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Temporary Delay in CMS Ordering/Referring Policy
Thursday, April 25, CMS announced a temporary delay in CMS ordering/referring policy.
PSA Alert: CMS Announces 2% Sequestration Cuts for April 1, 2013
On Friday, CMS released the following message regarding Medicare claims and the upcoming sequestration payment cuts. We will continue to monitor the issue and keep you informed.
Introducing ReveNews, a pathology-focused client newsletter.
PSA Alert: 2013 CPT Changes
The 2013 edition of the CPT code book contains significant changes for pathology and laboratory services, particularly in relation to molecular testing. These changes, additions and deletions are summarized in this article.
PSA Alert: SGR Cut Adverted for 2013
The legilation prevents the Medicare physician payment SGR cut for one year. It eliminates the 27% Medicare physician payment cut, which otherwise would have taken effect as of January 1, and replaces it with a "zero percent update" to the Medicare Physician Fee Schedule Conversion Factor for 2013.
PSA November 2012 Examiner
This issue of the PSA Examiner discusses Dissecting the Impact of the 2013 Medicare Physician Fee Schedule on Coding and Reimbursement, Palmetto's G-Code Requirement for Prostate Biopsies, CMS Delays POS, Plus More.
PSA Alert: CMS Cuts 88305-TC by 52% & Increases 88305-PC by 2%
CMS has announced a series of changes to the 2013 Physician Fee Schedule impacting pathologists on January 1.
PSA Alert: Lead and Succeed in Personalized Medicine and Emerging Technologies
Dr. Louis Wright, PSA Founder, has asked PSA to forward new CAP reference material developed to assist pathologists in understanding future laboratory testing demands necessary to meet practice changes largely driven by Digital Pathology and Genomic Diagnostics, and changing models for Health Care delivery.
McKesson to Acquire MED3OOO
Combined organization to focus on services that help customers improve operational results and financial outcomes.
PSA Founder Receives Outstanding Service Award From the College of American Pathologists
Florence, SC (October 3, 2012) - PSA-LLC-A MED3OOO company, announced recently, Louis Wright, Jr., MD, founder of PSA, was awarded the Outstanding Service Award by the College of American Pathologists (CAP) at a special ceremony held in San Diego, Calif., on September 8, 2012, at CAP ’12 – THE Pathologists’ Meeting™.
PSA Alert: CMS Delays POS; Promises Future Clarification for Pathology Services
The Centers for Medicare and Medicaid Services (CMS) has published a revised policy of place of service (POS) with a new effective date of April 1, 2013.
PSA Alert: CMS POS Guidance Still Pending Clarification
CMS to delay POS changes again. In February of this year, CMS announced a new policy to clarify proper Place of Service (POS) coding that was to take effect on April 1. However, the proposed changes were not well received by many provider groups and actually created more questions than it answered with respect to POS coding for most anatomic pathology procedures.
PSA August 2012 Examiner
This issue of the PSA Examiner discusses Blue Cross Blue Shield's Out-Of-Network Policy, CMS POS Change, United Healthcare Reimbursements of TC Services in ASCs, Plus More!
PSA Alert: Palmetto GBA Medicare Provides Clarification on Coding of Prostate Biopsies
There has been some ambiguity regarding the Medicare policy for billing and reimbursement of prostate biopsy specimens since the January 1, 2012 version of the National Correct Coding Initiative (NCCI) manual was released.
PSA Alert: Changes to 3-Day Payments Window Will Not Impact PSA Clients
PSA has received several questions over the last couple of days about changes to the "three-day payment window" that were effective July 1. The three-day payment window for diagnostic services is not new. In fact, since 1998, Medicare has prohibited hospitals from being reimbursed separately for the technical component of any diagnostic services provided to Medicare beneficiaries in the three days preceding a hospital admission for the same diagnosis.
PSA Alert: Update on United Healthcare Reimbursement of Laboratory TC Services in ASCs
In May PSA notified its clients that we had become aware that United Heatlthcare had begun sending notices to laboratories and pathology practices proposing to amend their contracts as it relates to reimbursement of the technical component (TC) of pathology services provided in an ambulatory surgical center (ASC) setting.
PSA June 2012 Examiner
This issue of the PSA Examiner discusses UHC Proposes to Stop Paying for TC in ASCs, Medicare Changes Enrollment Guidlelines, Aetna to Require CLIA & CAP Accreditation for In-Office Labs, Plus More.
PSA Alert: Aetna to Require CLIA & CAP Accreditation for In-Office Labs
Letter to Physicians with In-Office Labs: Aetna has recently begun notifying physician practices which have been billing for "in-office surgical pathology testing" that they will be required to provide documentation of both CLIA certification and CAP accreditation in order to continue receiving payment for those services in the future.
PSA Alert: United Healthcare to Stop Paying for TC in ASCs
PSA has recently become aware that United Healthcare has begun sending notices to laboratories and pathology practices proposing to amend their contracts as it relates to reimbursement of the technical component (TC) of pathology services provided in an ambulatory surgical center (ASC) setting.
PSA April 2012 Examiner
This issue of the PSA Examiner discusses CMS to Delay POS Change, SGR, ICD-10 & TC Grandfather, NCCI Edits Updates and much more.
PSA Alert: CMS to Delay POS Change
PSA has just received word from CMS that the place of service (POS) changes introduced in Transmittal 2407 last month will be delayed until October.
PSA Alert: PSA Request Clarification from CMS on POS Guidance
PSA has been working with CAP to communicate to CMS a variety of concerns regarding CMS's new instructions for assigning place of service (POS) codes. PSA has also been in direct contact with CMS to address our concerns and request clarification.
PSA Alert: SGR, ICD-10 & TC Grandfather
A brief update on the SGR Conversion Factor, TC Grandfather Legislation, and ICD-10 Implementation Deadline
PSA Alert: CMS Issues Revised Guidance on Place of Service
The Centers for Medicare and Medicaid Services has recently issued a transmittal which introduces new instructions for assigning the place of service (POS) for professional component services. Previous regulations had required that the POS was to be determined by the location where the service was actually performed; however, that rule had been the source of much confusion...
PSA January 2012 Examiner
This issue of the PSA Examiner discusses Special Stains Update, New PQRS Measures, 2012 CPT Codes and much more.
PSA Alert: 2012 CPT Codes
The 2012 edition of the CPT code book contains significant changes for pathology and laboratory services, particularly in relation to molecular testing.
PSA Alert: Special Stains Update for 2012
The 2012 edition of the AMA CPT Code book put an end to the controversy regarding the unit of service for special stains for codes 88312-88319.
PSA Alert: 2012 PQRS Measures Specifications Now Available from CMS
Beginning January 1, 2012 five PQRS measures will be available for pathologists. The two long-standing measures are for Breast Cancer Resection and Colorectal Cancer Resections. There were no changes to the Breast Cancer Resection measure; however, the Quality Data Codes (QDCs) for Colorectal Cancer Resection have completely changed.
The TC Grandfather Exception will Sunset December 31, 2011
In the event that the TC Grandfather is allowed to sunset, independent laboratories and pathology practices which currently serve these largely rural “covered” hospitals will no longer be able to bill their Medicare Part B carriers for the technical component of anatomic pathology services provided to Medicare inpatients and outpatients.
PSA November 2011 Examiner
This issue of the PSA Examiner discusses Medicare Enrollment Revalidation, 2012 PQRS Reporting, Coding Compliance Issues of 2012 and much more.
PSA Alert: CMS Extends Revised ABN Mandatory Use Date to January 1, 2012
CMS has revised the Advanced Beneficiary Notice of Non-Coverage (ABN) CMS-R-131 form. CMS added a statement to their website dated September 20, 2011, noting the mandatory use date has been extended to January 1, 2012.
PSA August 2011 Examiner
This issue of the PSA Examiner discusses RAC Attacks, 2012 ICD-9 Codes Changes, Five Steps to Building a Lean Lab and much more.
PSA Annouces Preferred Pricing on Ventana's Dual ISH test
The HER2 Dual ISH is the first fully automated assay approved by the FDA for determination of HER2 gene status in breast cancer as an aid in the assessment of patients considered for treatment with Herceptin (trastuzumab). The HER2 Dual ISH assay transforms the diagnostic process by providing complete, walk-away automation on the VENTANA BenchMark XT instrument and dramatically reducing the turnaround time for accurate results.
PSA Alert: CMS Requires Use of Revised ABN by November 11, 2011
CMS has revised the Advanced Beneficiary Notice of Non-Coverage (ABN) CMS-R-131 form. The mandatory use date for the revised ABN form was originally scheduled for September 1, 2011. However, in an effort to allow providers and suppliers additional time to transition to the new notice and exhaust their supply of preprinted ABN forms, the mandatory use date has been changed to November 1, 2011.
PSA June 2011 Examiner
This issue of the PSA Examiner discusses 5010 Billing and ICD10 Coding Conversion, PECOS Enrollment, Thyroid FNA Coding Question, and more.
PSA Alert: CMS Physician Signature Requirement Update
In February PSA informed you that the Centers for Medicare and Medicaid Services (CMS) had privately announced its intention to rescind the physician signature requirement for laboratory requisitions. Since that time, CMS Director Jonathon Blum has continued to privately assure leaders in the laboratory industry that CMS is working to get the Physician Signature Rule rescinded, and it is our understanding that a new proposed rule is already in the works; however, late last week PSA learned that CMS was encountering some difficulty (translated "red tape") with the process, and Director Blum indicated that CMS would likely implement another delay in enforcement before April 1.
PSA Alert: CMS to Withdraw Signature Rule
The Clinical Laboratory Coalition is reporting today that the Centers for Medicare and Medicaid Services (CMS) has privately announced their intention to rescind the physician signature requirement for laboratory requisitions. This report comes on the heels of a series of Open Forums hosted by CMS in recent weeks as well as a series of meetings with laboratory industry representatives who have decried the new signature requirement as unworkable in its present form.
PSA February 2011 Examiner
This issue of the PSA Examiner discusses How to Avoid Audit Headaches, Operating Your Practice as a Healthcare Business,2011 PQRI (now PQRS) updates and much more.
PSA Alert: CMS Delays Enforcement of Physician Signature Rule
In the November 29, 2010 Medicare Physician Fee Schedule final rule, the Centers for Medicare and Medicaid Services (CMS) finalized its proposed policy to require a physician's or qualified non-physician practitioner's (NPP) signature on requisitions for clinical diagnostic laboratory tests paid under the clinical laboratory fee schedule effective January 1, 2011."
PSA December 2010 Examiner
This issue of the PSA Examiner discusses PECOS Update, Special Stains Unit Still Under Debate, 2011 New CPT Codes and much more.
PSA Alert: House Votes to Extend SGR Freeze Until December 31
The House of Representatives voted today to freeze the current Medicare Fee Schedule Conversion Factor until December 31 in order to avoid a 23% decrease that is currently scheduled take place on December 1. The bill, which was passed by the Senate last week, now goes to the President to be signed into law."
PSA Alert: CMS to Require Signature on ALL Requisitions beginning January 1
The Center for Medicare and Medicaid Services (CMS) has recently announced that it has finalized a proposed rule published this summer which will require the signature of the ordering physician on all paper laboratory requisitions effective January 1, 2011. In spite of heavy opposition from the laboratory community, CMS argued that this step was necessary in order to clearly address the signature issue and put an end to confusion about signature requirements associated with its previous attempts to distinguish between "orders" and "requisitions".
PSA November 2010 Examiner
This issue of the PSA Examiner discusses 2011 ICD-9 Code Changes, Genzyme to Sell Genetic Testing Business, Top Five Outreach Industry Trends and much more.
PSA September 2010 Examiner
This issue of the PSA Examiner discusses In-Office Lab Q&A with Jane Pine Wood, Revenue as a By-Product of Investment, Pap Coding Question, and much more.
Revenue as a By-Product of Investment: 6 Factors to Consider When Researching Billing Companies
In today’s economy of declining reimbursement and increased regulation, physician groups nationwide have understandably begun researching their billing options in hopes of higher collections and lower billing fees. When evaluating the outsourcing or migrating of billing functions from one venor to another, consider the following 6 factors:
PSA August 2010 Examiner
This issue of the PSA Examiner discusses Auditors - What They Don't Know Can Hurt You, Medicare Changes Unit of Service for Special Stains and FNAs, Current Medicare Audit Issues Involving Laboratory and Pathology Services, and much more.
PSA Alert: President Signs "Doc Fix"
Last night, the House of Representatives passed HR 3962, the "Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010", as amended by the Senate last week, and President Obama signed it into law this morning. This temporary "doc fix" reverses the 21% SGR reduction which went into effect on June 1 and replaces it with a 2.2% increase which will be retroactive to June 1.
PSA June 2010 Examiner
This issue of the PSA Examiner discusses New PECOS Enrollment Deadline, Pathologists Can Still Earn Medicare PQRI Incentives, Red Flag Rule Deadline Extended, and much more.
Pathology Practices: Are Your Payers Paying You Correctly?
Unfortunately in today’s pathology practices, many of our contracted insurance companies pay significantly less than our charge. Also to complicate matters, each participating insurance company may have different plans with different reimbursement rates for each plan and most pathology practices participate with numerous insurance companies.
PSA Alert: New PECOS Enrollment Deadline for Pathologists and Referring Physicians
CMS has recently announced that it has moved the date for enrollment in PECOS up six months to July 6, 2010. PSA is hopeful that, while the regulation now requires providers to be enrolled in PECOS by July 6, 2010 the Medicare carriers will not begin denying claims before the originally published date of January 3, 2011.
Pathologists Can Still Earn Medicare PQRI Incentives
During 2010, the Medicare Physician Quality Reporting Initiative (PQRI) will pay a 2% bonus to pathologists who register and report data on 80% of their cases for the specified CPT codes. However, independent pathology laboratories still cannot participate in the PQRI program. Also, PSA, LLC reports it can be challenging to audit the Medicare PQRI bonus amount paid at year’s end against the actual amount that was billed to Medicare by individual pathologists for the CPT codes included in the PQRI program.
PSA Alert: Medicare Physician Fee Schedule
CMS announced late yesterday that it has instructed its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule (MPFS) for the first 10 business days in June (effectively, through June 14), in order to allow more time for Congress to pass legislation that will avert the 21% negative update currently scheduled to rake effect on June 1.
PSA April 2010 Examiner
This issue of the PSA Examiner discusses PECOS Enrollment, Payor Relationship Management Strategies and Trends, How to Utilize Your Billing Reports to Maintain Market Share, New Business Alliance with NeoGenomics Laboratories, and much more.
Enrolling in PECOS
On January 3, 2011 Medicare will discontinue paying claims for physicians if both the physician and referring provider are not enrolled in PECOS (Internet-based Provider Enrollment, Chain and Ownership System). It is important to understand that enrollment in PECOS is a separate process from traditional Medicare enrollment. Although enrolled in Medicare, many physicians are not enrolled in PECOS.
PSA Enters into Business Alliance Agreement with NeoGenomics Laboratories
Pathology Service Associates, LLC (PSA), a MED3OOO Company, the country’s leading provider of revenue cycle management and other business support services to independent pathologists across the United States, has entered into a Business Alliance Agreement with NeoGenomics Laboratories,Inc.
Temporary Freeze on Medicare Physician Fee Schedule
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