like us on facebook connect with us on linkedin follow us on twitter October 13, 2022

To learn more about Pharmacyclics' Imbruvica By Your Side, 
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Registration Open for MSHO's 13th Annual Payer Update!

Live Event November 9, 2022 - Schoolcraft College, Livonia

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MSHO Featured Corporate Sponsor Assistance Program

• ADC Therapeutics' Advancing Patient Support 
• The Eisai Assistance Program
• Meijer Specialty Pharmacy's Patient Assistance Program

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WPS Oncology Related LCD Updates

October 2022

Stay current on retired and revised policies/articles

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WPS Recent Oncology Related News

Part A, Part B and Part A/B News

• PC-Print October 2022 CARC and RARC Updates Now Available
• PC-ACE Billing Software Upgrade Version 5.6 Now Available Online
• Medicare Hot Links to 2022 Final Rules and the WPS Fee Schedules

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CMS-Medicare

Recent Oncology Related Articles

• Q4 Changes made to HPPS
• ICD-10 Coordination and Maintenance Committee Meeting
• Inflation Reduction Act
• Help Promote Efficiency, Reduce Burden, & Advance Equity
• Recent LearnResource & MedLearn Matters Articles

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Michigan RAC Information

Region 1 - Performant Recovery, Inc.

Be sure to audit yourself before the RAC audits you!

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Recent RAC Monitor Article

This edition includes articles on

• How to Integrate an SDoH Coding and Quality Question

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BCBSM/BCN

Recent Oncology Related News

• Clarification: DME/P&O and telehealth visits
• e-referral system out of service Oct. 15-16
• Delayed WPS Medicare Part A & B 277CA reports
• Skysona® to require prior authorization starting Oct. 20
• And many more

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BCBSM/BCN

Publications

• The Record
• BCN Provider News

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Current Payer Issue Tracking Page

Last Reviewed/Updated 10/12/22

• 10/11 Update on BCBSM Denials for Auth Exceeds Allowed

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Resolved Payer Issues

Last Reviewed/Updated 10/12/22

• BCBSM Phesgo Issue and Denials for Auth Exceeds Allowed

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Medicaid

Recent Oncology Related News

Medicaid Updates Include
• MSA Bulletin Updates
• Biller "B" Aware Notices

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Newsletters of Interest

• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network News

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Priority Health Update

• New clinical edit goes into effect Oct. 15, 2022
• PriorityWell Choice Benefits launching Dec. 1
• Legacy THC providers must wrap up claims, appeals by Dec. 31, 2022

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ASK MSHO

October 2022

• Documentation codes required for billing 96365 - 96379 & billing multiple injections of the same substance

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