Welcome to the Reimbursement Bulletin!
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This Bulletin will be published semi-monthly. As always, any comments, suggestions, stories or questions can be sent to billing@msho.org. We hope you enjoy this issue!
~ They are called 'co-pay accumulators,' and they're a way insurers make you pay more for Meds
~ Rituxan Hycela C-Code for Hospital Outpatient Setting
~ COA Statement On 340B Optimization Act
~ CMS to Recast 'Meaningful Use' Data Reporting Rules Details >
The handouts are available on the MSHO Website!Details >Wednesday, July 25, 2018SAVE THE DATE! Details >Wednesday, October 17, 2018Schoolcraft College - Livonia, MI
SAVE THE DATE! Details >
May 2018Including...
~ May 2, 2018 CMS Re-work of the National Coverage Determination for ESAs Still Pending
~ WPS LCD changes related to MolDx... Details >Check out these upcoming training events....Including....
~ Teleconference on 6/5 on New to Medicare- Appeals Overview, and many more! Details >
Region 1 - Performant Recovery, Inc.May 2018 Details >This edition includes articles on......~ Auditors Going from Targeting Just Physicians to Targeting Physicians and NPPs
~ Exclusive: Medicaid: The State of the Union Details >Recent Oncology Related Articles~ Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – July 2018 Update
~ Open Payments Review and Dispute Data by May 15
~ CMS Changes Name of the EHR Incentive Programs and Advancing Care Information to “Promoting Interoperability”
~ Proper Use of the KX Modifier for Part B Immunosuppressive Drug Claims
~ Quality Payment Program: Answering Your Frequently Asked Questions Call — May 16
~ April 2018 OPPS Pricer File
~ Quarterly Update to the NCCI PTP Edits, Version 24.2 MLN Matters Article
~ Guidelines for Teaching Physicians, Interns, and Residents Booklet
~ ICD-10-CM/PCS: The Next Generation of Coding Booklet
~ General Equivalence Mappings FAQs Booklet
~ CMS Transmittal 191 on OCM Bundling Edits Details >
Recent Oncology Related News~ Reminder from MSHO - Z51.11 in first diagnosis position on BCBSM claims
~ Effective July 1, BCN won’t accept late claims
~ Clinical Quality Corner tip sheets updated for 2018
~ More medical drugs added to site of care infusion requirement, beginning July 1 Details >
Last Updated 5/2/18Review the reported payer reimbursement issues MSHO is currently addressing...
~ BCBSM is denying some drugs when the Z51.11 ICD10 code is in the first position.
~ BCBSM PPO is denying CPT 96366, therapeutic infusion additional hour when billed with 96413 Details >Recent Oncology Related Issues and NewsMedicaid Advantage Pending Issues; stay tuned, MSA Bulletins, Biller "B" Aware Notices Details >Update on Erythropoiesis Stimulating Agents (ESA) NCD/LCDDetails >~ Aetna OfficeLink Updates
~ BCN Provider News
~ Cigna
~ HAP/HealthPlus ProviderPlus
~ Humana YourPractice
~ UHC NetworkBulletin
~ UHC Medical Policy Update
Details >
~ The role of PBMs in the drug supply chain — and why it matters to advisers Details >
~ Auditing Issues Uncovered in Physician Documentation: Part I
~ Top 5 Developments and Concerns of Community Oncology Practices
~ Feds Boast $2.4B in Healthcare Fraud Judgments, Settlements Details >
May 2018, Frequently Asked QuestionsTopics Include: WPS High Dollar Review, "Incident To" and Midlevel Providers, Concurrent Infusion and Discharging a Patient Details > |
