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Clinical lab

Modified: 1/9/2020
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]
Modified: 1/8/2020
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.
Modified: 12/30/2019
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: 12/28/2019
Provider specialty page on the CMS website.
Modified: 12/9/2019
This article provides tips from First Coast to assist in preventing clinical laboratory test claim errors under the CERT program.
Modified: 11/30/2019
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: 8/29/2019
This tutorial of the CMS.gov website CLIA page will demonstrate how to determine if a CPT code requires the QW modifier.
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.