Starting Jan. 1, 2022, this new enterprise-wide policy, Preventive Medicine & Screening, gives you guidance on the appropriate use of Evaluation & Management (E&M) Codes when billing for preventive screening services. In addition, you can now see the quarterly updated version of the Preventive Services List (Commercial) for EmblemHealth and for ConnectiCare.
Definitive Drug Testing (Commercial & Medicaid)
Definitive drug testing, also known as confirmation testing, is used when it is necessary to identify specific medications, illicit substances, and metabolites. Starting Jan. 1, 2022, our claims system will be updated to automate the limitations and exclusions section of our policy regarding HCPCS codes G0481-G0483. See full article on definitive drug testing.
New Policy for Commercial Members in 2022: No Cost/Reduced Cost Drugs, Implants & Devices
Starting Jan. 1, 2022, the No Cost/Reduced Cost Drugs, Implants & Devices Reimbursement Policy will be applied to both inpatient and outpatient hospital services for both EmblemHealth and ConnectiCare commercial members in the same way that we have been processing Medicare claims since Jan. 1, 2020. This policy has coding guidelines for reporting drugs, devices, and/or implants with their associated Change of Address (and Contact) Notification Providers must notify Medicaid of any change of address, telephone number, or other pertinent information within 15 days of the change. For more detail on this requirement and how to submit changes, click to read Reminder: Keep Your Directory Data Current. Medicaid: New York State Medicaid Update The Office of Health Insurance Programs of the New York State Department of Health regularly posts a Medicaid Update. Click here to view their latest announcements. procedures when obtained by the provider at full cost, no cost, or at a reduced cost.
