TAG:
cpt code
Many Trends in AP Spell Lots of Change Ahead
CEO SUMMARY: Every second year, THE DARK REPORT releases its list of key trends in anatomic pathology. These trends help shape an understanding about the state of the pathology profession. Our current list includes 11 identifiable trends. This is not an auspicious sign for pathologists wh…
Coding Edits Are a Potential Hammerblow to Pathology
DURING THE NEXT SIX MONTHS, WE WILL WITNESS an intense debate between the pathology profession and the Medicare/Medicaid bureaucracy. This battle will center around the proposed MUEs (Medically Unbelievable Edits) which place restrictions on the units of service per patient per day on key CPT codes w…
Proposed Coding Edits May Restrict 88305 Use
CEO SUMMARY: When the Medicare contractor tasked with developing MUEs (Medically Unbelievable Edits) for this year’s Correct Coding Initiative work released the proposed list of edits to the AMA, it didn’t take long for the bad news to reach the pathology profession. Restriction on un…
Florida Medicaid Contract Is On-Again, Off-Again
CEO SUMMARY: Start with a flawed idea: Medicaid lab testing costs in Florida can be cut by awarding an exclusive statewide contract to one laboratory company. Compound that bad idea by designing a contract awards process that guarantees the state will pay twice for a number of tests while…
Measuring Daily Productivity of Pathologists Can Be Complex
“Conflict in groups stems from trying to use one measurement system to meet all practice goals. This is the pitfall to avoid.” —Dennis Padget CEO SUMMARY: Productivity measurement systems are widely used outside the healthcare industry to bet…
AP Test Over-Utilization Will Be One Achilles’ Heel
CEO SUMMARY: Over-utilization is likely to be a prime concern when federal healthcare enforcers eventually investigate in-house anatomic pathology laboratories owned by specialist physicians. Some in-house pathology lab condo promoters are basing financial performance on 100% utilization …
Changing Economics Motivate Urologists & GIs
CEO SUMMARY: Over the past 18 months, more specialist groups have created their own anatomic pathology laboratories than were created in the past five years. It’s a gold rush to tap and capture profits generated by the anatomic pathology services provided to their patient populations. T…
Offering Molecular Tests Has Surprises & Pitfalls
CEO SUMMARY: Laboratories that offer some of the new assays based on molecular technologies often find themselves facing significant financial risk. That’s because payers are skeptical about new lab tests which come at a high price, but don’t offer substantial clinical benefit. One ea…
AACC and CAP Meetings Generate Useful Insights
IT WAS A BUSY TIME LAST WEEK on the lab industry meeting circuit. THE DARK REPORT made the rounds and uncovered some valuable intelligence for lab directors and pathologists. First on the meeting tour was Philadelphia, site of the American Association of Clinical Chemistry (AACC) a…
HealthcheckUSA Makes Progress With Consumers
CEO SUMMARY: There’s a story behind the story at HealthcheckUSA, one of the nation’s best-known sources offering consumers direct access to laboratory testing. Its primary business is holding community screens and grocery store lab testing programs throughout the United States. Becaus…
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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