TAG:
cpt coding
Genetic Tests Grow in Number, Complexity
CEO SUMMARY: Getting paid for genetic tests continues to be a challenge. This is true for both payers and the labs that perform the tests. Even physicians are dissatisfied with the status quo because they must deal with patients unhappy about the high cost of genetic tests. The prob…
AP Groups Can Protect Revenue, Pathologist Compensation
CEO SUMMARY: Many anatomic pathology groups are watching their revenue decline and margins shrink on the same or greater case volume. These trends make it imperative to have a deeper understanding of the operational and financial variables that contribute to stability in the group’s fi…
More Genetic Counseling Leads to Fewer Lab Tests
CEO SUMMARY: Cigna was the first national health insurer to require independent board-certified genetic counseling before approving coverage for certain genetic tests. Since launching this program in September 2013, the insurer has seen a 450% increase in genetic counseling for Cigna …
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 …
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…
Payers Move to Pre-Authorize Expensive Genetic Tests
CEO Summary: Pre-authorization of expensive genetic and molecular tests is fast-becoming a priority for most of the nation’s health insurers. For clinical labs and pathology groups that don’t respond, this trend is a threat. On the other hand, because payers need all the skil…
Numerous Issues Identified With Bid Demo’s 303 Tests
CEO SUMMARY: One experienced expert in billing and coding was surprised at the list of 303 tests to be included in the Medicare Laboratory Competitive Bidding Demonstration Project. He notes that the list of 303 tests includes a number of codes and descriptions that are not consistent wit…
Molecular Diagnostics: How Beaumont Built A Successful Program
CEO SUMMARY: It was about 15 years ago when William Beaumont Hospital and Beaumont Reference Laboratories first began offering molecular diagnostic testing services to clinicians. This successful effort came about because of effective strategic planning, use of consulting expertise at key…
Aligning Pathologist Productivity With Compensation Can Be Challenging
“Growing interest in ways to link a pathologist’s productivity to his/her compensation makes this a widely-discussed topic within many pathology group practices.” –Dennis Padget CEO SUMMARY: Part Three continues THE DARK REPORT’S series on meas…
More Firms Now Offer Web Lab Info Products
CEO SUMMARY: Since our last vendor directory in winter 2001, the number of companies selling browser-based systems for laboratory testing ordering and results reporting has doubled! That’s a sign that laboratories recognize the need to have an Internet strategy and are taking steps to d…
CURRENT ISSUE
Volume XXXI, No. 11 – August 12, 2024
This issue identifies current lab trends as experienced by the two Blood Brothers, Labcorp and Quest Diagnostics, and delves into these trends. Also, a new survey highlights consumer healthcare trends that labs should be aware of.
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