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Medical Mutual of Ohio Denials on IHC

Once again we find another carrier creating a policy reflective of the Local Coverage Determination (LCD) that was published recently by WPS Medicare. Medical Mutual of Ohio (MMO) had tied the 88342 code to Lynch Syndrome tumor testing, thus requiring a prior authorization for any 88342 that comes through their door for processing.

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Codes G0461 & G0462 Denying in Error

Yes folks, another issue with the G0461 and G0462 codes, this time due to a missed update to the Skilled Nursing Facility (SNF) consolidated billing code edit lists.

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Cause for Concern with new BCBS of Georgia Provider Agreement

It appears that Blue Cross Blue Shield of Georgia (BCBSGA) may be changing the rules without giving participating physicians fair advance notice. A new Blue Cross Blue Shield of Georgia (BCBSGA) provider agreement will automatically go into effect on November 15, 2014, replacing existing agreement(s).

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