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Tag Archives: Centers for Medicare & Medicaid Services —

Puzzling out the positive shift in the final 14-day rule

March 2018—When the CMS’ new 14-day rule took effect Jan. 1, conditions for laboratories doing outpatient reference testing might have changed for the better. But 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.

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Xifin highlights flaws in CMS draft PAMA pricing

Sept. 27, 2017—Xifin has conducted an initial review of the draft laboratory rates published on Sept. 22 by the Centers for Medicare and Medicaid Services for 2018 clinical laboratory tests under the Protecting Access to Medicare Act. Xifin’s preliminary analysis reveals fundamental concerns with the exercise that provides the basis for challenging the proposed schedule. Chief among the company’s concerns ...

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CAP proposals on IHC, PQRS accepted for Medicare in ’15

November 2014—The Centers for Medicare and Medicaid Services on Oct. 31 published its 2015 Medicare physician fee schedule to set payment rates and policy for the next year, including the relative value units for existing and new Current Procedural Terminology codes. Several of the CAP’s recommendations and proposals were accepted for inclusion, such as three new quality measures designed for pathologists and eliminating G-codes to pay for immunohistochemistry services.

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On cuts and consequences, pathologists make their case

October 2013—James Richard, DO, directs CAP-Lab, an independent laboratory in Lansing, Mich., where he manages the business and does everything from signing off on pathology reports to paying the mortgage on the building. But among the many issues he tackles running his practice and in the midst of a shift in health care in the U.S., a single rule proposed by the Centers for Medicare and Medicaid Services is what’s keeping him awake at night.

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Heart failure high-wire act

July 2013—After weeks of bewilderment, W. Frank Peacock, MD, finally solved the mystery of one of his so-called frequent fliers in the Emergency Department. At the time, Dr. Peacock was vice chair, Emergency Medicine, at the Cleveland Clinic. Every Monday morning, week after week, a local pastor would show up with symptoms of possible heart failure.

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