Saturday, July 2, 2022

AMA Releases Bonanza of New Category III Codes, Don't Miss the Digital Pathology Codes

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 AMA has released new Category III CPT codes, which will be effective on January 1, 2023 .  Where to Find Codes, Prices The home page for Ca...

AMA Releases Code Proposals for Lab Tests for September 2022 CPT Meeting

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AMA recently released the website for registration and agendas for the September 2023 CPT meeting in Seattle.  July 1, they released for pub...

AMA Releases New PLA Codes

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On July 1, 2022, AMA released new PLA codes.   In this quarterly process, AMA released codes applied-for three months early (around April 1)...
Friday, July 1, 2022

Very Brief Blog: Glimpse Into Real World Lab Charges and Payments

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Last month I had a routine annual physical and my internist ordered a number of blood tests.  (I'll jump past any discussion what's ...
Thursday, June 30, 2022

Very Brief Blog: CPT Posts Website for September Seattle Meeting

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Every four months, AMA CPT creates a new webpage for its next upcoming CPT editorial meeting.   This is where you find meeting agendas, regi...

Very Brief Blog; SALSA Act, PAMA Reform: 13 Page Copy Here

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Over the past week, there have been press releases and announcements about the proposed SALSA ACT, which would introduce several modificatio...
Monday, June 27, 2022

Very Brief Blog; AMA Posts Webpage for "Tumor Genomics Testing Workgroup" for coding reform

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The AMA is hosting a multi-stakeholder multi-session workgroup on potential coding reforms in genomics for tumor testing.   Note that the AM...

Very Brief Blog: Congress Considers Legislation to Fix PAMA Lab Pricing

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 A brief heads-up blog.  ACLA and other lab stakeholders support, and Congress has introduced, a legislative fix for PAMA called "SALSA...

Very Brief Blog: Heads Up: Optum Press Release on Lab Waste; Press.

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 A "heads-up" brief blog. On June 22, 2022, Optum issued a press release on new programs to reduce unnecessary lab testing through...

Very Brief Blog: CMS Updates Roster of Lab Pricing Panel Members

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 On June 23 last week, CMS held the public comment meeting for pricing new lab tests (there were 35 speakers and a spectrum of about 100 cod...
Sunday, June 26, 2022

Nerd Note: Medicare Advantage Plans Don't Have to Follow Many Part B Rules; Example

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There's a general principal that Medicare Advantage plans aren't required to follow the (tens of thousands of pages of) CMS Part B c...
Friday, June 24, 2022

SCOTUS Lets CMS Rule for Hospital Payments Stand; But Dissent is Interesting

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We often think of SCOTUS decisions has having major moral or political debates at risk (gun rights, inter-racial marriage).   But many cases...
Thursday, June 23, 2022

MolDx Releases Draft LCD: Diagnosis of the Difficult Melanoma

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See an October 2022 update with some additional facts and comments. ____ One of the first gene expression tests to help decide ambiguous pa...
Tuesday, June 21, 2022

Congress: Make ARPA-Health More Independent of NIH

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The usually reliable "Government Executive" trade journal has an article today that "Defying Biden, Congress Moves to Give Ne...
Thursday, June 16, 2022

Very Brief Blog: CMS Starts NCD Process on Beta-Amyloid PET Scans

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CMS reopens discussion on a ten-year-old NCD that allows beta-amyloid PET scans to be covered only in clinical trials. ___________ Famously,...