Friday, March 23, 2018

Very Brief Blog: CAP TODAY publishes article on the puzzling 14 day rule

Anne Paxton, one of the lead journalist for CAP TODAY, has published an article on CMS's confusing 14 day rule and its recent changes.  See online open access, here.

The Intro?  "For labs navigating the new billing regulations, some forecasters are predicting confused seas ahead.  “We’ve been reaching out to a number of our customers who I know will be affected by this and saying ‘What’s your take?’ and together just putting our heads around what it really means. But there is still quite a bit of confusion out there,” says Kurt Matthes, vice president, reengineering and service, at revenue cycle management software provider Telcor.

See the full article at CAP TODAY.   They write that "CMS opted against exempting ADLT tests because they are FDA cleared or approved, genomic sequencing procedures..." [sic]  CMS did state that in final November rulemaking, but it sounded goofy then and that doesn't seem to be how CMS is implementing the rule. In the most recent implementation instructions, GSP and genomic PLA tests are categorized in the way that leads to exemption from the 14 day rule.  CMS put up a website for date of service lab policy on February 27, no doubt after the CAP TODAY article had gone to press.