Latest News
Automatic 2021 MIPS exemptions granted by CMS
Earlier this month, CMS announced individual clinicians required to report Merit-based Incentive Payment System data in the 2021 performance year will be granted an automatic exemption due to the ongoing COVID-19 Public Health Emergency (PHE).
HHS withdraws policy for LDTs to bolster Covid test review
The policy directed FDA not to enforce premarket review requirements for LDTs. HHS said this move will help to ensure Covid tests are more reliable.
Inflation Medicare cuts and the pinch point of community pathology revenue
I believe the revenue world of pathology is currently in a pinch point, an area of extreme danger which will change the industry going forward.
2022 CPT updates for pathology consults
The following are 2022 Current Procedural Terminology (CPT) coding updates for pathology consultations.
Laboratory revenue cycle management in a non-post-pandemic world
I heard the phrase “post pandemic” this week and thought to myself, “Are we ever going to be in a post-pandemic state, or has the world changed?” As I have said all along, things seen cannot be unseen. I think we are going to be living in a Covid world going forward.
Waiting for the magic pill of Covid treatment
I like to look at health care like my old computer. There is a software side and a hardware side. The software to me, is the vaccines, drugs and treatments of a disease. The hardware is the tests and diagnostic tools.
2022 Covid-19 coding updates and revisions
The following updates and revisions for Covid-19-related codes became effective Oct. 1, 2021:
Cigna again moves to end PC clinical pathology payments
After holding off on the move during the summer amid significant pushback from pathology and lab advocates, Cigna appears to again be moving forward with its plan to end reimbursement for the professional component of clinical pathology (PC/CP) beginning Nov. 1, 2021.
Aetna to reduce timely filing limits for non-par providers in 2022
Aetna has announced timely filing limits for non-participating providers will be reduced from 27 months to 12 months for traditional medical claims beginning Jan. 1, 2022.
As Medicare enrollment approaches, ensure seniors in your life are prepared
Medicare open enrollment begins Oct. 15 and runs through Dec. 7. If you have elderly parents, aunts, uncles, or friends, talk to them about changes they want to make.
UHC Medicare Advantage claims to require DEX Z-code beginning Oct. 1
Given this news, now would be a great time to review your test compendium and payer mix. Are there any qualifying tests that need to be registered on the MolDX?
Case study: Utilizing the Covid-19 Coverage Assistance Fund
The Covid-19 Coverage Assistance Fund was created to cover the cost of administering the vaccine to patients whose insurance doesn't cover vaccination.
First Provider Relief Fund spending reports due Sept. 30
Health care providers who received distributions from the Health and Human Services Provider Relief Fund between April 1 and June 30, 2020, must submit their first report on use of those funds by Sept. 30, 2021.
Most private payers reinstate cost sharing for Covid hospitalizations
With Covid-19 vaccines now readily available, most private payers have moved to reinstate cost sharing for Covid-19-related hospitalizations and treatments.
As more labs perform Covid variant testing, will payors reimburse?
“This is not the same Covid as last year and there are treatment implications with each variant,” says Dr. William Budd. “The severity of the strain of Covid can vary. It is medically significant to know if your patient has an aggressive variant vs. a less aggressive variant.
Who's reviewing revenue strategy with you at this time?
Are you billing all the correct CPT codes? You’d be surprised at what you might be missing. We will review your Fee Schedule/Charge Master at no cost.
That’s right. For free.