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Pathology/Lab Coding Alert

CLFS Pricing Proposal:

Don't Expect Pay for MAAA Algorithm

Published on Tue Oct 09, 2012

Just add up the lab tests, CMS says.Despite consistent stakeholder recommendations to price Multi-analyte Assays with Algorithmic Analyses (MAAAs) in a manner that accounts for the cost of algorithm development, CMS says, "no," -- which means you can expect pay only for the underlying tests."Unlike a simple calculation, the algorithm should be recognized as a substantial and reimbursable component of the test," according to Peter Kazon, speaking on behalf of American Clinical Laboratory Association (ACLA) at the annual CMS Clinical Laboratory Fee Schedule (CLFS) public meeting.Read on to learn what your lab can expect for MAAA and other new CPT® 2013 codes paid on the CLFS based on CMS's CY 2013 preliminary payment determinations (available at www.cms.gov/ClinicalLabFeeSched/). Report Underlying Lab Tests for MAAAsYou'll find the following new codes in CPT® 2013, but you won't find new payment amounts on the CLFS, based on the CMS preliminary payment determination:815XX1 -- Oncology [...]
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