Dermatology remains exempt from Aetna in-office pathology lab accreditation policy
Recently, there has been confusion about Aetna’s accreditation policy, which exempts dermatologists and dermatopathologists from in-office pathology billing. Aetna has confirmed that there are no new changes to their policy and that they still will exempt dermatologists from the in-office pathology billing policy. Aetna stated this exception for dermatologists and dermatopathologists in a letter dated May 30. Last week, Aetna mailed a letter to all specialties other than dermatology that explains the timeline for the in-office pathology billing policy. Dermatology practices should not have received the July 10 letter. If you suspect your practice may have received the wrong letter, or have questions about how Aetna’s in-office pathology billing policy applies to you, please call Aetna’s Senior Network Manager Tammy Gaul at (215) 775‐2437 or fax correspondence to (860) 754‐1740.
The Academy has been working closely with Aetna since early April to address concerns about the recent change to its in-office surgical pathology testing policy that requires practices to be both Clinical Laboratory Improvement Amendments (CLIA) certified and College of American Pathologists (CAP) accredited to receive payment for surgical pathology services. This policy change is slated to go into effect on Aug. 1, 2012.
Aetna has assured the Academy
that dermatology practices
with in-office laboratories
will be exempt from this policy.Aetna has assured the Academy that dermatology practices with in-office laboratories will be exempt from this policy, and do not need to provide Aetna with any additional accreditation documentation to continue receiving payment for in-office surgical pathology testing. Aetna is providing written notification to the affected practices.
Immediately after Aetna announced this policy change in April, the Academy took the lead on the issue and convened a rapid-response team of leaders in the areas of dermatopathology and health care finance to address this important issue. The Academy's goal is to ensure that such policies do not negatively affect the delivery of timely diagnostic services, which are integral to providing high-quality, direct dermatologic care to patients in an office-based setting. We appreciate Aetna’s willingness to work with dermatology to clarify this issue.
For further information, please contact your Aetna representative.