In Billing
Jun 18th, 2012
Billing and coding guidelines for prostate molecular marker claims submitted to Palmetto GBA have changed. The Part B Medicare administrative contractor (MAC) for jurisdiction 1 (American Samoa, California, Guam, Hawaii, Nevada, and Northern Mariana Islands) has determined the service to be medically unnecessary and will not reimburse physicians for HOXD3, PTEN, and ERG molecular markers. ...
In Billing
Dec 15th, 2011
The 2012 annual update to the Clinical Laboratory Fee Schedule (CLFS) is anything but a quick read. In addition to the 2012 CLFS update, a Recurring Update Notification (RUN) provides instructions for mapping new codes for clinical laboratory tests and coding new molecular pathology procedure test codes, and updates for laboratory costs subject to the reasonable ...
In Coding
Dec 15th, 2011
Before your begin using your 2012 CPT® codebook on Jan. 1, be sure to check the American Medical Association’s (AMA) official errata, which include corrections and other information related to CPT® 2012. Especially interesting is a new instruction defining “other qualified health care professional,” as used in CPT®. For example, CPT® instructs that prolonged services ...
Dec 1st, 2011
Whether it’s new modifiers, E/M, radiology, or Category II codes, we have the outlook for what’s on the horizon. By Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC CPT® 2012 arrives with over 500 code changes, plus minor additions to the Evaluation and Management Services Guidelines. The revised evaluation and management (E/M) guidelines clarify the “three-year ...
In Billing
Oct 1st, 2010
Palmetto GBA launched the first phase of a new program Sept. 1 that is intended to increase the Medicare administrative contractor’s (MAC) accuracy rate for determining reasonable and necessary laboratory and molecular diagnostic services. The Part B Medicare administrative contractor (MAC) for jurisdiction 1 said the new program will allow for more accurate reimbursement of those services ...