How Private Health Insurers May Respond to FDA LDT Regulation

By Virchow | From the Volume XXXI, No. 8 – June 10, 2024 Issue

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Successful Ransomware Attack Misses Lab Claims

By R. Lewis Dark | From the Volume XXXI, No. 4 – March 18, 2024 Issue

HAS ANYONE NOTICED THAT CYBERCRIMINALS ARE STEADILY INCREASING THE SCALE AND MAGNITUDE OF THEIR AT…

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Payers Are Right to Be Wary of Claims for Some LDTs’ Value

By Virchow | From the Volume XXX, Number 17 – December 4, 2023 Issue

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Private Health Insurers Are Aware of Problems with CPT Code 81408

By Virchow | From the Volume XXX, No. 13 – September 11, 2023 Issue

EDITOR’S NO…

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UHC Will Delay Enforcement of Z-codes for Genetic Test Claims

By Scott Wallask | From the Volume XXX, No. 13 – September 11, 2023 Issue

IN THE LATEST BACKPEDAL ON ITS NEW POLICY, UNITEDHEALTHCARE (UHC) appears to have dropped its requirement for genetic testing laboratories to use Z-codes for claims under commercial health plans—for now. Earlie…

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Smaller Labs Must Verify Z-code Arrangement with Lab Companies

By Virchow | From the Volume XXX, No. 12 – August 21, 2023 Issue

EDITOR’S NO…

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OIG: Billing Code 81408 Is at ‘Risk of Improper Payment’

By Scott Wallask | From the Volume XXX, No. 11 – July 31, 2023 Issue

CEO SUMMARY: Clinical lab executives familiar with molecular test coding and billing will not be surprised to learn that billing code 81408—commonly used on genetic test claims—is at risk of fra…

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Optum and Avalon Discuss Genetic Test Claims Review

By Scott Wallask | From the Volume XXX, No. 9 – June 19, 2023 Issue

CEO SUMMARY: With the ever-increasing number of genetic tests on the market, payers are understandably frustrated with genetic test claims that don’t clearly outline the medical need for a procedure or it…

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Expect More Z-code Requirements for Genetic Tests

By R. Lewis Dark | From the Volume XXX, No. 9 – June 19, 2023 Issue

GENETIC TESTING COMPANIES ARE STILL REACTING TO LAST MONTH’S NEWS that one of the nation’s largest health insurers—UnitedHealthcare (UHC)—will require Z-codes for molecular test claims submitte…

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UHC’s Z-Code Requirement to Commence on Aug. 1

By Scott Wallask | From the Volume XXX, No. 8 – May 30, 2023 Issue

CEO SUMMARY: In what may be an alarming development for certain clinical laboratories, as of Aug. 1, UnitedHealthcare will require Z-codes for molecular test claims filed under its co…

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