CEO SUMMARY: Based on a study of denials and appeals involving about 20 million lab test claims, the team at XiFin Inc. presents here their findings. They also provide recommendations on steps labs can take to reduce denials and win a greater proportion of appeals. IN RECENT YEARS, THE ERA OF SUBMITTING CLINICAL LABORATORY TEST […]
Managing Denials and Appeals of Clinical Lab, Path Claims
Valuable insights on current payer trends in the processing of lab test claims
- By Robert Michel
- > From the Volume XXXI No. 15 - November 4, 2024 Issue
- Tags: 80053, administrative law judge, ALJ, Anatomic pathology, Anthem, AP, BCBS, BCBSF, Blue Cross Blue Shield, Blue Cross Blue Shield Federal, BRCA1 BRCA 2 Gene Analysis, Centers for Medicare and Medicaid Services, Cigna, clinical laboratory claims, CMS, CO151, CO252, CO50, CO55, CO96, commercial contracted, comprehensive metabolic panel, Consolidated Appropriations Act, dates of service, denial code, denial management, Diana Richard, executive war college, G0480, G0483, genetic testing, HCPCS G0416, HCPCS/CPT code, Healthcare Common Procedure Coding System, icd-10-cm, immunochemistry, ivd/lab informatics, LCD, local coverage determination, Medicaid, medical necessity, medically unlikely edit, Medicare Advantage, medicare physician fee schedule, microscopic examination, molecular testing, MPFS, MUE, National Correct Coding Initiative, national coverage determination, NCCI, NCD, needle biopsy, non-contracted plan, pathology claims, RCM, revenue cycle management, Stephanie Denham, unit of service, UOS, xifin
