Full Focus: Coding and Billing for Toxicology - Best Practices
Join us at 7 p.m. EST, Wednesday, December 13, for our final entry in our educational series on urine drug testing as we cover best practices for toxicology coding and billing with Ann Lambrix, VP of Lighthouse RCM Solutions. During this webinar, we will cover the steps labs and providers can take to ensure they receive compliant reimbursement for their toxicology services while also minimizing their denials and backend headaches.
This webinar series is hosted by Lighthouse Lab Services in collaboration with the Pain Society of the Carolinas, Tennessee Pain Society, New York State Pain Society, and the Pennsylvania Pain Society.
Attendees are eligible to earn up to 1 ACCME AMA PRA Category 1 Credit for their participation. Jointly Provided by AMEDCO.
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1. PAMA Cuts Delayed, See 2024 Medicare Fee Schedule Impact for Labs & Pathology
Labs received a welcome break from planned Clinical Lab Fee Schedule cuts this month when Protecting Access to Medicare Act (PAMA) reporting and associated test reimbursement reductions were delayed for another year with the passage of a short-term government funding bill.
Check out this article for more analysis on the PAMA delay and a breakdown of major changes in the final Medicare fee schedule for 2024.
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2. Special Offer: Let Us Beat Your Lab Director Price
As we ring in the holidays, we understand savings and revenue goals are top of mind for the labs and groups we assist. That's why we're offering to beat the price you are currently paying for lab director services with our competitive rates for full- and part-time Lab Directors. With a network of more than 5,000 qualified candidates, we have the largest network of Medical Directors who can guide your laboratory successfully and compliantly.
If our dedicated lab director consultants can't beat your current price, we'll give you a free gift for your time! Contact us today for a free quote or to learn more about our candidates.
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3. Lab Stakeholders Express Uncertainty on FDA LDT Proposal as Comment Deadline Nears
How would the FDA's new proposed rule granting the agency oversight of laboratory developed tests impact labs currently offering LDTs? According to 209 respondents from our recent webinar, the fallout could be severe if the rule passes in its current state.
About 58% of the lab owners and decision makers on the call said they anticipate the rule's impact would be largely negative and potentially affect their ability to remain in business, while another 19% said they expect the impact to be just slightly negative.
Don't forget, the FDA denied a request to extend the public comment period beyond Dec. 4, so now is the time to submit your thoughts on the impact this rule could have on your laboratory and ability to offer LDTs moving forward.
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Last month, we launched the "Candidate Corner" as a way to spotlight some of the great candidates our Medical Laboratory Recruiters work with each day. Check out a quick preview of one individual below, then click over to our blog to see all five candidates for November.
If you'd like to learn more about anyone listed in this section, or inquire about their ability to relocate, email us directly here!
Candidate - Lab Manager/Lab Operations Director
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Education: MS Organizational Leadership, BS Clinical Lab Science
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Certifications: MLS (ASCP), ISO 9001 QMS Auditor, Lean Six Sigma Green Belt
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Experience/Expertise: Core Lab, Hospitals/Healthcare Systems
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1. Using Billing Data to Bolster Payer Contract Negotiations
Recently, our client faced two critical decisions: whether to negotiate their contract with Cigna, and whether to establish a direct contract with Health Partners. Understanding the payment dynamics with Cigna was paramount. Were they receiving the appropriate reimbursement for all modalities of service, including carve-out rates for specific CPT codes?
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2. Unpacking the GI Panel Billing Mystery
Navigating the rules for properly coding and receiving payment for GI panels can be a maze of confusion if you don't understand the guidelines and limitations across various payers.
In our latest RCM case study, Client Engagement Manager Dyana Williams puts on her detective hat, breaks out the magnifying glass, and walks through a recent mystery our team helped a client solve to receive fair reimbursement!
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Deep Dive: NCCI Billing Edit Impacting Presumptive and Definitive Drug Testing and New LCD to Watch |
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On July 1, 2023, CMS implemented a National Correct Coding Initiative (“NCCI”) Procedure-to-Procedure (“PTP”) edit for codes 80305, 80306, and 80307 for presumptive drug test(s), and codes G0480-G0483, and G0659 for definitive drug test(s). The edit caused substantial billing and payment disruptions for providers before CMS withdrew it on Oct. 1, 2023, due to the impact it was having on patient care.
In this update, Ann Lambrix, VP of Revenue Cycle Management Solutions for Lighthouse Lab Services, details how other payers have responded since CMS withdrew its edit, and what payment issues still may be lingering as a result. She also offers a brief preview of a new Local Coverage Determination labs should have on their radar in the coming months.
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ICYMI: Recent Webinars & Educational Content |
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1. Developing a Custom Test Menu for Urine Drug Testing
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Recorded: Nov. 15, 2023
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Presented by: Dr. Sarah Harris, Chief Technical Officer, LLS
- View here
2. Unpacking the FDA's New Proposed Rule for LDTs
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Recorded: Nov. 8, 2023
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Presented by: Gail Javitt, Director, Hyman, Phelps, & McNamara
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View here
3. Emerging Street Drugs and New Threats to Watch For
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Recorded: Nov. 1, 2023
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Presented by: Dr. Erik Korte, Lab Director and Clinical Consultant, LLS
- View here
4. Urine Drug Testing 101
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Recorded: Oct. 26, 2023
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Presented by: Dr. Michael Sprintz, CEO, Cellarian, and Elliot Labovitz, Chief Sales Officer, LLS
- View here
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The Lab Insighter is a monthly publication for Lab Owners and Decision Makers.
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Contact us at:
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