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...]
Coronavirus
Reimbursement: Congress Calls on Insurers to Cover Coronavirus Testing without Charging Patients
March 17, 2020
REIMBURSEMENT
Genetic Testing: New Medicare Early NGS Cancer Test Coverage Policy Is Less than Meets the Eye
January 3, 2020
For Myriad Genetics, Foundation Medicine and other manufacturers of next-generation sequencing (NGS)-based test panels for early-stage cancer risk assessment, the recent announcement of CMS’ decision … [Read more...]
CO-ORDINATING DATA
Laboratory Information Systems (LIS): What You Need To Know To Get Paid
September 30, 2019
By Sean McSweeney bio Today, laboratory billing claims require more and more data to successfully get paid. One of the biggest reasons your claims may be getting denied is because you're not … [Read more...]
PAYER CONTRACTS
Three key items to negotiate for successful payer contracts
April 8, 2019
By Steve Selbst bio The purpose of this article is to help you, as a provider, to focus on three key items to look for in payer contracts that will help you to get profitable contracts in … [Read more...]
PAMA
Medicare Reimbursement: Part B Lab Payments in Final Year before PAMA
November 5, 2018
Part B payments for lab tests in 2017, the final year under the old reimbursement rules, totaled $7.1 billion, up slightly from the $6.8 billion Medicare paid in 2016 and little changed over the … [Read more...]
PUBLIC HEALTH
Toxicology Laboratories Play Key Role in Curbing the Drug Addiction and Opioid Epidemic
September 24, 2018
The National Independent Laboratory Association's (NILA's) Opioid Task Force is releasing a white paper entitled Curbing Drug Addiction and the Opioid Crisis: The Role of Toxicology Laboratories in … [Read more...]
EARNINGS
How to Avoid a Laboratory Audit
August 20, 2018
By Sean McSweeney bio Laboratory audits have a much harder impact on your lab than intended. As detailed by the NCBI, the audit's intent is to review and assess laboratory performance to … [Read more...]
PAMA
PAMA Unlocks Golden Age for Innovative Diagnostics
July 30, 2018
By Chance Scott bio The publication of the 2018 Clinical Laboratory Fee Schedule (CLFS) in January saw a long and heated debate within the lab community come to fruition. When Congress … [Read more...]
FEE SCHEDULES
How PAMA’s Effect in 2018 Molecular Diagnostic Reimbursement Will Make Labs More Money
June 25, 2018
By Sean McSweeney bio The year 2018 is slated to be much brighter for molecular diagnostic labs as PAMA fee schedules show a higher payment rate and amount for many cancer genomics and … [Read more...]
COVERAGE
Emerging Tests: Medicare to Cover Next Gen-Sequencing Tests for Advanced Cancer
March 26, 2018
In the PAMA era, there are two salient trends in Medicare Part B lab reimbursements: Sharply lower prices for traditional tests; and Wider coverage of newly emerging tests, including some that … [Read more...]
