC and problems with payments below the minimum fee schedule! Details >Recent Oncology Related NewsMedicaid Updates Include: • Michigan Seeks Approval to Streamline Medicaid; Request would provide easier access to coverage while keeping residents safe during COVID-19 outbreak • MSA Bulletin Updates • Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update
Details >Featuring this month: Priority HealthTidbits regarding: • Dedicated COVID-19 Provider Page • Expanded services for telephone visits, e-visits and hosted visits • Will allow the office visit codes for telehealth Details >• Changes to CMS's National Correct Coding Initiative resulting in some claims reprocessing, starting Apr. 1, 2020 • Healthy Michigan Plan work requirements canceled, effective immediately Details >
April 2020, Frequently Asked Questions with COVID-19 Focus•Physician "Incident To" • Sequestration • Place of Service 02 • Nurse Phone Calls • Definition of Qualified Healthcare Professional • Waiver Co-Pays • Place of Service • Telehealth Phone Calls • Patient Consent Requirements • Definition Patient Initiated • Phone Calls • Check in - G2012 • Medical Decision Making • PA/NP Telemedicine "Incident To" Details >
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