MolDx Archives

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Hurdles Continue When Labs Request Genetic Test Coverage

By Virchow | From the Volume XXXI, No. 13 – September 23, 2024 Issue

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Assessing the Clinical Service & Revenue Issues of the LDT Rule

By Robert Michel | From the Volume XXXI, No. 12 – September 3, 2024 Issue

BARRING INTERVENTION BY FEDERAL COURTS OR THE U.S. Congress, clinical labo…

Significant Developments Are Shaping Lab Market

By Robert Michel | From the Volume XXXI, No. 7 – May 20, 2024 Issue

CEO SUMMARY: With 140 speakers and 1,000+ attendees, this year’s Executive War College again provided a comprehensive picture of the specific forces reshaping the U.S. market for lab testing services. Presented here is a smorgasbord of information and innovation shared by different spea…

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…

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…

Technical Assessment Challenges for Z-Code Applications

By Scott Wallask | From the Volume XXX, No. 10 – July 10, 2023 Issue

CEO SUMMARY: Effective on Aug. 1, UnitedHealthcare will require Z-code submissions for many genetic tests. During a recent webinar, experts tackled a topic that may prove troublesome for labs seeking Z-codes: technical assessments. Key advice is to provide specific data about clin…

UnitedHealthcare’s Z-code Policy Starts on Aug. 1

By Robert Michel | From the Volume XXX, No. 10 – July 10, 2023 Issue

CEO SUMMARY: UnitedHealthcare’s (UHC) response to the ever-growing number of unique genetic tests and the continuing growth in the volume of those claims is a new policy. Effective Aug. 1, UHC will require a Z-code with genetic test claims. This req…

Stressful Weeks Ahead for Labs Thanks to Z-codes

By R. Lewis Dark | From the Volume XXX, No. 10 – July 10, 2023 Issue

We are not alone in recognizing that UnitedHealthcare’s…

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…

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…

Volume XXXI, No. 14 – October 14, 2024

For the second time in the past 16 months, respected health systems have taken steps to collaborate specifically to advance value-based care. Also, several statewide pilot programs—each involving tens of thousands of newborns—are publishing studies that demonstrate how exome, whole genome sequencing, and rapid whole genome sequencing can deliver both improved patient outcomes and a return on investment.

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