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New Business Helps Reduce Pathology Specimen ID Errors

CEO SUMMARY: Prevention of diagnostic testing errors is getting more attention by both physicians and pathology labs because patients are less tolerant of potentially life-changing errors. Strand Diagnostics’ Know Error system is designed to reduce or eliminate errors involving tissue s…

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Of 88305-TC and Other Bad News for Pathology Labs

BY NOW, VIRTUALLY ALL PATHOLOGISTS ARE AWARE of the announced cut in Medicare reimbursement for the technical component (TC) of CPT 88305. Effective on January 1, 2012, Medicare will pay 52% less for this CPT code. From the prior level of $69.78, the new reimbursement will be $33.70. As news of this…

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OURLab Founder Lays Out New Business Strategy

CEO SUMMARY: For OURLabs of Nashville, Tennessee, it was the host of changes in the lab testing marketplace that motivated it to go looking for a partner. Its recently-announced merger with OPKO Health, Inc., of Miami, Florida, creates opportunities for OURLab pathologists to do more in t…

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Labs Have Questions about Prostate Biopsy Policy

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 increas…

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Lawyer Advises on Risk Of Prostate Biopsy Audits

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 Me…

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Prostate Biopsy Claims Affected by Policy Change

CEO SUMMARY: Quietly, with no fanfare and little advance public notice, the Medicare program is taking steps to change reimbursement policy for prostate biopsies. On August 7, 2012, Palmetto GBA adopted the new policy published on January 1, 2012, by the National Correct …

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Health Insurers Now Finding Ways to Cut Costs and Shed Risks

CEO SUMMARY: Both employers and health insurers are taking aggressive steps to rein in healthcare costs. Several strategies to control spending and create powerful new incentives for providers are gaining favor. At this year’s Executive War College, Paul Mango of McKinsey & Company,…

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2011’s Top 10 Lab Stories Point to a Busy 2012

CEO SUMMARY: Given the specific news stories that make up THE DARK REPORT’S list of the “Top Ten Lab Stories for 2011,” it might be said that 2011 was a rather quiet year overshadowed by anticipation of the coming reforms mandated by the Accountable Care Act of 2010. For the clinica…

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ACLA Has its Say Regarding Molecular Dx Proposals

CEO SUMMARY: It is not known how many public comments have been submitted to Palmetto GBA, the big Medicare carrier, in response to its published proposals to change how code stacked claims for genetic and molecular tests will be handled, effective February 27, 2012, for labs in Medicare …

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Molecular Code Stacks Now in the Payers’ Bull’s Eye

LIKE A STEAM BOILER READY TO EXPLODE FROM TOO MUCH PRESSURE, the nation’s health insurers have reached a point of no return on the subject of code-stacked claims for genetic testing and molecular diagnostics assays. Simply put, payers are ready to tackle this sensitive issue. Payers have reasonabl…

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