News
TELCOR is excited to share industry news and updates with our stakeholders across the country.
CMS Puts Patients Over Paperwork with New Rule Addressing the Prior Authorization Process
CMS finalized a signature accomplishment of the new Office of Burden Reduction & Health Informatics (OBRHI). This final rule builds on the efforts to drive interoperability, empower patients, and reduce [...]
COVID-19 News from UnitedHealthcare: Temporary Cost Share Waivers for Testing and Testing-Related Visits Extended
Individual and Group Market health plans: From Feb. 4, 2020 through the national public health emergency period, currently scheduled to end April 20, 2021, UnitedHealthcare is waiving cost sharing for [...]
Extreme and Uncontrollable Circumstances Exception
To further support clinicians during the COVID-19 Public Health Emergency (PHE), CMS extended the 2020 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception application deadline to February 1. [...]
Trump Signs COVID-19 Relief Package Provisions Affecting Pathologists, Laboratories
For several months, the CAP had urged Congress to enact additional relief to alleviate the effects of the coronavirus pandemic and further support pathologists and laboratories. In year-end legislation that [...]
ICD-10 Code Files for Fiscal Year 2021
In response to the COVID-19 public health emergency, new ICD-10 codes are effective January 1, 2021: 21 procedure codes (ICD-10-PCS): CMS will implement new codes to describe the introduction or [...]
Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.1
The latest package of NCCI Procedure-to-Procedure (PTP) edits, Version 27.1 effective April 1, 2021, will be available via the CMS Virtual Data Center (VDC). A test file will be available [...]
Addition of the QW Modifier to Healthcare Common Procedure Coding System (HCPCS) Codes 87811 and 87428
This article provides information regarding the addition of the QW modifier to the following CMS HCPCS codes: 87811 [Infectious agent antigen detection by immunoassay with direct optical (i.e., visual) observation; [...]
Congress Acts To Spare Consumers From Costly Surprise Medical Bills
Part of the COVID-19 relief bill passed by Congress on December 21, 2020 includes a provision on surprise medical billing starting in 2022. This measure helps in situations where patients [...]
Palmetto GBA Released COVID-19 Laboratory Test Pricing
Medicare payment amounts for COVID-19 tests, including nationally priced and Jurisdiction J and M Palmetto GBA contractor-priced codes, are now posted on the Palmetto GBA websites. This list includes Medicare payment [...]
Six New ICD-10 Diagnosis Codes for COVID-19 Created with Effective Date of 1/1/2021
In response to the national emergency that was declared concerning the COVID-19 outbreak, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) is implementing six [...]