Wednesday, August 9, 2023

Catching Up with DARK REPORT: From 81408 Fraud to Z Codes

 I've subscribed to the trade journal DARK REPORT for years.   I'm sorry I haven't been to their outstanding spring conference - Pathology War College - in New Orleans since before 2020.

There are a number of highlights in the July 31 issue.

  • 81408 FRAUD

Regarding 81408 fraud, the bring readers up to date on the July 2023 OIG report about a billion dollar of easy money autopaid by the Novitas and FCSO MAC's the last couple years.  See my blog here and the OIG report here.  See Genomeweb here.

  • 81408 Death Watch?   OIG wrote that "there were no longer payments on [81408] by December 31, 2021."  
  • Well, I hope so, but we'll find out in October 2023, in a couple months, when CMS releases payments by CPT code for ...CY2022.

 Regarding Z codes, they initiate a new section, VIRCHOW, about the intersection of the lab industry and managing care.  There's a several-page article speculating on how slow or fast Z codes will spread in the insurance industry.   Another article states that United Healthcare has delayed Z codes for several months (formerly August 1).

Regarding digital pathology, they have a long article about the full-on adoption of whole slide imaging (WSI) at Universit of Louisville.


Dark media also have a free weekly newsletter, TDR INSIDER

See also their blog series, open access, Dark Daily.

They offer a current webinar on Z codes, $195, here.