The U.S. Centers for Disease Control and Prevention (CDC) issued official guidance to labs and other health care providers on which ICD-10-CM diagnosis codes to use for 2019 novel coronavirus … [Read more...]
Coronavirus
Reimbursement: Congress Calls on Insurers to Cover Coronavirus Testing without Charging Patients
March 17, 2020
As labs scramble to come up with a coronavirus detection assay and CMS creates a billing and coding regimen, Congress is working to ensure that private payors provide coverage of SARS-CoV-2 testing. … [Read more...]
ACLA
Lab industry leaders meet with White House on COVID-19 testing
March 8, 2020
The American Clinical Laboratory Association (ACLA) has issued a statement following a meeting last week with the White House's Coronavirus Task Force. Here is a statement from ACLA President Julie … [Read more...]
Coronavirus
Two commercial labs testing now for COVID-19
March 8, 2020
Two commercial lab companies have announced they are moving into testing for COVID-19. LabCorp. said Thursday it was immediately offering testing for COVID-19 and Quest Diagnostics has announced it … [Read more...]
Coronavirus
CMS Develops Additional Code for Coronavirus Lab Tests
March 8, 2020
On March 6, the Centers for Medicare & Medicaid Services (CMS) announced a second Healthcare Common Procedure Coding System (HCPCS) code that can be used by laboratories to bill for certain … [Read more...]
MACRA REQUIREMENT
How to Adjust to the April 2018 Medicare Beneficiary Cards
July 9, 2018
By Sean McSweeney bio In a press release on May 30, 2017, the Centers for Medicare & Medicaid Services (CMS) commented regarding their fraud prevention initiative program and their … [Read more...]
FEE SCHEDULES
Industry Buzz: ACLA Goes for Kill in PAMA Lab Fees Challenge Case
February 26, 2018
Attorneys for the American Clinical Laboratory Association asked the federal court for summary judgment in its lawsuit challenging the legality of the new PAMA-based Medicare Part B fee schedule for … [Read more...]
FEE SCHEDULES
OPPS 2018: Revised Payment Rates & a New ADLT Date of Service Exemption
November 13, 2017
With all of the PAMA commotion, CMS's publication of the 2018 Medicare Hospital and Ambulatory Surgical Outpatient Prospective Payment System (OPPS) final rule has flown under the radar. In case you … [Read more...]
TOP OF THE NEWS
PAMA-Geddon: CMS Slashes 2018 Part B Lab Rates
October 24, 2017
Resisting industry pleas for a delay, CMS is sticking to the Jan. 1 start date for the new PAMA payment system. Even worse, it's sticking to its misguided formula for pricing lab tests. Result: The … [Read more...]
MEDICARE COVERAGE
“Applicable Labs”: The Fly in the PAMA Market-Based Pricing Ointment
October 23, 2017
The lab industry has no objection to basing Medicare payments for lab tests on the actual rates charged to payors in the private market. What has the industry so upset is how CMS has executed the … [Read more...]
