Tag intelligence

Hematology reimbursement alerts

Reimbursement alerts filtered by specialty and region tags for faster analysis across coding, compliance, and revenue integrity.

Critical tag risk

Overview

36 alerts match the tag Hematology. Review high-value policy alerts and the underlying claims guidance that matters.

Quick stats

Alert count

36

Distinct policy codes

36

Average signal score

69

Related codes

Signal breakdown

36 shown · 36 total in platform

Risk: Critical
3

Critical

8%

25

High

69%

8

Routine

22%

0

Low

1%

New this month

+5

alerts added in last 30 days

Effective soon

no upcoming deadlines

FDA Approval: ARGATROBAN IN 0.9% SODIUM CHLORIDE (ARGATROBAN) — Type 5 - New Formulation or New Manufacturer

Policy FDA-NDA206769Hematology

Critical

Argatroban in 0.9% Sodium Chloride (NDA206769) is a new intravenous formulation of the established direct thrombin inhibitor argatroban, approved via a Type 5 submission by Teva Pharmaceuticals. As an

FDA Approval: SARCLISA (ISATUXIMAB) — Type 1 - New Molecular Entity

Policy FDA-BLA761113Hematology

Critical

Sarclisa (isatuximab) is an injectable CD38-directed cytolytic antibody approved for multiple myeloma, administered via intravenous injection and billing under Medicare Part B. As a hospital or office

FDA Approval: BESREMI (ROPEGINTERFERON ALFA-2B) — Type 1 - New Molecular Entity

Policy FDA-BLA761166Hematology

Critical

Besremi (ropeginterferon alfa-2b) is a subcutaneously administered injectable approved for polycythemia vera, supporting a Part B billing pathway as a physician-administered drug. As an orphan drug in

FDA Approval: ARGATROBAN (ARGATROBAN) — Type 5 - New Formulation or New Manufacturer

Policy FDA-NDA209552Hematology

High

The recent FDA approval of Argatroban as an injectable drug suggests it will likely be assigned a J-code for billing under Medicare Part B. Since it is an anticoagulant, providers may receive pass-thr

FDA Approval: ARGATROBAN IN DEXTROSE (ARGATROBAN) — Type 5 - New Formulation or New Manufacturer

Policy FDA-NDA201743Hematology

High

Argatroban in dextrose is an injectable medication that is likely to receive a J-code assignment for Medicare billing. Since it falls under Part B, billing may involve ASP+6% reimbursement if it meets

Proposed LCD DL39923: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms — Noridian

Policy LCD-DL39923Hematology

Routine

The proposed LCD for Non-Next Generation Sequencing Tests could limit coverage for certain diagnostic tests in evaluating BCR-ABL negative myeloproliferative neoplasms. Facilities may see a decrease i

Proposed LCD DL40000: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms — CGS

Policy LCD-DL40000Hematology

Routine

The proposed LCD on non-next generation sequencing tests for diagnosing BCR-ABL negative myeloproliferative neoplasms may lead to changes in reimbursement policies and coverage determinations, impacti

Proposed LCD DL40022: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms — WPS

Policy LCD-DL40022Hematology

Routine

The proposed LCD could significantly impact billing practices for non-next generation sequencing tests used in diagnosing BCR-ABL negative myeloproliferative neoplasms. It may lead to a more stringent

Proposed LCD DL40238: MolDX: Genetic Testing for Hereditary Thrombophilia — Palmetto GBA

Policy LCD-DL40238Hematology

Routine

The proposed LCD on genetic testing for hereditary thrombophilia could influence billing practices related to genetic testing claims. Providers may need to ensure compliance with the new guidelines to

Proposed LCD DL40259: MolDX: Genetic Testing for Hereditary Thrombophilia — CGS

Policy LCD-DL40259Hematology

Routine

The proposed Local Coverage Determination (LCD) for genetic testing related to hereditary thrombophilia could significantly impact claims processing and reimbursement rates for genetic tests in this a

Proposed LCD DL40242: MolDX: Genetic Testing for Hereditary Thrombophilia — Noridian

Policy LCD-DL40242Hematology

Routine

The proposed Local Coverage Determination (LCD) for genetic testing related to hereditary thrombophilia requires billing team review

Proposed LCD DL40274: MolDX: Genetic Testing for Hereditary Thrombophilia — WPS

Policy LCD-DL40274Hematology

Routine

The proposed LCD on genetic testing for hereditary thrombophilia could lead to enhanced coverage for specific tests, impacting the way providers bill for related services. This may increase the number

Proposed LCD DL40334: Erythropoiesis Stimulating Agents — NGS

Policy LCD-DL40334Hematology

Routine

The proposed LCD for Erythropoiesis Stimulating Agents may significantly influence billing practices for providers utilizing these treatments. Depending on the final decision, there could be changes t

LCD L40000: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms — CGS

Policy LCD-L40000Hematology

High

The LCD outlines coverage for non-next generation sequencing tests for diagnosing BCR-ABL negative myeloproliferative neoplasms, which may significantly influence reimbursement policies. Providers wil

LCD L39919: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms — Palmetto GBA

Policy LCD-L39919Hematology

High

The new LCD on Non-Next Generation Sequencing Tests for BCR-ABL Negative Myeloproliferative Neoplasms could lead to supports compliance with updated rates for these tests. This may impact reimbursement rates a

LCD L40022: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms — WPS

Policy LCD-L40022Hematology

High

With the new LCD regarding non-next generation sequencing tests for diagnosing BCR-ABL negative myeloproliferative neoplasms effective from August 17, 2025, providers must ensure adjustments are made

LCD L36400: MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR) — WPS

Policy LCD-L36400Hematology

High

The implementation of this new LCD on genetic testing for hypercoagulability may create billing complexities for providers. It emphasizes the need for proper documentation and ICD-10 coding to ensure

LCD L36186: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease — Noridian

Policy LCD-L36186Hematology

High

The implementation of the MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease LCD may impact the billing processes for providers, particularly in the areas of documentation and codi

LCD L36180: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease — Noridian

Policy LCD-L36180Hematology

High

The implementation of this Local Coverage Determination (LCD) by Noridian may affect the billing process for genetic testing related to BCR-ABL negative myeloproliferative disease. Providers should en

LCD L36117: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease — CGS

Policy LCD-L36117Hematology

High

The new LCD for genetic testing of BCR-ABL negative myeloproliferative disease will impact billing by establishing specific criteria for coverage, thereby influencing reimbursement rates and patient a

LCD L36044: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease — Palmetto GBA

Policy LCD-L36044Hematology

High

The recent LCD from Palmetto GBA affects billing for genetic testing related to BCR-ABL Negative Myeloproliferative Disease. Providers must ensure compliance with the updated guidelines to avoid claim

LCD L36815: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease — WPS

Policy LCD-L36815Hematology

High

The new LCD for genetic testing related to BCR-ABL negative myeloproliferative disease will clarify billing procedures and permissible tests. It is crucial for claims to align with the specified crite

LCD L36155: MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR) — Noridian

Policy LCD-L36155Hematology

High

The introduction of the new LCD for genetic testing related to hypercoagulability may have significant billing implications for providers. It will be essential for practices to verify patient eligibil

LCD L36159: MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR) — Noridian

Policy LCD-L36159Hematology

High

The new MolDX guidelines for genetic testing related to hypercoagulability and thrombophilia will require careful attention to billing compliance. This may lead to an supports compliance with updated rates inquiries rel

LCD L39923: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms — Noridian

Policy LCD-L39923Hematology

High

The introduction of LCD for non-next generation sequencing tests will impact the billing process for myeloproliferative neoplasms diagnosis, necessitating updates to coding practices. Providers must e

LCD L39927: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms — Noridian

Policy LCD-L39927Hematology

High

The implementation of the LCD for non-next generation sequencing tests for diagnosing BCR-ABL negative myeloproliferative neoplasms requires billing team review

LCD L39396: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin — Noridian

Policy LCD-L39396Hematology

High

The coverage policy for allogeneic hematopoietic cell transplantation in treating primary refractory or relapsed Hodgkin's and Non-Hodgkin's lymphomas may significantly impact billing practices, as th

LCD L34314: Immune Globulin Intravenous (IVIg) — Noridian

Policy LCD-L34314Hematology

High

The upcoming LCD for Immune Globulin Intravenous (IVIg) may lead to changes in billing practices and reimbursement rates for providers. It is essential for healthcare professionals to prepare for pote

LCD L39434: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin — CGS

Policy LCD-L39434Hematology

High

The new LCD will impact billing for allogeneic hematopoietic cell transplantation procedures in patients with primary refractory or relapsed lymphoma. Providers should ensure proper coding and documen

LCD L34356: Erythropoiesis Stimulating Agents (ESA) — CGS

Policy LCD-L34356Hematology

High

The introduction of new LCD for Erythropoiesis Stimulating Agents may impact billing procedures due to the specific guidelines outlined by CGS. Providers need to ensure that their documentation suppor

LCD L39398: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin — Noridian

Policy LCD-L39398Hematology

High

The recent LCD from Noridian for Allogeneic Hematopoietic Cell Transplantation will likely impact billing for providers treating patients with refractory or relapsed Hodgkin's and Non-Hodgkin's Lympho

LCD L38268: Immune Thrombocytopenia (ITP) Therapy — CGS

Policy LCD-L38268Hematology

High

The new LCD for Immune Thrombocytopenia (ITP) therapy set to take effect on March 5, 2026, will impact billing practices for related services. Providers will need to review and adjust their coding and

LCD L35891: Intravenous Immune Globulin — CGS

Policy LCD-L35891Hematology

High

The effective date of the LCD for Intravenous Immune Globulin may affect billing practices as it introduces new criteria for reimbursement. Providers will need to be aware of updated documentation and

LCD L33610: Intravenous Immune Globulin — CGS

Policy LCD-L33610Hematology

High

The introduction of the LCD for Intravenous Immune Globulin by CGS could significantly impact billing practices for healthcare providers. Effective April 1, 2026, adherence to the guidelines outlined

FDA Approval: ULTOMIRIS (RAVULIZUMAB) — Type 1 - New Molecular Entity

Policy FDA-BLA761108Hematology

High

Ultomiris (Ravulizumab), an injectable complement inhibitor, is likely to be assigned a J-code for billing under Part B. The drug is classified as a high-cost therapy, which may result in additional r

FDA Approval: SOLIRIS (ECULIZUMAB) — Type 1 - New Molecular Entity

Policy FDA-BLA125166Hematology

High

Soliris (Eculizumab) is an injectable drug that will likely be assigned a J-code for Medicare billing. As a Part B candidate, it may qualify for pass-through payment and be reimbursed at the Average S