ReviewJournal of clinical microbiology2025
The laboratory billing process and its applications to molecular microbiology testing: guidance for laboratorians.
Review in Journal of clinical microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
5 authors.
Funding
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Abstract
The processes used by laboratories to seek reimbursement for services performed are complex and often unclear to laboratorians, a key group that has the clinical and technical knowledge to influence reimbursement. In this review, we provide a comprehensive overview of laboratory billing processes for insurance billing and hospital inpatient services, as well as the various procedure codes used in these processes. Understanding the health plan landscape is also of critical importance, as health plan policies and coverage decisions have downstream effects on accessibility of testing for patients. A detailed overview of health plans and how coverage determinations are made and communicated is discussed in this review. Lastly, we present actionable areas of opportunity in clinical microbiology where laboratorians, as well as test manufacturers, can focus on improving reimbursement (syndromic panels, antimicrobial resistance, and next-generation sequencing) to expand access to these evolving technologies and encourage adoption in clinical laboratories.
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