FOOD SAFETY & INFECTIOUS DISEASES
reimbursement of three to five pathogen
panels in limited clinical circumstances
and issuing a no-coverage decision for
respiratory viral panels of six or more
pathogens (see call-out box). Moreover,
LCDs for GIP panels maintained that
reimbursement will only be issued for five
targets (though with the addendum that
if Clostridium difficile colitis is suspected,
coverage will be expanded for up to 11
targets) (see call-out box).
Though the long-term impact of these
policy changes is unclear, APHL foresees
revisions to clinical ordering and testing
practices. A decrease in clinical laboratory
testing as a result of these policies
would potentially weaken public health
surveillance systems that rely on these
data streams. Dr. Pete Shult, associate
director of the Wisconsin State Laboratory
of Hygiene, notes that as a public health
laboratory there is “relatively low impact,”
but he intends to contact clinical partners
“to understand the impact on clinical
labs and, ultimately, the quality and
robustness of state surveillance data.”
It is possible that these decisions will
eventually drive the diagnostic testing
market toward smaller tailored panels.
These reimbursement policy decisions
illustrate the need for continued dialogue
among stakeholders from CMS, private
payers, clinical and public health
laboratories, MACs and the medical
device industry. While there is impetus
to limit reimbursement for these panels–
particularly as the number of analytes
continues to grow–public health agencies
need to be aware of the potential impact
to diagnostic testing and surveillance.
APHL will continue to monitor the
effects of this policy change and engage
members accordingly. n
Respiratory Viral Panel Palmetto Local
Coverage Determination
Respiratory viral NAAT panels including
3-5 pathogens will be reimbursed only in
limited circumstances (i.e., tests under the
87631 code will be covered in susceptible
populations). Panels including 6 or more
pathogens are not covered.
The Association for Biosafety and Biosecurity
Your Biosafety Resource!
ABSA International was founded in 1984 to promote biosafety as a scientific discipline
and serve the growing biosafety and biosecurity needs of scientists, laboratorians,
health care workers, and biosafety professionals throughout the world.
ABSA International Activities and Resources
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Annual Biological Safety Conference, Training Courses, and Webinars
Applied Biosafety: Journal of ABSA International
Biosafety Publications – Including Anthology of Biosafety Series
Biosafety Training Resources
Animal Biosafety Training Video – www.absa.org/resanimal.html
Credentialed Biosafety Professionals – Registered Biosafety Professional (RBP)
and Certified Biological Safety Professional (CBSP)
BSL-2/-3 and ABSL-2/-3 Accreditation Program – www.absaaccreditation.org
Biosafety ListServ, Job Board, Risk Group Database, Biosafety Buyer’s Guide, Training Tools,
and more…
www.absa.org
PublicHealthLabs
@APHL
APHL.org
Winter 2019 LAB MATTERS
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