TAG:
molecular diagnostic services
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…
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…
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…
June 22, 2015 Intelligence: Late Breaking Lab News
By Robert Michel | From the Volume XXII NO. 9 – June 22, 2015 Issue
Turf wars are breaking out among local pathology groups as consolidation involving hospitals and physicians’ practices continues to reshape many regional healthcare markets. The latest sign of this trend comes from Washington State, where CellNetix of Seattle announced an agreement to provide …
Some Labs Report Faster Pay for Molecular, Genetic Tests
By Joseph Burns | From the Volume XXII NO. 8 – June 1, 2015 Issue
DURING RECENT MONTHS, some labs are reporting improvement in how their claims for certain molecular and genetic tests are being reimbursed. This is progress from the financial crises experienced during 2013 for many labs performing molecular and genetic tests….
Some Labs Report Faster Pay For Molecular, Genetic Tests via New CPT Code Reimbursement Program
By Mary Van Doren | From the Volume XXII NO. 8 – June 1, 2015 Issue
DURING RECENT MONTHS, some labs are reporting improvement in how their claims for certain molecular and genetic tests are being reim…
Much Uncertainty About Pay for Molecular Codes
By Joseph Burns | From the Volume XX No. 7 – May 28, 2013 Issue
CEO SUMMARY: Having gone unpaid since January 1 for the 114 new molecular CPT codes, many clinical labs and pathology groups have stopped running these tests or laid off staff. Some are considering closing their doors. Evidence indicates that certain Medicare contractors are deciding that…
Unprecedented Growth Rates for Molecular Testing
By Joseph Burns | From the Volume XIX No. – October 8, 2012 Issue
CEO SUMMARY: There will be an expanding role for innovative clinical labs as healthcare moves forward on its path toward personalized medicine. However, to capitalize on this opportunity, pathology groups and clinical labs will need to beef up their information systems. They will also nee…
February 20, 2012 “Intelligence: Late Breaking Lab News”
By Robert Michel | From the Volume XIX No. 3 – February 20, 2012 Issue
In its effort to change how code stacking is used to bill for certain genetic and molecular tests, Palmetto GBA announced changes to its Molecular Diagnostic Services Program (MolDx). Earlier this month, the Medicare carrier announced that the effective date for claim submissions und…
ACLA Has its Say Regarding Molecular Dx Proposals
By Robert Michel | From the Volume XVIII No. 17 – December 19, 2011 Issue
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 …
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