Reimbursement

Feds Say Insurers Not Required to Pay for Employer Return to Work COVID-19 Testing

June 30, 2020

Since the public health emergency began, the US government has taken the position that insurers shouldn’t be allowed to make consumers pay for COVID-19 lab tests. But now comes news that insurers will … [Read more...]

Billing & Coding

AMA Creates New CPT Code 87426 for COVID-19 Antigen Testing

June 30, 2020

On June 24, the American Medical Association Current Procedural Terminology (CPT) approved new CPT code 87426 to report COVID-19 antigen tests, which use immunofluorescent or immunochromatographic … [Read more...]

Billing & Coding

CMS Issues Reminders for Billing COVID-19 Specimen Collection & Symptom/Exposure Assessment

June 29, 2020

On June 18, CMS offered up some guidance on billing Medicare for COVID-19 symptom and exposure assessment and specimen collection performed on and after March 1, 2020: Use CPT code 99211 to bill … [Read more...]

Congress to HHS

Give Labs the Money They Need to Develop COVID-19 Testing Capacity

June 17, 2020

This is a bad time to be a clinical lab in the U.S. Although a recovery seems to be in the works, the pandemic has drastically reduced testing for just about anything and everything other than … [Read more...]

Labs In Court

A roundup of recent cases and enforcement actions involving the diagnostics industry

June 3, 2020

Whistleblower Lawsuit Can’t Start Until Criminal Investigation Ends  Case: Two former MedComp Laboratory Sciences employees filed a whistleblower lawsuit accusing the lab of concocting an elaborate … [Read more...]

Medicare Reimbursement

CMS Waivers Expand COVID-19 Testing Coverage Rules

June 1, 2020

On May 1, CMS issued regulatory waivers temporarily expanding coverage and clarifying billing of COVID-19 testing for Medicare and Medicaid beneficiaries during the public health emergency (PHE). Here … [Read more...]

COVID-19 Relief

HHS Clarifies Rules for Receipt of Provider Relief Fund Payments

May 27, 2020

If like so many other providers trying to survive COVID-19 business disruption, your lab is getting federal CARES relief payments, you need to be aware of the recent rule changes announced by HHS. … [Read more...]

CARES Act

CMS Issues Guidance on Private Payor Reimbursement of COVID-19 Testing

May 24, 2020

If your lab is performing COVID-19 testing for patients covered by private insurance and health plans, you need to be aware of the reimbursement rules set out in the new COVID-19 relief legislation. … [Read more...]

Medicare Reimbursement

New CMS Waivers Dramatically Expand Coverage Rules for COVID-19 Testing

May 24, 2020

CMS doesn’t want the usual compliance red tape to stand in the way of desperately needed COVID-19 testing. So, on May 1, the agency issued regulatory waivers temporarily expanding coverage of testing … [Read more...]

CMS

Reimbursement of COVID-19 Testing: Private Payors

May 2, 2020

COVID-19 relief legislation, i.e., the Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security Act (CARES) require payors to cover COVID-19 testing without … [Read more...]


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