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Billing and Coding: The Value of Clinical Validation

Billing and Coding: The Value of Clinical Validation

by Michael Schubert, PhD | Jan 23, 2024 | CMS-lca, Coding-lca, Essential, Lab Industry Advisor, Reimbursement-lca

What clinical validation really means—and why every member of the laboratory should understand it.

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New CMS Rule Unlikely to Speed Medicare Coverage of Breakthrough Devices

New CMS Rule Unlikely to Speed Medicare Coverage of Breakthrough Devices

by Rachel Muenz | Sep 6, 2023 | News, Open Content

The recently proposed TCET rule appears to be too stringent to significantly hasten the Medicare coverage process for device makers.

Compliance Perspectives: How to Comply with the CMS 60-Day Overpayment Repayment Rule

Compliance Perspectives: How to Comply with the CMS 60-Day Overpayment Repayment Rule

by Glenn S. Demby | Sep 1, 2023 | Compliance Perspectives-lca, Essential, Lab Compliance Advisor

While overpayments may not be your fault, they expose your lab to the risk of liability under the Affordable Care Act.

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How to Ensure Proper Documentation for Billing Laboratory Services

How to Ensure Proper Documentation for Billing Laboratory Services

by Diana Voorhees, MA, MLS(ASCP)SH, CLCP, CPCO | Aug 31, 2023 | Essential, Lab Compliance Advisor, Reimbursement-lca

What do lab professionals need to do to ensure sufficient documentation for billing clinical laboratory and pathology services?

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Enforcement Trends: OIG Calls Out CMS for Not Preventing Medicare Genetic Testing Overpayments

Enforcement Trends: OIG Calls Out CMS for Not Preventing Medicare Genetic Testing Overpayments

by Glenn S. Demby | Aug 24, 2023 | Enforcement-nir, Essential, National Lab Reporter

Inadequate CMS oversight resulted in $888.2 million in improper payments for the highest reimbursing molecular pathology genetic tests, report says.

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