Monday, January 4, 2021

Very Brief Blog: AMA releases January 1, 2021 PLA Codes

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AMA releases new batches of Proprietary Laboratory Analysis codes every quarter.   The new batch for January 1, 2021 is out.  Codes released...

Very Brief Blog: NIH RADx-Funded Novel COVID PCR Device...Being Advertised

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 For COVID, emergency use authorizations (EUAs) come in a range of sizes and formats - for lab-developed tests, for test kits to run on big ...

Very Brief Blog: CMS Applying CLIA-Waivers to COVID CPT Codes

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In Medicare claims processing, CMS processes laboratory CPT codes against edits related to CLIA lab status.   Most lab codes can only be pro...
Tuesday, December 29, 2020

Very Brief Blog: Medicare's 2018 Spending for CYP (PGx) Codes; Falling 2018-2019

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The entry point for this blog is that I noticed a drop in national Part B spending for the most frequent pharmacogenetics codes (81225, 8122...
Saturday, December 26, 2020

Blog #5 of 5: 81407 as Weirdest Tier 2 Code (&) Strange Impact on 70/30 Billing Rule (&) Wacko CLIA-CMS Edits

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Triggered by the December 22 release of the OIG report on lab spending for CY2019, I've written a set of 5 blogs. #1 - OIG report; Focus...

Blog #4 of 5: NGS MAC Manages 20% of Medicare, Pays 0.1% of Tier 2 Codes

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Triggered by the December 22 release of the OIG report on lab spending for CY2019, I've written a set of 5 blogs. #1 - OIG report; Focus...
Thursday, December 24, 2020

Blog #3 of 5: Inferring MolDx Edits on TIer 2 Codes: Amazing Data

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Triggered by the December 22 release of the OIG report on lab spending for CY2019, I've written a set of 5 blogs. #1 - OIG report; Focus...

Blog #2 of 5: Medicare Tier Two Molecular Code Spending: 2019 vs 2018, and Where

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Triggered by the December 22 release of the OIG report on lab spending for CY2019, I've written a set of 5 blogs. #1 - OIG report; Focus...

CMS Updates Pathology Correct Coding Manual for CY2021

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 Medicare has a national Correct Coding Initiative whose rules and policies are binding for Medicare submissions.   (There is a Medicaid ini...
Wednesday, December 23, 2020

Very Brief Blog: CMS COVID Data Shows Highest Risk for Black Beneficiaries

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CMS has a webpage where it posts beneficiary data about COVID, based on claims data.  CMS notes the data is not designed for epidemiology pu...

Very Brief Blog: Noridian MAC Awarded Jurisdiction E Contract, Again

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Early in 2020, I wrote a blog about the fact that the West Coast / Jurisdiction E Medicare contract was under a routine recompete ( here ). ...

Very Brief Blog: CMS Offers Preview of Possible Future Quality Measures

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CMS slowly rolls out changes to the complex system of hospital and physician quality measures through annual rulemaking, typically working a...

Very Brief Blog: A Very Brief Peek at Medicare Provisions in Budget Law

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Many detailed analyses of the giant budget bill just passed by House and Senate will appear quickly.  It's 5593 pages (although only a s...
Tuesday, December 22, 2020

Blog #1 of 5: OIG Releases Annual Report on Lab Spending: CY2019

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Triggered by the December 22 release of the OIG report on lab spending for CY2019, I've written a set of 5 blogs. #1 - OIG report; Focus...