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    Wiki BCBS Local Plan Question

    I work for an independent laboratory that has an ordering provider who straddles a state line. We're getting a bit of pushback regarding what would decide the local plan from the ordering provider because their NPI is registered in one state but the specimens are being ordered and obtained in...
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    Wiki Modifier QW Question

    I posted this question previously and thought I had found my answer so I deleted it like a dummy. However, I didn't so I wanted to ask again. I work at an independent laboratory that has a CoA CLIA and does urine tox, some molecular testing, and some blood testing. One of our Medicaid payers...
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    Wiki UT Medicaid Urine Drug Testing Carve-out

    I know this is a rather specific question so even if you have any input that would be fantastic. I've been going back and forth for the last 5-6 years with MCOs in Utah about the substance use disorder (SUD) carve out for UDT. The only place the carve-out is mentioned is in a MIB from April 2018...
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    Wiki CMS Rescinds UDT NCCI Edits

    Good news for my fellow lab billers! CMS has decided to retroactively rescind/delete the urine drug testing NCCI edits back to 7/1/23. I'm not sure what they hoped to accomplish with the edit, but apparently it wasn't the solution they hoped for. If they were looking for ways to put further...
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    Wiki Patient With Medicaid in 2 States - Who would you bill?

    I have occasionally come across patients who, somehow & some way, have active Medicaid in two states. For example, they have active Medicaid in Arizona while being active with Medi-Cal at the same time. I've also seen one state have a COB with another state (ex. Nevada Medicaid shows that...
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