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Volume XIX No. 13 - September 17, 2012

In Medicare Bullā€™s Eye: Lab Test Reimbursement

Commentary and Opinion by R. Lewis Dark /

YOU CAN CONSIDER THIS ISSUE OF THE DARK REPORT TO BE an early warning of the escalating effort by public and private payers to rein in the ā€œsoaring costā€ of clinical laboratory testing and anatomic pathology services. The intelligence briefings you will read on the following pages address important topics, specifically: 1) a new Medicare […]

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Labs Have Questions about Prostate Biopsy Policy

Laboratory Billing /

CEO SUMMARY: How will pathology laboratories respond to the publication of revised policies in how laboratories should file Medicare Part B claims for prostate biopsies? Not only will there be a sharp drop in the reimbursement paid for a 12-core prostate biopsy, but labs may be at increased risk of a RAC audit, along with

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Changed Medicare Policy Adds to Regulatory Risk

Laboratory Billing /

CEO SUMMARY: When Medicareā€™s National Correct Coding Initiative (NCCI) manual took effect on January 1, 2012, it contained a significant change in how prostate biopsy claims are to be coded. This change was widely overlooked by the pathology profession and even dismissed entirely for its ambiguity and inconsistency with previously published guidance on the subject.

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Lawyer Advises on Risk Of Prostate Biopsy Audits

Laboratory Compliance /

CEO SUMMARY: For labs currently processing prostate biopsy cases with five or more cores and for those pathologists interpreting those cases, there is a lack of clarity about new Medicare policies. As one example, risk of an audit is significant because of recent guidance issued by one Medicare contractor. Another source of risk for labs

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CLMA Asks Labs for Examples of RAC Auditor Overreach

Laboratory Compliance /

STORIES ABOUT HOW PRIVATE MEDICARE AUDITORS are overreaching in their zeal to identify fraud have caught the attention of the U.S. Senate Finance Committee. It is asking providers to submit examples of overzealous RAC auditors. For its part, the Clinical Laboratory Management Association (CLMA) is collecting examples of recovery audit contractor (RAC) auditors behaving badly

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Competitive Bidding: Once Again, Itā€™s Back!

Laboratory Management /

CEO SUMMARY: For the clinical lab industry, the concept of competitive bidding for Medicare Part B Clinical Lab Testing may be like the movie ā€œGroundhog Day.ā€ The hero, Bill Murray, kept reliving the same day over and over. So it seems to be with competitive bidding. In the latest replay, RTI Technologies just published a

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Sonic Healthcare, Bio-Reference Report Financial Performance

Clinical Laboratory Trends /

IN RECENT WEEKS, two of the nationā€™s larger public laboratory companies issued their earnings reports. In both cases, revenue growth was strong, a distinct difference from the recent financial performance of their two largest lab public company competitors. It was on August 21, 2012, when Sonic Healthcare, Ltd., of Sydney, Australia, issued its financial performance

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Lab Specimen Transport Eliminates Need for Ice

Laboratory Equipment /

CEO SUMMARY: Because of its unique design and reliability, a new product for transporting laboratory specimens and units of blood without the use of ice and dry ice is gaining favor with innovative laboratories across the country. Kaiser Permanente of the Mid-Atlantic States uses this ice-free specimen transport solution to move units of blood from

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September 17, 2012 “Intelligence: Late Breaking Lab News”

Late Breaking Lab News /

Exome sequencing testing for cancer patients is now offered by the Cancer Genetics Laboratory at Baylor College of Medicine (BCM) in Houston, Texas. This clinical testing will be performed using next-generation gene sequencing technology. Pathologists at Baylor are among the first in the nation to offer exome-based testing services. ā€œCancer exome sequencing is poised to

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