Question:

What are common laboratory fraud and abuse schemes?

Answer:

There are a multitude of different ways that laboratories can find themselves in peril. The most common areas relate to improper relationships, billing standard abuse, and medically unnecessary testing. All of these can prove dangerous to compliance protocols, and violation of any one could bring serious consequences.

  • Pass-through Billing
  • Partial Physician Ownership and Co-referral Networks
  • Improper use of Modifier 91
  • Unbundling of Laboratory Panels
  • Use of Excessively Broad Panels
  • Standing Orders for Laboratory Tests
  • Improper and Excessive Urine Drug Testing
  • Improper and Excessive Genetic Testing

This question was answered in an edition of our Laboratory Compliance Manager. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

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