The government payor made some adjustments in finalizing the 2018 clinical lab fee schedule, but the industry continues to feel CMS is ignoring its most salient concerns.
The agency is excluding certain advanced diagnostic lab tests and molecular pathology tests from a billing regulation that created administrative headaches for many labs.
Anthem said the automated system is an efficient way to ensure coverage for medically necessary genetic tests, but that's not what genetic counselors have described.
Since last year the AMA has issued 23 PLA codes for firms that want to better track use of their tests, but the effect of the codes on improving reimbursement remains to be seen.
BUPA Global and other private health insurers have approved reimbursement for OncoDNA's test, which is intended to provide a complete genetic profile of a patient's tumor.
Payors say online, automated systems will bring standardization and efficiency to prior authorizations, but doctors and labs are uncertain about the impact on patient care.
Researchers have sequenced the northern white rhinoceros to gauge whether it could be brought back from the edge of extinction, the New York Times reports.
