Latest News

MIPS 2023: Reporting for Pathologists

CMS has announced what lies ahead for the Merit-based Incentive Payment System (MIPS) program with proposed adjustments for the 2023 performance year, which impacts Medicare Part B payments in 2025.

2023 Proposed Medicare PFS: See Impact to Pathology

The proposed conversion factor is $33.08, a decrease of $1.53 to the 2022 PFS conversion factor of $34.61. Both pathology and independent laboratories are expected to see their overall allowed charges drop by -1%.

No Surprises Act Frequently Asked Questions

The No Surprises Act (NSA) provides individuals and families covered by group and individual health plans protection against unexpected, high-priced medical bills for services delivered at in-network facilities by out-of-network (OON) providers.

Case Study: Prostate Biopsy Billing Issues

Not only was the issue resolved to reprocess 95 claims for an additional payment of $70,000, but the payor’s system also was corrected so that claims would pay correctly moving forward and the client would not continue to have underpaid claims.

Covid Billing

OIG to Focus Audits on COVID Add-On Payments

The OIG has announced its intention to audit add-on payments for high-throughput technology made by Medicare for COVID-19 CDLTs. These audits are expected to begin in 2023.

Lessons from Executive War College 2022

Every year the sky is falling, at least that’s how it seems. I have been attending Executive War College since the 90s and thank God we’ve been able to change and adapt with the dramas of running a healthcare business. These are things I learned from presentations by Robert Michel, editor-in-chief of the Dark Report, and others:

Items to Watch as the Public Health Emergency Winds Down

Due to a number of COVID funds being exhausted or close to tapped out, this is likely to be the final extension. Here are some items to keep in mind as labs and pathologists prepare for the potential end of the PHE.

Covid variant testing

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.

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