Upcoming CPT (NEW) Code Changes Effective from October 1, 2019

Upcoming CPT (NEW) Code Changes Effective from October 1, 2019

2019 CPT Code Changes: 0105U: Nephrology (chronic kidney disease), multiplex electrochemiluminescent immunoassay (ECLIA) of tumor necrosis factor receptor 1A, receptor superfamily 2 (TNFR1, TNFR2), and kidney injury molecule-1 (KIM-1) combined with longitudinal clinical data, including APOL1 genotype if available, and plasma (isolated fresh or frozen), algorithm reported as probability score for rapid kidney function decline…

Upcoming HCPCS (DELETED/REVISED) Code Changes Effective from October 1, 2019

Upcoming HCPCS (DELETED/REVISED) Code Changes Effective from October 1, 2019

Deleted Codes: J1942 Injection, aripiprazole lauroxil, 1 mg S1090 Mometasone furoate sinus implant, 370 micrograms Revised Codes: J0641 Inj., levoleucovorin, 0.5 mg J2794 Inj., risperdal consta, 0.5 mg J7311 Inj., retisert, 0.01 mg J7313 Inj., iluvien, 0.01 mg Q4122 Dermacell, awm, porous sq cm Q4165 Keramatrix, Kerasorb sq cm Q4184 Cellesta or duo per sq…

2020 ICD-10 CM Revised Codes Effective from October 1, 2019

2020 ICD-10 CM Revised Codes Effective from October 1, 2019

Revised Codes B96.21 Shigatoxin-producingEscherichiacoli[E.coli][STEC]O157asthecauseofdiseasesclassifiedelsewhere B96.22 OtherspecifiedShigatoxin-producingEscherichiacoli[E.coli][STEC]asthecauseofdiseasesclassifiedelsewhere B96.23 UnspecifiedShigatoxin-producingEscherichiacoli[E.coli][STEC]asthecauseofdiseasesclassifiedelsewhere G43.A0 Cyclicalvomiting,inmigraine,notintractable G43.A1 Cyclicalvomiting,inmigraine,intractable I70.238 Atherosclerosisofnativearteriesofrightlegwithulcerationofotherpartoflowerleg I70.248 Atherosclerosisofnativearteriesofleftlegwithulcerationofotherpartoflowerleg J44.0 Chronicobstructivepulmonarydiseasewith(acute)lowerrespiratoryinfection M50.120 Mid-cervicaldiscdisorder,unspecifiedlevel M66.88 Spontaneousruptureofothertendons,othersites M67.839 Otherspecifieddisordersofsynoviumandtendon,unspecifiedwrist M77.5 Otherenthesopathyoffootandankle M77.50 Otherenthesopathyofunspecifiedfootandankle M77.51 Otherenthesopathyofrightfootandankle M77.52 Otherenthesopathyofleftfootandankle N35.814 Otheranteriorurethralstricture,male R82.993 Hyperuricosuria T40.906 Underdosingofunspecifiedpsychodysleptics[hallucinogens] T40.906A Underdosingofunspecifiedpsychodysleptics[hallucinogens],initialencounter T40.906D Underdosingofunspecifiedpsychodysleptics[hallucinogens],subsequentencounter T40.906S Underdosingofunspecifiedpsychodysleptics[hallucinogens],sequela T40.996 Underdosingofotherpsychodysleptics[hallucinogens] T40.996A Underdosingofotherpsychodysleptics[hallucinogens],initialencounter T40.996D Underdosingofotherpsychodysleptics[hallucinogens],subsequentencounter T40.996S Underdosingofotherpsychodysleptics[hallucinogens],sequela T44.1X6 Underdosingofotherparasympathomimetics[cholinergics] T44.1X6A…

Anthem Changes Timely-Filing (TFL ) Deadlines Effective On October 1, 2019

Anthem Changes Timely-Filing (TFL ) Deadlines Effective On October 1, 2019

Anthem has sent out a notice to all providers who have signed non-Medicare (Commercial) or Medicare Advantage contracts with them, stating as,  “Effective for all commercial and Medicare Advantage Professional Claims submitted to the plan on or after Oct. 1, 2019, the Anthem Blue Cross and Blue Shield (Anthem) Provider Agreement(s) will be amended to…

Coding Guidelines for Hepatitis B Screening – Reimbursement Tips

Coding Guidelines for Hepatitis B Screening – Reimbursement Tips

This would help your organization join the fight against Hepatitis B (HBV) infection by understanding what conditions are necessary for coverage of HBV screening and how to properly code the Hepatitis B surface antigen (HBsAg) serologic test. Conditions for Coverage of HBsAg Serologic Testing: The patient’s primary care physician or practitioner,  an eligible Medicare provider,…

Changes in Bypass Payment Edits (3-days and 1-day) For Donor Post-Kidney Transplant

Changes in Bypass Payment Edits (3-days and 1-day) For Donor Post-Kidney Transplant

The MACs to implement logic that ensures they bypass payment window edits (3-days and 1-day) when processing claims for donor post-kidney transplant complications services. MACs will hold certain claims, as noted below, until Medicare’s Common Working File (CWF) system edits these claims correctly. 3-Day Payment Window Edits: 7109: Outpatient Diagnostic Service against Inpatient in history…

ICD-10 PCS Deleted Codes Effective October 1st, 2019

ICD-10 PCS Deleted Codes Effective October 1st, 2019

ICD-10 PCS  Deleted Codes 370046 Dilation of Right Internal Mammary Artery, Bifurcation, with Drug-eluting Intraluminal Device, Open Approach370056 Dilation of Right Internal Mammary Artery, Bifurcation, with Two Drug-eluting Intraluminal Devices, Open Approach370066 Dilation of Right Internal Mammary Artery, Bifurcation, with Three Drug-eluting Intraluminal Devices, Open Approach370076 Dilation of Right Internal Mammary Artery, Bifurcation, with Four…

ICD-10 PCS New Codes Effective October 1st, 2019

ICD-10 PCS New Codes Effective October 1st, 2019

ICD-10 PCS NEW CODES 001607A Bypass Cerebral Ventricle to Subgaleal Space with Autologous Tissue Substitute, Open Approach00160JA Bypass Cerebral Ventricle to Subgaleal Space with Synthetic Substitute, Open Approach00160KA Bypass Cerebral Ventricle to Subgaleal Space with Nonautologous Tissue Substitute, Open Approach001637A Bypass Cerebral Ventricle to Subgaleal Space with Autologous Tissue Substitute, Percutaneous Approach00163JA Bypass Cerebral Ventricle…

BCBS – New Reimbursement Guidelines for Smoking Cessation effective from September 26, 2019

Effective September 26, 2019, Horizon BCBSNJ will change the way consider certain professional claims for smoking cessation services provided September 26, 2019. In accordance with CMS guidelines, Horizon BCBSNJ shall consider for reimbursement smoking and tobacco cessation counseling visits (99406 or 99407) for asymptomatic patients when billed with an approved diagnosis code. Approved Diagnosis Codes: Nicotine dependence (F17.21-F17.299)…