BILLING & CODING

Medicare Reimbursement: CMS Begins Implementing New HOPPS Date of Service Rules for ADLTs & Molecular Pathology Tests

CMS has begun implementing the new rules that exempt advanced diagnostic laboratory tests (ADLTs) and molecular pathology tests from Medicare Hospital Outpatient Prospective Payment System (HOPPS) … [Read more...]

PAMA

PAMA Unlocks Golden Age for Innovative Diagnostics

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...]

FOCUS ON

Value Care: CMS Value Modifier Programs Ends Not with a Bang but a Whimper

Thanks for nothing. While CMS likes to congratulate itself for using provider pay adjustments to "transform the healthcare delivery system," more often than not, the rhetoric fails to live … [Read more...]

HEALTH CARE REFORM

Medicare Reimbursement: Federal Government Funding Extension Includes a Boatload of Medicare Changes

The government shutdown fiasco is having an impact on Medicare spending and reimbursement. But the crucial details are being buried in the legislative paperwork. So we decided to ferret them out for … [Read more...]

INSIDE THE LAB INDUSTRY

PAMA-geddon: Lab Industry Asks Court to Stop New Medicare Fee Schedule

With CMS refusing to back down, the lab industry has escalated the dispute and asked a U.S. District Court to step in and prevent enforcement of the 2018 PAMA-inspired Part B Clinical Lab Fee Schedule … [Read more...]

REIMBURSEMENT

Medicare Reimbursement: CMS Finalizes Controversial PAMA Fee Schedule

It's official. CMS is going forward with its controversial 2018 PAMA Clinical Laboratory Fee Schedule (CLFS). Regrettably, the final version closely tracks the preliminary one (See GCA, Oct. 24, 2017, … [Read more...]

MEDICARE REIMBURSEMENT

CMS Finalizes Controversial PAMA Fee Schedule

It's official. CMS is going forward with its controversial 2018 PAMA Clinical Laboratory Fee Schedule (CLFS). Regrettably, the final version closely tracks the preliminary one (See GCA, Oct. 24, 2017, … [Read more...]

COMPLIANCE

OIG Calls on CMS to Do Better at Medicare Collecting Overpayments

The system Medicare uses to detect and recover overpayments isn't working as well as it should be, according to a new OIG report. The Overpayment Collection System CMS relies on special contractors … [Read more...]

TOP OF THE NEWS

PAMA-Geddon: CMS Slashes 2018 Part B Lab Rates

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...]

REIMBURSEMENT TRENDS

Billing & Coding: Proposed New Molecular Pathology Crosswalk Codes for 2018

The newly proposed 2018 Clinical Laboratory Fee Schedule includes over 130 crosswalked CPT codes, including roughly 30 new codes for molecular pathology tests. New Crosswalked Molecular Pathology … [Read more...]


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