CEO SUMMARY: Each year since 2015, Medicare officials have posted the prices charged by every physician. That now makes it possible for pathology group practices to conduct a price study of their region and state to learn how their group’s prices compare with other pathology providers. A national pathology consultant points out that one way
Tag: pathology billing
WHEN A BILLING SERVICE company disposes of patients’ lab test records, it should do so in compliance with federal and state privacy rules. That means all protected health information (PHI) should be shredded or incinerated.
Four pathology groups in Massachusetts learned this lesson the hard way when they and their billing company agreed to pay collectively
CEO SUMMARY: When Medicare’s National Correct Coding Initiative (NCCI) manual took effect on January 1, 2012, it contained a significant change in how prostate biopsy claims are to be coded. This change was widely overlooked by the pathology profession and even dismissed entirely for its ambiguity and inconsistency with previously published guidance on the subject.
CEO SUMMARY: How will pathology laboratories respond to the publication of revised policies in how laboratories should file Medicare Part B claims for prostate biopsies? Not only will there be a sharp drop in the reimbursement paid for a 12-core prostate biopsy, but labs may be at increased risk of a RAC audit, along with
CEO SUMMARY: Quietly, with no fanfare and little advance public notice, the Medicare program is taking steps to change reimbursement policy for prostate biopsies. On August 7, 2012, Palmetto GBA adopted the new policy published on January 1, 2012, by the National Correct Coding Initiative (NCCI). Pathology billing experts and attorneys state that this policy
CEO SUMMARY: Across the nation, clinical laboratories and pathology groups are reacting to the new Medicare rule that requires a physician signature on a paper requisition for clinical laboratory tests. Laboratories using paper requisitions will need to add a signature line, then print and distribute these new requisitions to their clients. Pathologists and lab administrators
CEO SUMMARY: Pathologists at four Massachusetts hospitals got a powerful reminder recently that a breach of protected health information (PHI) can occur at any time for the most unexpected reason. Earlier this month, the Boston Globe reported that the pathology reports and patient information for tens of thousands of individuals had been found unshredded and
CLARIENT INKS PACT WITH GENERATION HEALTH FOR GENETIC TESTING
PAYER PRE-AUTHORIZATION OF GENETIC TESTS is the reason for the newly-announced contract between Clarient, Inc., and Generation Health, Inc., of Upper Saddle River, New Jersey.
Announced on June 10, the agreement positions Clarient to be the preferred provider of genetic tests for Generation Health. Generation Health was founded
CEO SUMMARY: During 2010, the Medicare Physician Quality Reporting Initiative (PQRI) will pay a 2% bonus to pathologists who register and report data on 80% of their cases for the specified CPT codes. However, independent pathology laboratories still cannot participate in the PQRI program. Also, PSA, LLC, reports it can be challenging to audit the
CEO SUMMARY: In a federal case involving billing improprieties and insurance fraud, a federal judge sentenced Michigan dermatologist Robert W. Stokes, M.D., to 126 months in prison and ordered him to pay $178,100 in fines and assessments, with the amount of restitution yet to be determined. Stokes was tried in federal court last April facing