TAG:
cpt
Federal Whistleblower Suit Settled by Dianon Systems
IT’S A REMINDER THAT WHISTLEBLOWERS continue to look for opportunities to turn in laboratories, even if the violations are relatively minor. Last month, Dianon Systems Inc., of Stratford, Connecticut, agreed to pay $1.5 million to settle a federal false claims action originally fi…
An Economic Perspective On Discounted PC Deals
CEO SUMMARY: By opening their own in-office pathology laboratories, specialist physicians are undermining a long-established referral relationship with the pathology profession. Pathologists are debating the merits of this market-based trend and its effect on their profession. However thi…
Michigan Derm Convicted On 31 Fraud Charges
CEO SUMMARY: Last year, dermatologist Robert W. Stokes, D.O., of Grand Rapids, Michigan, was indicted by the federal government for 72 counts relating to various offenses, including upcoding, and improper coding. Of this total, 35 counts against Stokes involved his billing payers for labo…
Sonic Healthcare & CPL Make First Acquisition
CEO SUMMARY: Expanding from its base in Texas, Clinical Pathology Laboratories, Inc. (CPL) has acquired Cognoscenti Health Institute, LLC of Orlando, Florida. The deal was done discreetly and gives Sonic Healthcare, Ltd., parent of CPL, a solid foothold in Florida. Cognoscenti has also ma…
Lab MUEs Reconsidered, CMS Changes Course
CEOSUMMARY: It may bear are moment of common sense. Last month, Medicare officials stated their intent to exclude clinical laboratory and anatomic pathology CPT codes from the “Phase One” implementation of Medically Unbelievable Edits (MUEs). It is a positive step, and comes in respon…
May 22, 2006 “Intelligence: Late Breaking Lab News”
Another investment firm has acquired an anatomic pathology company. It was announced today that Water Street Capital Partners of Chicago, Illinois, has acquired a majority ownership in Lakewood Pathology Associates, located in Lakewood, New Jersey. Under new ownershi…
CMS Defers MUE Edits Until After Jan. 1, 2007
CEO SUMMARY: Medicare officials have granted a temporary respite on the troubling proposal to institute service restrictions per patient on some 80 pathology CPT codes and 1,100 clinical laboratory codes. These proposals are part of a new round of Medically Unbelievable Edits (MUEs). CMS …
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…
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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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