A letter dated September 23, 2021 from Cigna says, “As a result of a recent review, we will deny separate reimbursement for Current Procedural Terminology (CPT®) codes billed with modifier 26 for the professional component of laboratory testing when the CMS National Physician Fee Schedule does not recognize the existence of a professional component for the code and when the facility where the service is provided is contractually responsible for laboratory management and oversight services.
The College of American Pathologists (CAP) opposes this plan. According to the CAP website, they are analyzing communications from Cigna to determine its exact effect.
###
TELCOR is an industry leader in the laboratory revenue cycle management and point of care testing markets, providing unparalleled health care software products and services, and exceptional customer support. Our proven implementations are performed by clinically experienced, IT knowledgeable resources who understand each customer’s unique environment.