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Clinical lab

Modified: 1/16/2018
Change request (CR) 10446 informs contractors about the 2018 codes that are both subject to, and excluded from clinical laboratory improvement amendments (CLIA) edits. The CR also includes the codes discontinued as of December 31, 2017. [MM10446]
Modified: 1/8/2018
Change request (CR) 10418 describes the latest tests approved by the Food and Drug Administration (FDA) as waived tests under with the Clinical Laboratory Improvement Amendments of 1988 (CLIA). The Current Procedural Terminology (CPT) codes for the new tests must have the modifier QW to be recognized as a waived test. [MM10418]
Modified: 1/3/2018
This article provides tips from First Coast to assist in preventing clinical laboratory test claim errors under the CERT program.
Modified: 12/20/2017
Some clinical laboratories in the U.S. Virgin Islands are charging patients prior to performing services, a potential assignment violation. The article outlines Medicare regulations and potential penalties applicable to laboratories.
Modified: 12/18/2017
Change request 10409 releases the annual update to the clinical laboratory fee schedule (CLFS) and laboratory services subject to reasonable charge payment, which provides instructions for accessing the 2018 CLFS data file, mapping for new codes, and updates for laboratory costs subject to the reasonable charge payment. [MM10409]
Modified: 12/6/2017
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and implemented compliance plans. The OIG has supplied guidance as to the elements of a model compliance plan.
Modified: 10/9/2017
The CERT A/B MAC Outreach & Education Task Force published the guide, “Complying with documentation requirements for laboratory services” to educate laboratories and ordering/referring physicians on documentation requirements for laboratory services. Read more to learn about the improper payments for laboratory services identified by the Comprehensive Error Rate Testing (CERT) program due to documentation errors.
Modified: 9/27/2017
Effective for claims with dates of service on and after July 1, 2012, pathologists and independent laboratories that provide the technical component of physician pathology services furnished to hospital patients may no longer bill for and receive Medicare payment for these services.
Modified: 9/13/2017
This tutorial of the CMS.gov website CLIA page will demonstrate how to determine if a CPT code requires the QW modifier.
Modified: 8/3/2017
Provider specialty page on the CMS website.
Modified: 3/19/2015
There are no items in this section at this time.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.