Noridian Medicare specifically regions JE California, Hawaii, Nevada, American Samoa, Guam and the Northern Mariana Islands. Region JF Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming. Have had all chiropractic claims denied improperly with a reason code of CO50, not medically necessary. Noridian Medicare has Read more…
Medicare Fees were slightly adjusted from the published rates from 2019. HJ Ross Network members please request your updated fees. Note the fee changes were minor some regions had no change with other slight increases or slight reductions. Deductible did not update and remains $198. Note the âparâ rate is Read more…
Optum Health will begin covering the VA for states essentially east and north of Texas. If youâre a provider in VA CCN Regions 1, 2, or 3 and youâre transitioning to Optum for the new CCN contract, you can still accept TriWest authorizations during any overlap period and bill for those services. Read more…
California Blue Cross Claims submitted on or after October 1, 2019 will be subject to a ninety (90) day timely filing requirement, and Blue Cross will refuse payment if submitted more than ninety (90) days after the date of service. If Plan is the secondary payor, the ninety (90) day Read more…
Recent claims for VA under the PC3 program We have noted recent payment denials for manual therapy 97140 and massage 97124 even with GP and 59 modifiers. It appears the VA is adopting the CCI edits and bundling both codes to CMT when done to the same region. This, of Read more…
Horizon BCBSNJ previously announced plans to collaborate with American Specialty Health (ASH) to implement and administer their Chiropractic & Physical Medicine Services Program for acupuncture, chiropractic, occupational therapy, physical therapy and speech therapy, effective January 1, 2020, subject to regulatory approval by the New Jersey Department of Banking and Insurance. Read more…
2020 ICD10-CM Updates 71,932 codes in ICD10-CM 2018 72,184 codes in ICD10-CM 2019 273 New Codes 21 Deleted Codes 30 revisions As occurs every October 1 there are additions and deletions to the ICD10 code set. This year is had very minor updates and changes related to chiropractic coding and Read more…
We have received information from sources with direct contact with ASH representatives that stated that the contract between ASH and Blue Shield of California will not go through if there is not a high enough percentage of providers who enroll Note the benefits nor allowed amounts do not change whether Read more…
The latest update for 2020 Blue Shield of California ASH Plans, directly from ASH 1. The Blue Shield PPO plans to move to ASH January 1, 2020, are as follows: ⢠Individual and Family Plans (IFP): on-exchange and mirrored. The small business group plans: on-exchange and mirrored These plans do Read more…
The latest information is indicating that the visit threshold will be 5 visits whether a provider is in our out of network and allowances will be the same for in and out of network services. Patients may have lesser copays or deductibles for in-network providers. Self-funded plans under Blue Read more…