Z-Code transitions have become a requirement as of July 1st, 2018, but far too many labs are still behind on implementing them into their revenue cycle management (RCM) practices.
Molecular Diagnostics (MolDX) is experiencing a much brighter year than 2017, but Z-Codes have come around to impeade your revenue collection.
We here at Apache Health want to provide some know-how to incorporate into your billing cycle in order to get claims out the door the right way and on the first try.
The Background on Z-Codes
Palmetto beat out Cahaba for MAC jurisdiction JJ this Summer, and for those who fall into that geographic location, much is changing on your billing front.
As of July 1st, 2018, any claim received with a date of service on or after Feb. 28th will require a Z-code on the claim line if the service is covered under molecular diagnostics testing.
Any claim without it should be hit with a denial, and provide a kink in your revenue flow.
To mitigate this MolDx labs need to start using Z-codes on everything necessary, but how do you put them in correctly?
The first step, let's establish everyone affected by this change. Jurisdiction JJ lab providers Palmetto GBA, Noridian, WPS, and CGS all now require Z-Code relationships on claim line items.
Second step, the easiest way to apply Z-codes is to apply for them from Dex Diagnostics and to have a code association by CPT code as well as the panel.
This way your basis for each claim entry is covered. Simply put, Dex will assign a Z-Code that is approved for association with applicable panels and CPT codes.
If you need assistance with Z-Code application, Apache can provide a referral for any client in need.
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