May 2023

UHC’s Z-Code Requirement for Molecular Test Claims Starts Aug. 1

In what may be an alarming development for certain clinical laboratories, as of Aug. 1, UnitedHealthcare will require Z-codes for molecular test claims filed under its commercial health plans. Labs unfamiliar with Z-codes have only a short window of time to register for the codes and collect needed clinical data to support accuracy and utility. …

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For Labs, a Little Angel and Devil Sit Behind Z-Codes

Commentary and Opinion by R. Lewis Dark / By R. Lewis Dark

Much lies underneath the surface of UnitedHealthcare’s (UHC) new policy mandating Z-code use for molecular tests covered under its commercial health plans. It’s a development that creates headaches for many genetic testing companies. As we explain in our lead story starting here, as of Aug. 1, UHC will require Z-codes for molecular tests that use …

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UHC’s Z-Code Requirement to Commence on Aug. 1

Clinical Laboratory, Clinical Laboratory Trends, Genetic Testing, Lab Intelligence, Laboratory Compliance, Molecular Diagnostics / By Scott Wallask

CEO SUMMARY: In what may be an alarming development for certain clinical laboratories, as of Aug. 1, UnitedHealthcare will require Z-codes for molecular test claims filed under its commercial health plans. Labs unfamiliar with Z-codes have only a short window of time to register for the codes and collect needed clinical data to support accuracy …

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Data Analytics Improves Lab Productivity, Turnaround Time

Clinical Laboratory, IVD/Lab Informatics, Laboratory Management, People / By Scott Wallask

CEO SUMMARY: An increased ability to analyze internal diagnostic data helped MultiCare Health System improve laboratory test turnaround times in real time and more efficiently staff its locations on a day-to-day basis. The data analysis tools also provided insights into the performance of MultiCare’s lab outreach sales teams. Faced with a growing need to objectively …

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UnitedHealthcare Policy Change Requires NPI Numbers on Medicare Advantage Claims

Laboratory Billing, Laboratory Compliance / By Robert Michel

ANOTHER NEW POLICY RECENTLY ANNOUNCED by UnitedHealthcare (UHC) sets a deadline for June 1, 2023, requiring clinical laboratories and other ancillary providers to include the ordering physician’s National Provider Identifier (NPI) for UHC’s Medicare Advantage plans. UHC published this change in its May 2023 Medicare Advantage Reimbursement Policy Update Bulletin as follows: Effective with date …

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CLIA Lab Accreditors Reveal Most Frequent Deficiencies

Clinical Laboratory, Lab Risk & Compliance, Laboratory Compliance / By Scott Wallask

CEO SUMMARY: CAP, The Joint Commission, COLA, and A2LA took the stage at the recent Executive War College to detail their respective lists of the 10 most often-cited standards during their labs inspections in 2022. In presenting these citation rundowns, several common deficiencies repeatedly appeared. These include incomplete assessments of employee competency, inadequate proficiency testing, …

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CMS Ends Remote Reading of Pathology Glass Slides

Anatomic Pathology, Digital Pathology, Lab Risk & Compliance, Laboratory Compliance, Pathology Trends / By Scott Wallask

CEO SUMMARY: On the day the federal government ended the public health emergency for SARS-CoV-2, CMS issued an updated FAQ that ended the allowance for remote reviews of glass slides by pathologists. Remote digital image reviews by pathologists and other lab personnel can continue for now. EFFECTIVE IMMEDIATELY, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES …

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Elizabeth Holmes Still Wants ‘To Contribute’ in Healthcare

Clinical Laboratory, Lab Risk & Compliance, Laboratory Compliance, Laboratory Equipment, People / By Scott Wallask

CLINICL LABORATORY AND ANATOMIC PATHOLOGY PROFESSIONALS have another reason to shake their heads at the Elizabeth Holmes saga. On May 6, The New York Times ran a strange, somewhat fawning profile piece about Holmes, the convicted founder and former CEO at Theranos. In the story, Holmes contended that she still thinks about contributing to the …

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Despite COVID-19 Losses, IVD Executives Remain Upbeat

Clinical Laboratory, In Vitro Diagnostics, IVD/Lab Informatics, Laboratory Equipment / By Donna Marie Pocius

Continuing declines in COVID-19 test revenues was a common theme during the first quarter 2023 earning reports released by the nation’s largest in vitro diagnostics (IVD) manufacturers. At the same time, there was optimism as different IVD firms highlighted advancement and business opportunities in the following areas: • Digital pathology. • Companion diagnostics. • New …

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May 30, 2023, Intelligence: Late-Breaking Lab News

Late Breaking Lab News / By Scott Wallask

Hospital laboratory outreach programs continue to be acquisition targets for national laboratory companies. Earlier this month, Labcorp in Burlington, North Carolina, announced it will acquire the outreach businesses of Jefferson Health in Philadelphia and Providence Oregon. Providence Oregon is part of Providence Health & Services based in Renton, Washington, which operates in five Western states. …

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