| Date | Billing Notice |
|---|---|
| 📌 IMPORTANT | Overutilization and Denial Notice – Aculabs |
| 📌 IMPORTANT | Causes for Exceeding LCD Maximum – Aculabs |
| 📌 IMPORTANT | Importance of Advanced Beneficiary Notices – Aculabs |
| 01/25/2021 | CDC Issues New ICD-10 Codes for COVID-19 Related Conditions |
| 11/07/2019 | HICN Claims Reject for Medicare Starting 1/1/2020 |
| 04/25/2019 | Provider Notice Re: Aetna & Aetna Better Health |
Please be aware that Aculabs operates on paperless billing. Please reach out to your Customer Service Rep for your billing office’s Web Portal credentials to access your Account Info/Statements and downloadable Invoices.
COVID-19 Testing & Payment
Aculabs would like to remind all client facilities that the facility will be responsible for any and all COVID-19 testing for Part A and Managed Care patients. The test codes considered in the umbrella of COVID-19 testing are as follows:
| Code | Test Name | Price |
|---|---|---|
| #3991/3992/892/3994 | CORONAVIRUS COVID-2 (SWAB) | $60.00* |
| #6034 | SARS-COVID-2 IGM (BLOOD) | $65.00 |
| #6055 | SARS-COVID-2 IGG | $65.00 |
| #6072 | SARS-COVID-2 IGA | $65.00 |
| #740 | COV-19 ANTIBODY TOT.BLOOD | $50.00 |
| #774 | ANTI-SARS-COV-2 S Ab | $50.00 |
Insurance Information
Please see below for billing information related to specific insurance plans and coverage.
Aculabs is actively working on becoming a provider for the following Managed Medicaid payors. For the time being, all services performed on patients with the following insurance will be denied and the facility will be held liable:
- Aetna Better Health of New Jersey
- Aetna Better Health of Pennsylvania
As of May 1, 2018, AmeriHealth New Jersey grants exclusivity of provider status for all outpatient laboratory services to LabCorp.
We are currently an out-of-network provider for Cigna health plans.
We are currently an out-of-network provider for the following Emblem Health plans:
- Emblem H.I. Co.
- Emblem Health Plan GHI
Regarding residents with the following insurance, a preauthorization number must now be obtained before services can be processed:
- Health Partner Plans, Managed Medicaid
We appreciate your understanding and compliance at this time.
Aculabs is participating in Horizon’s Non-Managed (PPO/Indemnity) network. Aculabs is an out-of-network provider with the following HMO/Managed Care contracts; POS, Omnia, EPO, Direct Access, HMO and Medicare Advantage.
We are currently an out-of-network provider for Humana HMO plans.
We are currently an out-of-network provider for InnovAge health plans.
Aculabs is currently a non-participating provider for the following plans:
- Keystone First Community HealthChoices
Regarding residents with the following insurance, a preauthorization number must now be obtained before services can be processed:
- PA Health & Wellness (We are now a provider effective 11/2019)
We appreciate your understanding and compliance at this time.
Medicaid Information
While we are a contracted provider with Horizon NJ Health, some tests fall into the category of non-coverage.
Please be aware:
- For DAS, Medicaid patients will not be billed and the bill for ordering the test will instead fall on the facility.
- For Keppra testing, patients under Keystone 65, Personal Choice, Keystone, and Independence plans part of IBC will not be billed and the bill for ordering the test will instead fall on the facility.
New Test Information
Our Customer Service Representatives are available at customerservice@aculabs.com for any questions regarding new testing.
| Date | Test Code | Name | Price | CPT Code | Notes |
|---|---|---|---|---|---|
| 2021-10-01 | #777 | RESP. SYNCYTIAL VIRUS Ag (RSV) | $33.15 | 87807QW | For ordering an RSV separate from a larger panel. |
Price Changes for Testing
Our Billing Department is available at (732) 777-2588 to help with any questions regarding your facilities’ invoices and billing.
| Date Effective | Test Code | Test Name | New Price |
|---|---|---|---|
| 2020-05-01 | #7000 | AMINO ACID PROFILE, QUANT, PLASMA | $235.47 |
| 2020-05-01 | #4147 | AMIODARONE (CORDARONE) | $35.49 |
| 2020-05-01 | #4385 | ANTI-XA | $253.50 |
| 2020-05-01 | #889 | CD3,CD4,CD8 T-CELLS | $124.44 |
| 2020-05-01 | #8898 | CD4 LYMPHOCYTE COUNT | $60.75 |
| 2020-05-01 | #5231 | CELL COUNT, SYNOVIAL FLUID | $23.89 |
| 2020-05-01 | #2439 | CRYPTOSPORIDIUM AG STOOL | $120.12 |
| 2020-05-01 | #4202 | D-DIMER QUANTITATIVE | $28.67 |
| 2020-05-01 | #1191 | ENDOMYSIAL IGA AUTOANTIB. | $43.68 |
| 2020-05-01 | #1345 | HEREDITARY HEMO. (C282Y, H63D, S65C) | $167.90 |
| 2020-05-01 | #628 | PHOSPHORUS, URINE/24HR | $13.65 |
| 2020-05-01 | #5460 | PTH PLUS CALCIUM | $75.08 |
| 2020-05-01 | #5697 | RESP. SYNCTIAL VIRUS, EIA | $36.86 |
| 2020-05-01 | #1311 | STOOL FOR FAT QUALITATIVE | $45.05 |
| 2020-05-01 | #3392 | TROPONIN T | $73.11 |
| 2020-05-01 | #4775 | VALPROIC ACID FREE | $35.49 |
| 2020-05-01 | #1805 | VORICONAZOLE | $541.13 |
| 2020-09-01 | #3522 | FOLATE RBC | $62.79 |
| 2020-09-01 | #7741 | H. PYLORI | $94.19 |
| 2020-09-01 | #1441 | GANGLIOSIDE GM-1 ABS (IGG / IGM) | $245.38 |
| 2020-10-01 | #MRP2 | RESPIRATORY PROFILE 2-IVD + SARS PCR | $416.78 |
| 2021-01-01 | #509 | C REACT.PROTEIN HIGH SENS | $55.60 |
| 2021-01-01 | #507 | C REACT.PROTEIN INFLAMM. | $55.60 |
| 2021-01-01 | #3155 | ESTRADIOIL & SENSITIVITY | $118.77 |
| 2021-01-01 | #2443 | HELICOBACTER PYLORI ANTIGEN STOOL | $59.38 |
| 2021-01-01 | #3125 | IMMUNOFIXATION (IFE), SERUM | $42.32 |
| 2021-01-01 | #9711 | MUMPS IGG IGM | $35.49 |
| 2021-01-01 | #5116 | VITAMIN D 25-HYDROXY, D2 + D3 | $129.35 |
| 2021-04-01 | #5580 | HEPATITIS C VIRUS, RT PCR | $184.96 |
| 2021-04-01 | #8156 | HYPERSENSITIVITY PNEUMONI | $563.55 |
| 2021-04-01 | #1300 | AFP W/ AFP-L3%, SERUM | $118.08 |
| 2021-06-01 | #7205 | AMIKACIN TROUGH | $45.05 |
| 2021-06-01 | #5207 | C DIFF DNA RT-PCR (STOOL) | $390.00 |
| 2021-06-01 | #9430 | CYTOMEGALOVIRUS (CMV) QUANT, PCR | $203.39 |
| 2021-06-01 | #8137 | HEPATITIS B DNA QUANTITATIVE RT-PCR | $227.50 |
| 2021-06-01 | #3015 | HIV I & II ANTIBODY | $107.54 |
| 2021-06-01 | #850 | INTACT N-TERMINAL PROPEPTIDE TYPE 1 | $120.00 |
| 2021-06-01 | #369 | PROCALCITONIN | $250.00 |
| 2021-06-01 | #8080 | WEST NILE VIRUS | $119.91 |
| 2021-08-01 | #2253 | AFPTM | $17.07 |
| 2021-08-01 | #3126 | CALCITONIN LEVEL | $34.13 |
| 2021-08-01 | #4870 | COPPER (WHOLE BLOOD) | $76.70 |
| 2021-08-01 | #487P | COPPER PLASMA/SERUM | $28.67 |
| 2021-08-01 | #1947 | FACTOR VIII ACTIVITY | $113.30 |
| 2021-08-01 | #1948 | FACTOR VIII INHIBITOR | $156.98 |
| 2021-08-01 | #100 | HCV REFLEX TO GENOTYPE | $187.69 |
| 2021-08-01 | #6994 | HOMOCYSTEINE LABCORP, PLASMA | $37.54 |
| 2021-08-01 | #3496 | METHYLMALONIC ACID, SERUM | $61.75 |
| 2021-08-01 | #5437 | MUSK ANTIBODY SERUM | $1,170.00 |
| 2021-08-01 | #629 | PLEURAL FLUID ANALYSIS | $79.17 |
| 2021-08-01 | #1012 | RHEUM. FACTOR IGG,IGM,IGA | $113.98 |
| 2021-08-01 | #1227 | SRP AUTOANTIBODIES | $128.05 |
| 2021-08-01 | #8788 | STREPTOCOCCUS AG URINE | $50.51 |
| 2021-08-01 | #5226 | VIMPAT (LACOSAMIDE) | $190.42 |
| 2021-08-01 | #4731 | NIACIN,BLOOD (VITAMIN B3) | $175.05 |