Pathology/Lab Coding Alert

Question: In looking at our pathology payments, it appears that we’re still getting the “sequestration cuts,” but I thought those had expired. What’s the story?

Texas Subscriber

Answer: Back in 2013, CMS instituted “sequestration cuts,” which slashed Medicare fee-for-service pay by two percent. Although those were set to expire in 2015, they didn’t — the cuts are still in place.

CMS reminded practices of this fact in its March 3 “MLN Connects Provider e-News” bulletin, which noted that the two percent payment reduction will stay in place for the foreseeable future.

“The claims payment adjustment will continue to be applied to all claims after determining coinsurance, any applicable deductible, and any applicable Medicare Secondary Payment adjustments,” CMS said in the notification. “Though beneficiary payments for deductibles and coinsurance are not subject to the two percent payment reduction, Medicare’s payment to beneficiaries for unassigned claims is subject to the two percent reduction.”

To read more from the MLN Matters update, visit www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive-Items/2016-03-03-Enews.html#_Toc444672557.