Tagged with CPT Coding
CMS has announced plans to publish an addendum to the electronic clinical quality measure (eCQM) value sets to align with the most recent releases to terminologies.
CMS is proposing updates and policy changes under the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System.
Tufts Health Plan has released payment policy updates for the administration of anesthesia for medically necessary services rendered by contracting anesthesiologists in a physician office, inpatient or outpatient facility.
CMS’ Medicare Physician Fee Schedule (MPFS) proposal for Calendar Year (CY) 2019 includes blended rates for E/M services for levels 2-5, as well as two additional methods to document services.
The changes in CMS’ proposed Medicare Physician Fee Schedule (PFS) for 2019 include an increase to the technical component for certain CPT codes, as well as a proposed decrease for professional interpretation.
Highmark has announced that beginning October 1, eviCore will manage prior authorizations for Highmark members with non-emergent conditions requiring musculoskeletal (MSK) surgery or interventional pain management (IPM) services.
Humana has updated its Medicare Advantage, Commercial, and Medicaid payment policies for health care services delivered using electronic information and telecommunications technologies.
Following review of the CPT and HCPCS, Blue Cross and Blue Shield of Vermont (BCBSVT) has posted several coding, prior approval, investigational services, and unit designation changes.
On July 12, CMS published its proposed policy, payment, and quality provisions changes to the Medicare Physician Fee Schedule (MPFS) for Calendar Year (CY) 2019.
Effective July 1, Anthem will implement processing updates for service claims under certain programs, including radiation oncology and cardiology services, which require precertification through AIM Specialty Health® (AIM).
Effective September 1, Aetna will implement changes to its clinical payment and coding policy for several services and procedures, and will also implement several changes to its CPT® codes assigned to Enhanced Groupings (AEG) and/or Coventry Enhanced Groupings (CEG).
Beginning in July, UnitedHealthcare (UHC) will make changes to some commercial reimbursement policies, including after hours and weekend care, intraoperative neuromonitoring, and its professional and technical component policy for duplicate or repeat services of global test only.
Cigna has published a number of updates for its clinical, reimbursement, and administrative policies, including reimbursement policies for pharmacy and infusion services, cervical fusion, and cardiac ablation for supraventricular tachycardia.
Humana has published new and updated medical claims payment policy for certain CPT and diagnosis codes as well as correct coding updates, scheduled to take effect in July.
Aetna has released the most recent Current Procedural Terminology® (CPT®) codes added to Aetna Enhanced Grouper (AEG) and/or Coventry Enhanced Grouper (CEG) assignments.
Anthem Blue Cross Blue Shield (BCBS) published a notice stating that effective with dates of service on and after July 1st a separate company, AIM Specialty Health (AIM), will apply AIM’s Radiation Oncology Clinical Appropriateness Guidelines to precertification requests for certain services.
UnitedHealthcare (UHC) released a policy revision for molecular and genetic tests that have proven efficacy in the diagnosis or treatment of medical conditions.
CMS has released the latest coding changes, revisions, and feedback to National Coverage Determinations (NCDs) in the 10th revision of the ‘International Classification of Diseases (ICD-10) and Other Coding Revisions.
Blue Cross and Blue Shield of Rhode Island (BCBSRI) has updated its claims processing system. These updates became effective April 1 and include Category II performance measurement tracking codes and Category III temporary codes for emerging technology.
Blue Cross and Blue Shield of Vermont (BCBSVT) has released the list of recently updated medical policies and the corresponding effective dates.