In Billing
Mar 21st, 2016
Physicians are allowed to perform only a limited number of lab tests since 1991. To do so, they must apply for a Clinical Laboratory Improvement Amendment (CLIA) waiver. The Centers for Medicare & Medicaid Services (CMS) regulates all laboratory testing to ensure quality. The waiver allows physicians to perform certain test that CMS considers to ...
When providing toxicology drug testing, be sure requisition forms follow up-to-date guidance. In August 1998, the Office of Inspector General (OIG) published the Compliance Program Guidance for Clinical Laboratories. Among other recommendations, these guidelines stressed choice in requisition form design, allowing providers to make independent medical necessity decisions on each test ordered. The g...
In Audit
Dec 3rd, 2015
By Brad Ericson, MPC, CPC, COSC The Centers for Medicare and Medicaid Services released 49 corrections to the 2016 HCPCS Level II code set December 2, too late to be included in any 2016 HCPCS Level II codebook because publishers had already sent their books to print. But don’t fail to update as there are ...
Nov 18th, 2015
In 1988, Congress passed the Clinical Laboratory Improvement Amendment (CLIA). The goal of the CLIA regulations is to provide accurate results for tests performed, giving providers confidence in providing timely treatment to their patients, and minimizing the cost of medical testing by eliminating repetitive testing. CLIA Certificate Types The type of CLIA certification needed depends ...
In Billing
Feb 11th, 2015
The Centers for Medicare & Medicaid Services (CMS) released a provider education article (MLN Matters® MM9035), January 30, to inform physicians and their support staff of retroactive changes to HCPCS Level II codes subject to, or excluded from, Clinical Laboratory Improvement Amendments (CLIA) edits. Codes discontinued on December 31, 2014 are: G0417-G0419, 80100-80104, 80152, 80154, 80160, ...