LAByrinth

BTW, what were the top Medicare Laboratory Claims in CY 2023?

As a follow-up FYI tidbit to the previous article, here are 2023’s top fifteen laboratory claims according to the OIG:

• Blood test, comprehensive, chemicals
  (80053): $405.1 million
• Blood test, lipids
  (80061): $332.3 million
• Blood test, TSH
  (84443): $316.0 million
• Genetic test: colorectal cancer
  (81528): $301.0 million
• Detection, nucleic acid, amplified
  (87798): $292.4 million
• CBC, automated
  (85025): $282.3 million
• Vitamin D-3 level
  (82306): $250.9 million
• Hemoglobin A1C level
  (83036): $176.0 million
• Genetic test: cancer
  (81455): $145.2 million
• Drug test(s), 22+ drug classes
  (G0483): $145.1 million
• Presence of drug, by chemistry
  (80307): $129.1 million
• COVID-19 test: nucleic acid
  (U0003): $115.0 million
• Drug test(s), 15-21 drug classes
  (G0482): $110.5 million
• Genetic test: 55-74 genes, cell-free
  (0242U): $104.8 million
• COVID-19 test: multiplex amplified probe
  (87637): $103.6 million

The Self-Testing Corner: STIs and Prostate Cancer

According to a University of Michigan study, people aged 14 to 24 years prefer to self-test for STIs. Perhaps unsurprisingly, the reasons given were better privacy and less stigma.

As for prostate cancer, a Journal of Urology report based on surveys by Vanderbilt U and again, the U of MI, an at-home urine test proved as accurate as that which is collected on-site at a healthcare facility. Reportedly, it would help avoid MRIs and biopsies.

Self-tests, as noted, may have an obvious impact on laboratories that perform STI and prostate cancer testing for patients.

Click here for the U of MI press release on STIs and here for the report on prostate cancer self-testing.

(Self-testing by patients for anything is another reason to ensure your laboratory’s claims are submitted for maximized revenue. ADSRCM does that for our clients!)

Labfraudatory Article of the Month

In a whistleblowing case, the reportedly third largest laboratory in the US will pay over $700,000 to resolve allegations of billing the government for unnecessary blood testing. The relator (aka “whistleblower”) will receive nearly $113,000.

The allegation explains how the laboratory, from 2012 to 2023, conducted much more expensive blood testing than what medical providers prescribed for those patients. More specifically, CBC tests were typically ordered without WBC (white blood count). However, the laboratory performed those tests with WBC, making them more complex calling for larger reimbursements.

Click here for the Justice Department’s details.

Speaking of a Laboratory Sales Staff…

When a laboratory has a sales team, or even just a single salesperson, providing them with a way to self-serve on any number of levels on-demand using an app - without disrupting others at the laboratory - benefits everyone.

(ADSRCM and ADS provide no-cost access to a sales team portal!)

Next Up:

March and new articles and items of interest for laboratories!

Have questions? Simply click on the orange button to learn more about how you can drive maximized revenue and productivity for your laboratory with ADSRCM or about the MedicsPremier platform if in-laboratory automation is preferred!

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