April 2024

A listing of the individual articles included in the Jurisdiction E Medicare A News bulletin dated April 2024 is provided. Each article title functions as a hyperlink to a specific article.

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Articles Source
2024 Annual Update of HCPCS Codes for SNF CB Update CR13394
2024 Annual Update of Per-Beneficiary Threshold Amounts CR13371
2024 Annual Update to the Therapy Code List CR13341
2024 CPT/HCPCS Local Coverage Article (LCA) Updates
340B Drug Payment Policy Remedy Payment for Calendar Year (CY) 2018 to CY 2022
Activation of Validation Edits for Providers with Multiple Service Locations - Revised SE19007
Additional Self-Service Requirements Effective February 5, 2024
AIF for Calendar Year (CY) 2024 and Productivity Adjustment - Rescinded CR13400
Appropriate Use Criteria for Advanced Diagnostic Imaging: CY 2024 Update CR13485
April 2024 Update to the MS-DRG Grouper and MCE Version 41.1 CR13458
Billing and Coding: FDA Approved CLL Companion Diagnostic Test (A56009) Retirement - Effective March 30, 2023
Billing and Coding: Implantable Infusion Pumps for Chronic Pain (A55239) - R16 - Effective January 1, 2024
Billing and Coding: Minimal Residual Disease Testing for Hematologic Cancers (A58996) - R5 - Effective January 1, 2024
Billing and Coding: MolDX: DecisionDX-Melanoma (A57417) Retirement - Effective August 8, 2022
Billing and Coding: MolDX: Fragile X (A55241) - R6 - January 1, 2024
Billing and Coding: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease (A57421) - R10 - Effective January 1, 2024
Billing and Coding: MolDX: Microsatellite Instability-High (MSI-H) and Mismatch Repair Deficient (dMMR) Biomarker for Patients with Unresectable or Metastatic Solid Tumors (A56103) - R4 - Effective January 1, 2024
Billing and Coding: MolDX: Minimal Residual Disease Testing for Solid Tumor Cancers (A58454) - R6- January 1, 2024
Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer (A58718 ) - R3 - Effective March 12, 2024
Billing and Coding: MolDX: Molecular Diagnostic Tests (MDT) (A57526) - R16- January 1, 2024
Billing and Coding: MolDX: Molecular Diagnostic Tests (MDT) (A57526) - R17 - Effective January 1, 2024
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (A58720) - R15 - January 1, 2024
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (A58720) - R16 - Effective April 17, 2022
Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection (A58168) - R6 - Effective February 29, 2024
Billing and Coding: MolDX: Next-Generation Sequencing for Solid Tumors (A57901) - R6 - Effective January 1, 2024
Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies (A57891) - R7 - Effective January 1, 2024
Billing and Coding: MolDX: Pharmacogenomics Testing (A57384) - R13 - Effective January 25, 2024
Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors (A58973) - R4 - Effective January 1, 2024
Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer (A58181) - R7 - Effective January 1, 2024
Billing and Coding: MolDX: Proteomics Testing (A59641) - Effective January 31, 2024
Billing and Coding: MolDX: Proteomics Testing (A59641) - R1 - Effective January 31, 2024
Billing and Coding: MolDX: Proteomics Testing (A59641) - R2 - Effective January 31, 2024
Billing and Coding: MolDX: Repeat Germline Testing (A57331) - R10 - January 1, 2024
Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile Next-Generation Sequencing Testing in Cancer (A55624) - R10 - Effective March 21, 2024
Billing Requirements for IOP Services for Federally Qualified Health Centers & Rural Health Clinics CR13264
Changes to the Laboratory NCD Edit Software: July 2024 Update CR13554
Clinical Laboratory Fee Schedule & Laboratory Services Reasonable Charge Payment: Quarterly Update CR13541
Comprehensive Outpatient Rehabilitation Facility Services: Prevent Claim Denials
CORRECTION: Leqembi-Related Drug Clinical Trial Number
eMDR via the Electronic Submission of Medical Documentation System - Revised CR11003
ESRD Dialysis Line Level Covered Charges Under 100 Dollars - Resolved 11/15/23 Alert
Federally Qualified Health Center (FQHC) Prospective Payment System (PPS): Final Rule Updates
HCPCS Codes Used for SNF CB Enforcement: April 2024 Quarterly Update CR13501
HCPCS J0129 with JA Modifier Denied in Error for SAD Exclusion List - Resolved 02/21/23 Alert
Health Equity Services
HIPPS Codes Rejections in EDI - Resolved 12/08/23 Alert
Holding Claims for Pricing Based on the April 2024 FISS Release
Holding Claims for Pricing Based on the January 2024 FISS Release
Hospital Outpatient Prospective Payment System: January 2024 Update CR13488
How to Use the Office & Outpatient Evaluation and Management Visit Complexity Add-on Code G2211 CR13473
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