BILLING LC/MS/MS BEFORE SCREENING

Just received results form 2 of my competitors. Both of them are going straight to LC/MS/MS for confirmations for certain drug classes. The new definitions in 2017 state that labs are not permitted to go straight to LC/MS/MS if a commercially available screening test is available. Both of these labs screen for certain drugs by immunoassay and then go right to LC/MS/MS for other drugs. The other drugs total 8 classes so they can bill the screen and the 2nd tier LC/MS/MS confirmation code even if all the test are negative. When will Medicare and Medicaid stop this fraudulent practice. I am sick of my competition gaming the system. They are criminals and should be shut down immediately!

 

Look around! They are all going down. In fact, most of the crooks have double whammy coming. Most of the corrupt groups were involved with the compounded pain creams and exploited Tricare. They are using the anti kickback statute to come after the reps. These same groups Linked Pgx/tox with compounding. And hence now the lab field is completely screwed, as we now were infiltrated by compounding reps who all of a sudden are lab specialists.

I dont think the lab field will ever return to its heyday. Except for urine toxicology. Urine toxicology tests will have to be more specific. Given the opioid crisis, and now Trump at the forcenter of all this, I suspect that doctors will make the patient pay cash if there insurance company doesn't cover the specific toxicology test. If patients don't want to comply, they will not get there pain meds.

Toxicology litigation is decreasing, and insurance providers are fighting back by cutting reimbursement. Eventually, the patient will have to pay cash, or not recieve there pain meds.