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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
Date:12/7/2011

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 & Darkdaily.com. 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 d
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