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Why Medicare Carrier Proposes Major Changes in the Handling of Code Stacked Molecular Test Claims is Topic of December 20 Audio Conference

AUSTIN, Texas, Dec. 7, 2011 /PRNewswire/ -- Medicare carrier Palmetto GBA is proposing new processes that govern how it will handle code stack claims for molecular diagnostic tests (MDT) and laboratory-developed tests (LDT) in the J1 region, to become effective on February 27, 2012. This marks the first known effort by a payer to address specific problems caused when laboratories submit code stacked claims for genetic tests and molecular diagnostics assays.

These important developments will be covered in a special audio conference to be conducted on Tuesday, December 20, 2012, by The Dark Report & Featured speakers from Palmetto GBA are: Elaine Jeter, M.D., Medical Director; and Mike Barlow, Vice President. Jeter and Barlow will discuss five important subjects:

  •  Why the use of code stacks in claims for genetic and molecular tests creates issues for payers.
  •  How the two proposed local coverage determinations (LCD) will address the most important issues triggered by code stacking.
  •  Introduce labs to the Molecular Diagnostic Services Program (MolDx) and how a molecular test registry will be used in the MolDx program.
  • Describe the steps involved in using the MolDx registry, which includes each lab to register each of its MDTs and LDTs to obtain a Z-Code for each assay, and how labs should next submit the clinical and scientific material in support of each assay that will be used to make a coverage determination of that test.
  • What will take place in order for the coverage determination to be made for each assay with a Z-Code.
  • How code stacked claims for genetic and molecular tests from the J1 region will be handled prior to February 27, 2012, and after that date. 

This audio conference is an open public forum which allows every laboratory professional to hear these presentations and participate in the question and answer session that follows. It is also an opportunity for lab consultants and experts in genetic and molecular testing to hear, first-hand, the details behind the two proposed LCDs and MolDx, the proposed Molecular Diagnostic Services Program.

This high-value, low-cost 90-minute audio conference is of critical interest to laboratories performing molecular diagnostic tests and lab-developed tests. As noted above, Palmetto GBA executives will directly address the issues of concern to laboratory leaders to be caused by the growing number of code-stacked claims. In addition, the executives will answer specific questions from the audience during a phone Q&A. Media representatives who would like to listen to this audio conference should email Justin M. Clark at: 512-264-7103.

THE DARK REPORT ( invites you to participate in this important and timely new audio conference. For more information or to register, call toll-free: 800-560-6363

For additional information, Contact: Justin M. Clark, 512-264-7103

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