In Billing
Feb 14th, 2018
The HCPCS Level II code G0475 HIV antigen/antibody, combination assay, screening is effective for dates of service on or after April 13, 2015, and is subject to Clinical Laboratory Improvement Amendments (CLIA) edits, despite its omission in previous transmittals from the Centers for Medicare & Medicaid Services (CMS). For Medicare reimbursement, G0475 requires a facility to have either a ...
In Billing
Feb 5th, 2018
The Clinical Laboratory Improvement Amendments of 1988 (CLIA) requires that only certified labs may bill for laboratory services, unless the test in question has been granted a waiver. The Centers for Medicare & Medicaid Services (CMS) has announced several new laboratory services, recently approved by the Food and Drug Administration (FDA), which qualify for a ...
In Billing
Jan 23rd, 2018
The codes that are considered a laboratory test under Clinical Laboratory Improvement Amendments (CLIA) change each year. These codes require a facility to have either a CLIA certificate of registration (type code 9), a CLIA certificate of compliance (type code 1), or a CLIA certificate of accreditation (type code 3). A facility with a CLIA ...
In Audit
Nov 23rd, 2016
The Centers for Medicare & Medicaid Services (CMS) has tweaked the tests it says are waived from Clinical Improvement Amendment of 1988 (CLIA), releasing the list effective January 1, 2017. CLIA regulations require a facility to be certified for each test performed. To ensure that Medicare and Medicaid only pay for laboratory tests categorized as waived ...
Jul 1st, 2016
A final rule the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register on June 27 requires entities performing clinical diagnostic laboratory tests to report private payer rates for lab tests. CMS will use this data to calculate Medicare rates for lab tests paid under the Clinical Laboratory Fee Schedule (CLFS) beginning ...