WCH Issue February 2020

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Business Corner

As a small provider, it's hard to bargain for rates with the current demand you have. But combined with other companies' demands, you may be able to command leverage you never thought you could have. Read along and find out more.

WCH Accomplishments

Do You Still Have Issues with Closed Insurance Panels? Let WCH Help You Get Approved!

It is known that getting a radiology contract from HealthFirst is close to impossible, but WCH was able to make it work! If you are facing issues with closed insurance panel’s approval, find out how we can help you by reading along.

Info for providers

Acupuncture for Chronic Low Back Pain to be covered by Medicare for dates of service on and after January 21, 2020

Know the covered procedures codes, effective dates, fees, and learn who can perform the services by reading along.

OIG Audit Report:Outpatient Rehabilitation Therapy Services’ Non-Compliance with Medicare Requirements

According to OIG’s audit report, there were many Medicare claims related to Outpatient Rehabilitation Therapy Services that didn’t comply with Medicare’s terms. To learn more about this and how you can avoid such issues, read along.

What’s new

Healthfirst Reimbursement Policy Updates: Allergy Studies, Allergen Immunotherapy and Diabetic Management Services

Healthfirst is updating reimbursement policies of Allergen Immunotherapy, Allergy Studies, and Diabetic Management Services starting March 1, 2020. Read along to know more details about these changes.

From ASH to AIM: Empire BlueCross’ Medicare Advantage Outpatient Rehabilitation Program Transition Information

Starting April 2020, Empire BlueCross will make a transition to AIM Specialty Health® when it comes to the utilization management of its Medicare Advantage Outpatient Rehabilitation Program. For more in-depth information regarding this change, it is best to read more.

Medical Policy Revision: Intraoperative Neurophysiologic Monitoring, Electromyography and Nerve Conduction Studies

Starting May 7, 2020, Horizon will first review the medical records for Intraoperative Neurophysiologic Monitoring, Electromyography and Nerve Conduction Studies before covering these services. If you offer these services, make sure to read along.

Changes in Allergy Testing and Non-Pharmacologic Treatment policy

Starting February 17, 2020, there are limits on Cigna’s allergy-testing coverage. To know more about the affected CPT codes, read along.

Beacon Adopts New Medical Necessity Criteria

This March 2020, Beacon Health starts to use the InterQual ® medical necessity criteria of Change Healthcare. However, there will still be exemptions in this criteria. Find out what these exemptions are by reading along.

New ICD-10-CM code for vaping-related disorder to be implemented

New ICD-10-CM code for vaping-related disorder to be implemented April 1, 2020. To know more about the new ICD-10-CM code, it is best to read along.

CMS Develops New Code for Coronavirus Lab Test

Starting with April 01, 2020, Medicare will begin processing the new code for Coronavirus Lab Test for dates of service on or after February 4, 2020. Know more by reading along.

New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), October 1, 2020

ICD-10-CM Official Coding Guidelines - Coding encounters related to COVID-19. Know more by reading along.

Hiring a Nurse Practitioner to Your Practice: What You Need to Know

If you’re looking for new nurse practitioner hires, you should know how reimbursement, credentialing, and billing works for their service rendered. Know more about this by reading along.

Your Questions Answered

It’s never easy to run your own medical practice. Read more to find out how Dr. Inna Pildysh made it possible with 12 years of experience under her belt.