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What is MolDX and When Do I Need a Z-Code?

What is MolDX and When Do I Need a Z-Code?

by Alex Mitchell | Mar 19, 2026 | Clinical Laboratory, Payer Audits & Alerts, Denial Management, Revenue Cycle Management, Industry Insights

00:00 1X   Laboratories performing infectious disease testing and billing Medicare Part B within a MolDX jurisdiction are subject to a new Local Coverage Determination (LCD) that stands to significantly impact reimbursement for these services. Labs in the...
IHC Reimbursement Under the Microscope: What Pathology Groups Need to Know

IHC Reimbursement Under the Microscope: What Pathology Groups Need to Know

by Alex Mitchell | Feb 11, 2026 | Payer Audits & Alerts, Billing & CPT Codes, Revenue Cycle Management, Industry Insights

00:00 1X   Payment and coverage for immunohistochemistry (IHC) stains are facing increased scrutiny from both commercial and government payers. For pathology groups and laboratories, this heightened attention has translated into tighter policy language, expanded...
How Clinical Labs Can Improve Payer Network Access and Leverage

How Clinical Labs Can Improve Payer Network Access and Leverage

by Alex Mitchell | Jan 7, 2026 | Denial Management, Revenue Cycle Management, Industry Insights

00:00 1X   For most clinical laboratories looking to improve their payer network, reimbursement challenges aren’t an abstract business concern; they’re existential. For independent and small- to mid-sized reference labs/POLs, one reality remains consistent:...
Molecular Test Reimbursement: MolDX, Z-Codes & Payer Reform

Molecular Test Reimbursement: MolDX, Z-Codes & Payer Reform

by Alex Mitchell | Dec 2, 2025 | Denial Management, Billing & CPT Codes, Revenue Cycle Management, Industry Insights

00:00 1X   If you work in a clinical or molecular lab, you’re living this tension every day: advancements in testing keep moving forward, but reimbursement rules lag months or even years behind. New molecular tests, infectious disease diagnostics, and proprietary...
Balancing Compliance, Risk, and Revenue in Toxicology Testing

Balancing Compliance, Risk, and Revenue in Toxicology Testing

by Alex Mitchell | Nov 11, 2025 | Denial Management, Payer Audits & Alerts, Tips for New Lab Owners, Industry Insights, Clinical Laboratory

00:00 1X   For many labs, toxicology has long been a top target for payer audits. Reimbursement cuts and stricter “medical necessity” interpretations are raising denials, claw-backs, and scrutiny, especially around frequency of testing and documentation quality....
Expanding Molecular PCR Services by Securing Nationwide Payer Contracts

Expanding Molecular PCR Services by Securing Nationwide Payer Contracts

by Alex Mitchell | Oct 16, 2025 | Case Studies, Lab Operations & Management, Revenue Cycle Management, Industry Insights

Client: Infinite Genomics, LLC    Overview  Infinite Genomics was formed as a molecular diagnostic laboratory in 2021. Although the lab is located in North Little Rock Arkansas, it intended to offer PCR services to providers across the nation. To put that plan...
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