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Pathology/Lab Coding Alert

Here's How to Play 'The Price Is Right' for Clinical Lab Tests

Published on Sat Oct 30, 2004

Count on new-code rates for 2005 Here's the Medicare payment scoop you need for 11 new clinical laboratory codes.

Look at the table in "The Spotlight's on New Lab and pathology Codes - Are You Ready?", Article 6,  to see the CMS crosswalk recommendations and the 2005 national fee cap for the codes. You can use this information to start your 2005 coding and payment planning early.

CMS had publicized the codes earlier this year and asked for lab community input on pricing. Consistent with recommendations from the public, CMS crosswalked the new codes to existing tests that use similar methodology. CMS summarized public comments and announced the proposed Medicare reimbursement rates, which are available on the Internet at http://www.cms.hhs.gov/paymentsystems/clinlabsum05b.asp.

Also consistent with public comment, CMS will place new cytopathology and surgical pathology codes on the physician fee schedule rather than the clinical laboratory fee schedule.
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