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Friday, April 29 at the Somerset Inn, TroyDetails >
January 2022Updates that may be of interest to oncology including:
• Multiple MolDx Revised Policies, HCPCS and CPT updates and revisions to the Complex Drug Administration Coding 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:• Learning Center: Content Library Enhancements • On Demand Training Including; Appeals - Understanding the Basics, ABN Basics, YouTube Training and more... Details >
Recent Oncology Related Articles• Original Medicare vs. Medicare Advantage • Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Changes • National Correct Coding Initiative Medicare Policy Manual: Annual Update • 2022 Medicare & You Handbook • Checking Medicare Eligibility — Revised • Medicare Provider Compliance Tips • New/Modifications to the Place of Service (POS) Codes for Telehealth - Effective January 1, 2022 • Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.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 an article on:• Taking a Proactive Approach to Audit Defense Details >
Recent Oncology Related News• Advantages of using the e-referral system for prior authorization requests instead of calling or faxing • Telehealth services require place of service code 10 beginning February 1 for services provided in the patient's home • Additional drugs require prior authorization for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans, starting Jan. 27 • Changes to the medical oncology prior authorization list for URMBT members with Blue Cross non-Medicare plans, starting Feb. 21 • 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 1/18/22Review the reported payer reimbursement issues including: • multiple issues with BCBSM, Medicaid Not Recognizing a NDC for Zoladex, NDC issue with Treanda Resolved & Thank you to Sara Gouin from Ascension! 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 >• Our Clinical Pharmacists are Calling Some of Your Patients About Medication Adherence • Use Place of Service Code 10 for Virtual Services Provided in the Patient's Home • Appeals Tips for Medicare Non-Contracted Providers • 2022 Commercial Product Update Details >MSHO MEMBERS - IMPORTANT!!! Exchange plans: Prior authorization requirements for radiation and chemotherapy services Details >Featuring this month: Molina Healthcare of MichiganTidbits regarding: • Retrospective Authorization • Quick Reference Guide • 4 Medicare Plans in 2022 Details >
January 2022, Frequently Asked Questions• New J-code for Neulasta and Authorization Requirements • Split/Shared Visit Changes for 2022 • Telehealth Visits and Medicare • Billing for Blood Draw from a Port Same Day as an Office Visit
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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