Forbes Tells the World How Medicare Bollixed Molecular Diagnostic Test Payments, Leaving Nation’s Clinical Laboratories Unpaid for Months

Apr 22, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement

Columnist Steve Gottlieb, M.D., wrote that “This sort of bungling may be without precedent, even for the Medicare agency” Since the beginning of the year, most Medicare contractors and private health insurers have not paid clinical laboratories and anatomic pathology practices for molecular diagnostic test claims coded to the 114 new molecular test CPT codes. This unprecedented situation of labs going unpaid for more than three months has created financial turmoil and uncertainty across the...

Coding Consultant Uses Crowdsourcing for Clinical Pathology Laboratories to Post Amounts Paid by Medicare Contractors for Molecular Test Claims

Feb 18, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations

Medical laboratories have yet to learn how much to expect in payment for molecular pathology test claims submitted to the Medicare program Concern is rising among pathologists and clinical laboratory directors about what the Medicare program will pay this year for the 104 new molecular test CPT codes. These new CPT codes became effective on January 1, 2013. Few–if any–medical laboratories have received payments for Medicare claims submitted early in January. That’s because contractors for the...
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