Avoid confusion when you open correspondence after Jan. 1. UnitedHealthcare (UHC) is changing its Medicare brands to a single moniker to “facilitate a simpler, more efficient relationship with providers and our members.” UHC’s SecureHorizons, AARP MedicareComplete from SecureHorizons, and Evercare brands are being replaced. New member cards are already reflecting these changes.
SecureHorizons and Evercare will be called UnitedHealthcare. Members of AARP’s program will be members of AARP MedicareComplete from UnitedHealthcare.
UHC has posted a FAQ on its website to help explain the change.
October 28th, 2011
The Centers for Medicare & Medicaid Services (CMS) announced, Oct. 14, in two national coverage determinations (NCDs) that it will add to the list of preventive services by covering alcohol misuse screening and behavioral counseling, as well as screening for depression.
The annual updated version of the National Correct Coding Initiative (NCCI) policy manual for Medicare services will be effective Jan. 1, 2012, rather than Oct. 1, 2011. This manual will be posted on the NCCI website on or around Dec. 1, 2011.
CMS posts changes to each of its NCCI and Medically Unlikely Edit (MUE) edit files on a quarterly basis. Download a test file of Version 18.0, effective Jan. 1, 2012, from the National Correct Coding Initiative Edits Quarterly NCCI and MEU Version Update Changes page on the Centers for Medicare & Medicaid Services (CMS) website. The final file will be available “on or about” Nov. 17, according to CMS Transmittal 2322.
Visit the National Correct Coding Initiative Edits Overview page on the CMS website for more information about NCCI.
TrailBlazer Health Enterprises, Medicare administrative contractor for jurisdiction 4 (J4 MAC), posted two new job aids in October:
Both job aids review TrailBlazer Local Coverage Determinations (LCDs) for Routine Foot Care and Mycotic Nail Debridement, as well as CMS-1500 claim form instructions and Medicare policy.
For all newly released and revised job-aid training and educational materials, scroll through the alphabetized list on the Trailblazer website.
The Oncotype DX® Colon Cancer Assay meets criteria for analytical and clinical validity and clinical utility as a reasonable and necessary Medicare benefit, Palmetto GBA announced after completing a recent assessment.
Effective Sept. 18, 2011 the jurisdiction 1 Part B Medicare administrative contractor (J1-B MAC) says it will reimburse Oncotype DX® Colon Cancer Assay services for patients diagnosed with stage II colon cancer.
The Oncotype DX® Colon Cancer Assay, developed to predict the recurrence risk for patients with stage II colon cancer, is a 12-gene RT-PCR assay performed on paraffin-embedded primary colon tumor tissue.
To report an Oncotype DX® Colon Cancer Assay service provided to a Medicare patient, Palmetto GBA requests providers to submit the following claim information:
- CPT® code 84999 Unlisted chemistry procedure
- Enter ‘Oncotype DX colon’ in the comment/narrative field
- Select the appropriate ICD-9-CM code: 153.0-153.9, 154.0-154.2
Source: Palmetto GBA, “What’s New,” Sept. 29, 2011