Cigna to cease payment for professional component of clinical pathology
Cigna, one of the last remaining payers that reimburses the professional component of clinical pathology, will look to officially end that practice this summer, according to an update posted April 12. In the update to its Modifier 26 Professional Component Policy,...
UHC placing ‘pre-pay’ review on some Covid claims
Multiple labs we work with have recently received pre-payment records requests from UnitedHealthcare to support their Covid-19 testing. While UHC isn’t denying these tests for improper coding, the payments they’ve put on hold amount to nearly $1 million in...
Medicare clarifies billing rules for second run Covid-19 variant tests
When re-testing Covid-19 specimens to check for variants, Medicare has indicated you may bill U0004 for the second-run of a high-throughput test. For example, if a specimen tests positive, you may run the sample again to check for variants and bill U0004 (or the same...
2021 Covid-19 coding update
The following Covid-19 coding changes are effective as of Jan. 1, 2021: REMOVE: Z20.828 should NO LONGER BE USED for possible or suspected exposure to Covid-19 for dates of service (DOS) on or after Jan. 1, 2021. Z11.52 should NO LONGER BE USED for encounter...