Valerie Collier

ARUP Laboratories’ Access and Reimbursement Manager Valerie Collier, MS, CGC, will be featured as an expert panelist in a special upcoming Dark Report webinar on June 29.

June 23, 2023

Clinical laboratories are at risk for financial disruption this year after an announcement from one of the nation’s largest health insurers warned that major changes to the private payer’s molecular and genetic test claims policy were underway.

Effective August 1, 2023, UnitedHealthcare (UHC) will require Z-Codes for approximately 250 American Medical Association Current Procedural Terminology (CPT) codes when test claims are submitted for reimbursement. Laboratories billing UHC must take immediate action to adapt their billing practices and submit their molecular and genetic tests for Z-Code assignment to avoid claim denials after August 1.

ARUP Laboratories’ Access and Reimbursement Manager Valerie Collier, MS, CGC, will provide practical insights on how to successfully obtain Z-Codes and interact with the Diagnostics Exchange (DEX) Molecular Diagnostic (MolDx) Services Program in a special Dark Report webinar, “Essential Guide to Obtaining Z-Codes for Molecular and Genetic Tests: How to Apply and Prepare for New Private Payer Z-Code Requirements,” on Thursday, June 29, at 1 p.m. ET. Registration is free. 

“We will continue to see UnitedHealthcare requiring Z-Codes for additional molecular and genetic tests, and we expect to see other insurance companies using MolDx and adding this requirement in the future,” Collier said. “There are labs that have never used MolDx and may not have their tests in the registry because it was not necessary before. Now they are starting from square one.”

Collier, who successfully led the implementation of ARUP’s own MolDx Services Program, will share reflections on her experience ensuring access and coverage for ARUP’s MolDx tests. She hopes to equip other laboratories with the tools to overcome potential obstacles in the Z-Code application process.

“Larger laboratories have the resources and ability to put forward this huge effort, but not all labs are able to do so,” Collier said. “ARUP is leading the way with MolDx and Z-Codes so that we can assure our clients that we are here to support them in any issues that might come up with Z-Codes and reimbursement.”

The 90-minute webinar will offer guidance in five key areas: structure and function of DEX MolDx and the Z-Code registry, the application process for obtaining Z-Codes, analytic and clinical validation documentation, interplay with CPT, Proprietary Laboratory Analyses (PLA), and International Classification of Diseases, Tenth Revision (ICD-10) codes, and best practices when submitting Z-Code applications. Additionally, the webinar will feature a live question-and-answer session after each segment for attendees to discuss specific questions with the expert panelists.

Along with Collier, the webinar’s expert panel will include Gabriel Bien-Willner, MD, PhD, medical director of the Molecular Diagnostic Services Program and chief medical officer of Palmetto GBA, and Kyle Fetter, chief operating officer of XiFin.

View the previously recorded webinar here. Registration is required.

 

Camryn Fife, camryn.fife@aruplab.com