News-At-A-Glance: Illinois Could Prohibit Markup of AP Services

The Illinois Senate has passed a bill, SB 1630, that would require physicians to disclose the name and address of the laboratory that provided the anatomic pathology (AP) service and the amount the … [Read more...]

Compliance Corner

We are seeing more cases where an organ panel is ordered in the morning that contains an abnormal result. After treatment, the panel is followed up by an order later the same day for only the abnormal … [Read more...]

Compliance Perspectives: Keeping Legal Advice In-House: Protecting the Attorney-Client Privilege

Given that laboratories operate in a heavily regulated environment, the advice of legal counsel is integral to ensuring compliance with the many laws and regulations that govern the laboratory … [Read more...]

ABN Deemed Invalid by QIC Because It Used an Abbreviation

A properly executed and signed Medicare advance beneficiary notice (ABN) that used the term PSA in place of prostate-specific antigen was deemed invalid in an appeal by a hospital laboratory after the … [Read more...]

Laboratory Instrument Provider Accused of Health Care Fraud

A North Carolina-based manufacturer and provider of laboratory instruments and reagents, Carolina Liquid Chemistries Corp. (CLC) and its owners, were served with federal search warrants on May 7 … [Read more...]

Compliance Corner

Do you have a question about laboratory billing and coding or other compliance concerns? Send your question in and it may be addressed in a future Compliance Corner. Please send questions to … [Read more...]

Compliance Perspectives: Compliance Warning: Watch Out for 2015 Laboratory Drug CPT® Code Changes

The American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS) have posted the preliminary new, revised, and deleted CPT® codes for 2015. The Drug Testing and the … [Read more...]

Comparative Billing Report Identifies Special Stain Outliers

Approximately 5,000 individual providers of tissue exams by pathologists in August received a comparative billing report (CBR) that compared their billing patterns for immunohistochemistry (IHC) and … [Read more...]

Medicare Provides Details on How to Bill For Hepatitis C Screening

The Clinical laboratories should pay close attention to two new Medicare transmittals that explain how to bill for the new hepatitis C virus (HCV) screening benefit since claims that violate frequency … [Read more...]

Compliance Perspectives: Defending the Medical Necessity of Anatomic, Clinical Pathology Services

"Thou shalt bill only medically necessary services.” Even though the term medical necessity appears in nearly every coverage policy issued by payers and insurers, its precise meaning remains elusive. … [Read more...]