2024 Laboratory Reimbursement Trends and What to Expect in 2025
Revenue cycle management experts weigh in on the biggest developments of 2024 and how labs can best prepare for 2025 and beyond
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Articles and Reports
Using AI to Improve Reimbursement and Decrease Claim Denials
Though payers’ adoption of AI has made reimbursement more challenging for labs, providers can also use AI to address these issues
Private Payer Reimbursement for Genetic Testing Hinges on Clinical Utility
Two revenue cycle management experts offer tips for clinical labs to improve coverage decisions for genetic tests
Billing & Coding of Infectious Disease Testing
Recent developments pose reimbursement and compliance challenges for billing and coding infectious disease testing—here’s how to manage them.
Billing & Coding: What to Know About New Category III CPT Codes for Digital Pathology
The new codes have garnered attention as a future mechanism for additional reimbursement and thus deserve further discussion.
How to Perform a Billing, Coding, & Reimbursement Process Compliance Audit
Auditing in medical laboratories is critical for reviewing processes to identify erroneous outcomes, as well as areas for improvement.
Medicare to Pay for 22 Additional PLA Codes, Starting April 1
To ensure proper Medicare Part B billing and coding, your billing staff must be aware of all 22 of the newly recognized PLA codes.
The ABN Modifiers and How to Properly Use Them
Proper usage of ABN-related modifiers is a significant issue that has a direct impact on your lab’s reimbursement and compliance.
What Can Go Wrong with Outsourcing Lab Billing and Coding?
Lab leaders must be able to make a sound assessment of both the costs and benefits, and the liability risks involved.
A Due Diligence Checklist for Vetting Medical Billing Company Compliance
Labs have a duty to inquire into what their billing company is up to and whether it complies with all applicable regulations.
How to Explain the Current State of EKRA to Your Lab Executives
How to explain the current state of EKRA to your lab executives.
How to Comply with New Specimen Collection Fee and Travel Allowance Rules
Here are the changes to Medicare specimen collection fee and travel allowances included in the 2023 PFS and what you’ll need to know to comply.
Avoiding Improper Use of HCPCS Codes for COVID-19 Test Specimen Collection Fees
One of the biggest danger areas that labs and their billing staffs face in COVID-19 test reimbursement is improper use of HCPCS code G2023.
