Lexology January 17, 2024
Managed care companies continue to face increased risk from some providers potentially engaging in improper provision of health care services and billing, which may implicate fraud, waste, and abuse. Three areas where additional focus is warranted in 2024 are: (1) genetic testing; (2) durable medical equipment billing; and (3) med-spa services.
Key takeaways
- Update payment policies for genetic testing to structure payments similar to the use of G-Codes for urine drug testing
- Audit DME claims to ensure no improper unbundling or miscoding
- Review med-spa claims and documentation to confirm appropriate billing of services
Genetic testing
Rapid advancements in testing for various genetic disorders and diseases have led to exponential growth in genetic testing services. As a result of...
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