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Learn the latest changes to reporting products and procedures related to Chimeric Antigen Receptor T-cell therapy to ensure proper coding. Expensive cutting-edge cancer therapy is available to Medicare patients nationwide. Back in 2019, the Centers for Medicare & Medicaid Services (CMS) finalized the long-sought rules for coverage of chimeric antigen receptor (CAR) T-cell therapy, a […]
The post CAR-T Reimbursement Requirements Revamped Again appeared first on AAPC Knowledge Center.
CMS estimates a $ 2.3 billion increase in hospital payments next year due, in part, to a 2.5 percent bump in reimbursement rates under Medicare’s IPPS. On Aug. 2, 2021, the Centers for Medicare and Medicaid Services (CMS) posted the fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment […]
The post 2022 IPPS Final Rule Boosts Hospital Reimbursement appeared first on AAPC Knowledge Center.
Evaluation and management (E&M) services shall be considered for reimbursement on the same day as smoking and tobacco-use cessation counseling services (99406 or 99407) only when medically necessary, as indicated by appending Modifier 25 to the E&M service.
Limitation:
Horizon BCBSNJ shall limit smoking and tobacco-use cessation counseling (99406 or 99407) in any combination to eight times within a one-year period.
Reference:BCBSNJ
In accordance with Centers for Medicare and Medicaid Services (CMS) guidelines, Horizon BCBSNJ requires that claims for clinical laboratory services report the referring practitioner on the claim submission. This applies to participating and non-participating providers.
Effective November 15, 2019 Horizon BCBSNJ will change the way consider and reimburse certain clinical laboratory claims that do not include information about the referring practitioner information.
Based on the guidelines of this reimbursement policy, Horizon BCBSNJ will deny outpatient claims submitted by participating or nonparticipating clinical laboratories for services provided on and after November 15, 2019 if the referring practitioner information is not included.
To avoid claim outpatient clinical laboratory claim denials, include referring practitioner information as noted below,
To address claims denied for no referring practitioner information, clinical laboratories will have to submit a corrected claim that includes this required information. Until such time as this corrected claim information can be submitted and processed, members cannot be held liable for services related to these claim denials.
Source: https://www.horizonblue.com/providers/news/news-legal-notices/reimbursement-policy-implementation-outpatient-laboratory-claims-referring-practitioner-required
Reimbursements for sponsoring meetings and hosting exams are paid quarterly from AAPC into the chapter checking accounts according to the following schedule: Months in the quarters: Mark attendance by: Payments will appear in accounts: 1st Q – Jan, Feb, Mar 30 days after each meeting […]
The post Prepare Now to Receive the 1st Q Reimbursement in May appeared first on AAPC Knowledge Center.
Reimbursements for sponsoring meetings and hosting exams in April, May and June were deposited into the local chapter checking accounts on August 14th. Make sure your chapter received yours by checking your bank account. This information is not found on AAPC’s website, you must contact your bank or check your August bank statement to confirm. […]
The post Did You Get Your 2nd Q Reimbursement? appeared first on AAPC Knowledge Center.