April 2022

A listing of the individual articles included in the Jurisdiction E Medicare A News bulletin dated April 2022 is provided. Each article title functions as a hyperlink to a specific article.

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Articles Source
MolDX: Billing and Coding: PIK3CA Gene Tests (A55597) - R5 - Effective January 01, 2022
MolDX: Biomarkers in Cardiovascular Risk Assessment - R9 - Effective April 22, 2021
MolDX: BRCA1 and BRCA2 Genetic Testing (L36161) - R8 - Effective April 29, 2021
MolDX: Corus® CAD Assay (L37673) Retirement - Effective February 15, 2022
MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (L39001) Final LCD - Effective April 17, 2022
MolDX: Plasma-Based Genomic Profiling in Solid Tumors - Published for Review and Comments
MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer (L38327) - R1 - Effective January 06, 2022
MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease (L38339) - R1 - Effective February 03, 2022
Multiple MolDX Coverage Article Updates - Effective December 17, 2021
National Coverage Determination (NCD) 270.3 Blood-Derived Products for Chronic, Non-Healing Wounds - Revised CR12403
Network Outage Impacting Electronic Transaction Processing - Resolved 03/02/22 Alert
New & Expanded Flexibilities for RHCs & FQHCs during the COVID-19 PHE - Revised SE20016
New Occurrence Span Code and Revenue Code for Acute Hospital Care at Home CR12540
Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease - Published for Review and Comments
Nursing and Allied Health Medicare Advantage Payment - Revision to CY 2018 CR12596
PET Scan Tracers Rejecting Incorrectly - Resolved 03/23/22 Alert
Physicians Ordering DMEPOS for Patients
Policy Revision for Facet Joint Interventions for Pain Management Local Coverage Determination and Associated Billing and Coding Facet Joint Interventions for Pain Management Local Coverage Article - R1 - Effective February 03, 2022
Policy Revision for Respiratory Care (Respiratory Therapy) Local Coverage Determination and Associated Billing and Coding Respiratory Care (Respiratory Therapy) Local Coverage Article - R10 - Effective January 01, 2022
Quarterly Update for CLFS and Laboratory Services Subject to Reasonable Charge Payment CR12612
Quarterly Update to the End-Stage Renal Disease Prospective Payment System (ESRD PPS) CR12583
Quarterly Update to the MPFSDB - April 2022 Update CR12623
Resource Correction for ACT Minutes from September 15, 2021
Retirement of Proposed Epidural Procedures for Pain Management Local Coverage Determination (LCD) and Associated Billing and Coding: Epidural Procedure for Pain Management Local Coverage Article (LCA) - Effective January 5, 2022
Review Time Added to Notification Letters
Self-Administered Drug Exclusion List - R23 - Effective April 24, 2022
Self-Administered Drug Exclusion List - R24, Effective May 15, 2022
Skilled Nursing Facility (SNF) Claims Processing Updates - Revised CR12344
SNF Claims Processing Update to FYE Edits - Revised CR12457
Split or Shared Evaluation and Management Visits
The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year (FY) 2020 for IPPS Hospitals, IRFs, and LTCHs CR12628
Transvenous (Catheter) Pulmonary Embolectomy NCD Section 240.6 CR12537
Update to RHC All Inclusive Rate (AIR) Payment Limit for Calendar Year (CY) 2022 CR12489
Update to the FQHC PPS for Calendar Year (CY) 2022 CR12490
Urgent Prior Authorization Request Submission Errors (PAR)
W7009 Reason Code Denying Claims in Error - Resolved 03/15/22 Alert
You Spoke. We Listened.
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