In the 2018 OPPS proposed rule, CMS proposed a change to the current clinical laboratory date-of-service policies for molecular pathology tests and for Advanced Diagnostic Laboratory Tests.
Resolving claims returned with National Correct Coding Initiative edits or Medically Unlikely Edits can be a time-consuming process. Organizations need processes to promote best practices and keep appeals on track, as well as coding and billing policies that address common front-end problems that lead to these edits.
The CMS policy in the 2018 OPPS proposed rule with potentially the largest administrative and financial burden for hospitals should not be finalized, according to the agency’s own advisory panel.