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 members. Such counseling has helped to reduce utilization of genetic testing because informed patients understand that a genetic test might not
Tag: cpt coding
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 region J1. After filing its comments, the
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 reasonable questions about this type of clinical lab testing.
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 skills and knowledge that labs possess to intelligently manage utilization of molecular
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 with CPT codes used by laboratories to prepare
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 junctures, and careful evaluation of the finances for each molecular assay added to the
“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 measuring pathologist productivity. In this installment, pathology practice consultant Dennis Padget identifies different approaches to appropriately link pathologist productivity with compensation. After
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 deploy these types of Web-based services for their physicians.
IT’S BEEN THREE