Comprehensive Coding
Understanding the 2024 CLFS update—and the changes that are still to come.
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Articles and Reports
Expected Audit Targets for 2024 and How Laboratories Can Ensure Compliance
An overview of likely lab audit targets for the coming year, and how laboratories can ensure they’re prepared.
Medicare Expands Coverage of Molecular Cancer Screening Tests
In terms of Medicare coverage, 2023 is shaping up to be a fruitful year—here are five of the most significant approvals so far.
Emerging Tests: Medicare to Cover Next Gen-Sequencing Tests for Advanced Cancer
From - Laboratory Industry Report
In the PAMA era, there are two salient trends in Medicare Part B lab reimbursements…
Out of Network: 6 Frequently Asked Questions
By Richa Singh bio
As labs face an increasingly challenging reimbursement environment, more providers are doubling down on out-of-network strategies to maximize on collections opportunities…
PAMA-geddon: Lab Industry Asks Court to Stop New Medicare Fee Schedule
From - Laboratory Industry Report
With CMS refusing to back down, the lab industry has escalated the dispute and asked a U.S. District Court to step in and prevent enforcement of the 2018 PAMA-inspired…
CMS Ignores Flawed Processes, Finalizes 2018 PAMA Pricing; Labs Need to Take Immediate Action to Offset Impending Lean Times
By Kyle Fetter bio
The final 2018 clinical laboratory fee schedule (CLFS) is out, and it is evident that the argument that the Centers for Medicare & Medicaid Services (CMS) PAMA process was…
PAMA-Geddon: CMS Slashes 2018 Part B Lab Rates
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“Applicable Labs”: The Fly in the PAMA Market-Based Pricing Ointment
From - Laboratory Industry Report
The lab industry has no objection to basing Medicare payments for lab tests on the actual rates charged to payors in the private market. What has the industry so upset is how…
FDA Watch: Diagnostics Industry Is Losing a Longstanding “Frenemy”
From - Laboratory Industry Report
The diagnostics community is saying goodbye to a frenemy of 25 years. On Aug. 29, Alberto Gutierrez, director of the…
Draft 2018 CLFS Reveals Fundamental Flaws in PAMA Reporting Exercise; Time to Take Action
By Lâle White bio
As XIFIN predicted, the PAMA reporting exercise has resulted in significant proposed laboratory fee cuts. In fact…
Medicare Reimbursement: 4 Molecular Assays Score Big Coverage Wins
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Palmetto Gives Okay to Medicare Coverage of 5 New Molecular Tests
From - Laboratory Industry Report
Medicare contractors are slowly coming around on covering unproven molecular assays. The most notable new baby steps come from, Palmetto GBA (Columbia, SC), one of Medicare's most important contractors in the form of…
