Laboratory Question for the Week of June 8, 2026
Under PAMA regulations, how is pricing determined for new laboratory test codes that do not yet have established Medicare payment rates?
Under PAMA regulations, how is pricing determined for new laboratory test codes that do not yet have established Medicare payment rates?
What does an MUE (Medically Unlikely Edit) represent in relation to HCPCS/CPT® coding?
What types of improper laboratory claims are targeted in potential future OIG and Medicare audits?
When may a provider appropriately report both immunocytochemistry (IHC) and flow cytometry services for the same specimen?
How often should Hepatitis C screening occur high risk due to continued use of illicit injection drugs?
Can you clarify the terms “screening” or “screen?”
If the test our laboratory performs meets the definition of a PLA code do we have to use that code or can the laboratory report an existing Category I code that has a similar description?
Is a PLA code a CPT Category I code?
When is it appropriate to use modifier 59 for repeat procedures, and what documentation is required to support its use?
What are the X{EPSU} modifiers used in laboratory services?
Why were PLA codes 0285U and 0365U revised in 2026?
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