CodeMap® Compliance Briefing: April 10, 2018

Editor's Welcome: Over 21 months ago, CMS issued final regulations implementing the Protecting Access to Medicare Act of 2014 (PAMA). However, those regulations did not include detailed provisions concerning Advanced Diagnostic Lab Tests (ADLTs). On March 22, 2018, CMS finally published guidance concerning this type of testing and the associated reimbursement policies and procedures. As the following CodeMap® Compliance Briefing will demonstrate, the recent CMS guidance and the new qualification requirements for ADLTs are complex and detailed. Unfortunately, the added complexity and more stringent requirements may subtract from the potential usefulness of this category of tests. Until a few pioneering laboratories navigate these requirements, it will be difficult to determine whether these payment mechanisms will be helpful to lab....

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