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Home ► Clinical lab

Clinical lab

Clinical laboratory center external link

Modified: 9/15/2023

Provider specialty page on the CMS website.

Potential assignment violations by clinical laboratories

Modified: 3/14/2023

Some clinical laboratories in our jurisdiction are charging patients prior to performing services, a potential assignment violation. This article outlines Medicare regulations and potential penalties applicable to laboratories.

Compliance tips for laboratory services

Modified: 10/5/2022

This article provides tips from First Coast to assist in preventing clinical laboratory test claim errors under the CERT program.

Complying with laboratory services documentation requirements external pdf file

Modified: 8/22/2022

The CERT A/B MAC Outreach & Education Task Force published the guide, “Complying with laboratory services documentation requirements” 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.

Clinical laboratory fee schedule – Medicare travel allowance fees for collection of specimens external link

Modified: 1/18/2022

This article is for laboratories and providers billing MACs for specimen collection services they provide to Medicare patients. [MM12593]

Clinical Laboratory Improvement Amendments (CLIA) - CPT codes requiring QW modifier

Modified: 8/3/2021

This tutorial of the CMS.gov website CLIA page will demonstrate how to determine if a CPT code requires the QW modifier.

Coverage of the technical component of physician pathology services furnished to hospital patients

Modified: 11/14/2020

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.

Recommendations regarding the development of a model compliance plan for clinical laboratories

Modified: 10/3/2020

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.

Medicare Part B CLFS: Revised information for laboratories on collecting and reporting data for the private payor rate-based payment system

Modified: 9/26/2020

This article is for clinical laboratories who submit claims for services paid under the Medicare Part B clinical laboratory fee schedule (CLFS) to Medicare administrative contractors (MACs) for services furnished to Medicare beneficiaries. This article was revised January 8, 2020, to note that for CDLTs that are not ADLTs, the data reporting is delayed by one year and must now be reported from January - March 2021 (previously January - March 2020). All references to the 2020 data reporting period have been changed to 2021. The “CLFS Data Reporting Period Delayed” section was revised to summarize the changes. All other information remains the same. [SE19006]

Clinical Lab -- no current items

Modified: 3/19/2015

There are no items in this section at this time.

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