prostate biopsy

Labs Have Questions about Prostate Biopsy Policy

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 increas…

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Changed Medicare Policy Adds to Regulatory Risk

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 it…

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Lawyer Advises on Risk Of Prostate Biopsy Audits

CEO SUMMARY: For labs currently processing prostate biopsy cases with five or more cores and for those pathologists interpreting those cases, there is a lack of clarity about new Medicare policies. As one example, risk of an audit is significant because of recent guidance issued by one Me…

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Prostate Biopsy Claims Affected by Policy Change

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 …

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MD Self-Referral Issues Target of Utilization Study

CEO SUMMARY: When it comes to the in-office ancillary service (IOAS) exception to physician self-referral, the issue of in-clinic pathology services has become a hot potato. Publication in Health Affairs of a study of urologists’ self-referral of their patients for anatomic pathology se…

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Innovative AP Reports Created by Path Group

CEO SUMMARY: Too often local pathology groups fail to react to intensified sales competition for the biopsy referrals of clinicians in their community. In Torrance, California, the 30 pathologists of Pathology, Inc. decided it was time to invest capital and resources into developing their…

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Making a Difference in Tangible Ways

HOW OFTEN DOES SOMETHING you learn from THE DARK REPORT make a positive difference in your laboratory? We hear lots of examples from our clients and regular readers and I’d like to share two of them with you today. The first example comes from our special, exclusive, and expanded coverage about an…

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“Actionable Intelligence” In Real Time

BEFORE YOU READ THIS ISSUE, I would like to make three observations. Each will help you get maximum value from the information contained herein about the trend of in-house anatomic pathology (AP) laboratories in specialist physician groups. First, THE DARK REPORT’S coverage of this trend is unmatc…

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Part II: Path Condo Labs As A Threat to Pathology

SPECIALIST PHYSICIAN GROUPS are taking active steps to capture anatomic pathology (AP) revenues that result from specimens generated by their groups’ patients. Yet the anatomic pathology profession is only now awakening to this threat. To educate and alert pathologists and their group practice adm…

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Peeking Into Finances Of Pathology Lab Condos

CEO SUMMARY: In the possession of THE DARK REPORT is a copy of revenue and expense projections shown by a pathology condo laboratory complex promoter to prospective urology groups. They project that even smaller urology groups can realize worthwhile income if they invest in a pathology co…

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