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

Revised policies for molecular CPT codes, prostate biopsies, and 88305 may cause confusion

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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 private payers implement these new policies. Overall, 2013 will be a tough environment when it comes to ensuring full compliance with all the new billing and reimbursement policies for this testing.

Comments from Donna Beasley, DLM (ASCP), Laboratory Specialty Vice President at McKesson Corporation Revenue Management Solutions and Rina Wolf, Vice President of Commercialization Strategies, Consulting & Industry Affairs, for XIFIN, Inc.

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