like us on facebook connect with us on linkedin follow us on twitter October 26, 2022

LumakrasTo learn more about Amgen's Lumakras, CLICK HERE.

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MSHO's 13th Annual Payer Update

October 26 is last day for complimentary registration!

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MSHO Featured Corporate Sponsor Assistance Programs

• Adaptive Assist
• Natera Signatera
• TerSera SupportSource

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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
• Clerical Error Reopenings
• 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

• BPCI Advanced Model Extension
• Vacating Differential Payment Rate for 340B-Acquired Drugs
• ICD-10 Coordination and Maintenance Committee Meeting
• Inflation Reduction Act
• Help Promote Efficiency, Reduce Burden, & Advance Equity
• Recent Learn Resource & MedLearn Matters Articles

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Recent RAC Monitor Article

This edition includes articles on

• Challenging Medicare Provider Audits
• Modern UR Stressors Demand Innovation

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BCBSM/BCN

Recent Oncology Related News

• Treatment Pathway: Palliative Radiation for Oncology Patients on Hospice
• Next phases of Provider Secured Services
• New email box to reach provider consultants
• Medicare Advantage plans transitioning to Optum Rx PBM
• 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 10/26/22

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

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Resolved Payer Issues

Last Reviewed/Updated 10/26/22

• 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

• Chemotherapy clinical edit error
• Reviewing the implementation of 4 clinical edits: paused & modified on Oct 25
• HRA incentive open to more providers in 2023
• PriorityWell Choice Benefits launching Dec. 1

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Recent Oncology Related FDA Approvals and Expanded Indications

• AstraZeneca Imjudo (tremelimumab) in combination with Imfinzi (durvalumab)
• Janssen Biotech Tecvayli™ (teclistamab-cqyv)

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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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