RCM Strategies to Explore for Genetic Testing Compliance
Expert Ashley Zarling details nuances for clinical lab directors and compliance teams
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Articles and Reports
Recent MD Labs Ruling Has Implications for Test Requisitions and Commissions
A federal appeals court upheld the idea that clinical laboratories can rely on physician orders to justify medical necessity
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OIG Report on Lab Testing Should Prompt Compliance Review
Genetic testing now accounts for 43 percent of all Medicare Part B laboratory spending
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CMS Sheds New Light on Proper Use of Modifier 59
Due to the common misuse of this modifier, the Centers for Medicare & Medicaid Services recently issued important new guidance on its proper use.
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Getting Paid: How to Complete the ABN Form
Completing the Advance Beneficiary Notice of Noncoverage form can be extremely complex; this guide helps simplify the process.
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How Labs Can Avoid Problems When It Comes to Standing Orders
New CMS guidance includes information on how labs can avoid Medicare claims denials and documentation violations related to standing orders.
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Federal Court Calls PAMA Rule “Arbitrary,” but Refuses to Strike It Down
D.C. Circuit Court of Appeals agrees with lab industry that CMS got Medicare lab pricing all wrong, but says it’s unable to intervene.
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When & How to Use Changed Clinical Laboratory Consult Codes
Use of these codes has frequently raised concerns for compliance due to a lack of clarity regarding when they’re appropriate.
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The 14-Day Rule & Billing Medicare for Tests on Stored Specimens
While this reimbursement rule has been in effect since 2018, it can still be quite confusing; this article provides a guide to the basics.
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Billing & Coding of Outside Pathology Consultations
A briefing of the current requirements you can use to avoid billing and coding errors at your own lab or pathology practice.
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Genomic Tests for Prostate Cancer Risk Stratification Are Now Covered
A newly finalized local coverage determination from MAC Palmetto GBA sets out coverage criteria for two applications of these tests.
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Medicare Reimbursement Briefing: How Will Recent Changes Affect You?
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The 6 Changes to the 2022 Physician Fee Schedule Most Likely to Affect Your Lab
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