WPS GHA Announces MolDx Expansion to J5 and J8

MAC J5 for Iowa, Kansas, Missouri, and Nebraska
MAC J8 for Indiana and Michigan

WPS GHA is collaborating with the Molecular Diagnostics (MolDx) contractor concerning Molecular Diagnostic Testing (MDT). As part of this collaboration, all laboratory service providers in the Jurisdiction 5 and 8 providing MDT must register those MDT procedures/services with the MolDx contractor and submit coverage requests prior to being considered for reimbursement. Providers will have until February 15, 2017, to complete this process for current and any new tests billed, before the claim is returned unable to process if the unique identifier is not present on the claim. As a CMS contractor, WPS GHA must determine reasonable and necessary services and apply fair reimbursement to services that are provided to Medicare beneficiaries. WPS GHA will work together with the CMS MolDX contractor to determine coverage. Such decision making includes a technical assessment of the test as well as its clinical utility in the care of a patient in accordance with the Medicare statutes and rules.

Source: https://www.wpsgha.com