Since 1995, Reliable Business Intelligence for Clinical Laboratories, Pathology Groups and Laboratory Diagnostics

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prostate biopsy

Value of Miraca Falls By 92% from 2011 to 2017

CEO SUMMARY: Miraca Life Sciences amended its merger agreement with Avista Capital Partners after the lab lost value in the two months since the agreement was signed in September. Factors precipitating the revision were a significant decline in reimbursement rates, stiff competition from …

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Price Cuts, Long Delays in Payment Are Expected – December 31, 2012

CEO SUMMARY:  In addition to a steep cut in the 88305 CPT code, anatomic pathology laboratories can expect cuts in the payment from Medicare for molecular and prostate biopsy testing. Two national experts in lab billing and reimbursement warn labs to expect confusion in how both pub…

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At Mid-Year, Labs Struggle to Get Paid for Many Tests

CEO SUMMARY: At a recent coding and billing conference, pathology and lab clients of one of the nation’s largest revenue management companies agreed that three trends have caused lower revenues since the start of 2014. One trend seen by labs involves higher deductibles and copayments fr…

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ACLA, CAP Comment on Final 2014 Medicare Rules

CEO SUMMARY: On November 27, as the nation prepared for the Thanksgiving holiday, the federal Centers for Medicare & Medicaid Services (CMS) announced the long-awaited final rules for 2014. Early analysis of the 1,300 pages of rules CMS released indicates that the agency moderated one…

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Palmetto’s Prostate Biopsy Policy Removed after Talks with CMS

THERE IS SOME POSITIVE LAB INDUSTRY NEWS that has not been widely reported yet. It involves a decision to change an unwelcome Medicare policy that limited the number of prostate biopsy specimens per case that would be reimbursed. After discussions between lab industry groups and the federal …

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Urologists Weigh in on Prostate Biopsy Testing

CEO SUMMARY: Based on an impressive number of 4,230,129 vials collected from 437,937 biopsies, the new study is expected to add fuel to the fire of the ongoing debate about the appropriate number of prostate biopsies physicians should collect and refer to pathology labs for cancer testing…

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Price Cuts, Long Delays in Payment Are Expected

CEO SUMMARY: In addition to a steep cut in the 88305 CPT code, anatomic pathology laboratories can expect cuts in the payment from Medicare for molecular and prostate biopsy testing. Two national experts in lab billing and reimbursement warn labs to expect confusion in how both public and…

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2012’s Top Ten Lab Stories Predict More Challenges

CEO SUMMARY: It’s been a year with more lows than highs, when viewed through the lens of THE DARK REPORT’S “Top Ten Lab Stories of 2012.” The end of the TC grandfather clause, new policies for prostate biopsy billing, and a dramatic 52% cut to 88305- TC fees were widely reported. …

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OURLab Founder Lays Out New Business Strategy

CEO SUMMARY: For OURLabs of Nashville, Tennessee, it was the host of changes in the lab testing marketplace that motivated it to go looking for a partner. Its recently-announced merger with OPKO Health, Inc., of Miami, Florida, creates opportunities for OURLab pathologists to do more in t…

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Of 88305-TC and Other Bad News for Pathology Labs

BY NOW, VIRTUALLY ALL PATHOLOGISTS ARE AWARE of the announced cut in Medicare reimbursement for the technical component (TC) of CPT 88305. Effective on January 1, 2012, Medicare will pay 52% less for this CPT code. From the prior level of $69.78, the new reimbursement will be $33.70. As news of this…

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