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Pathology/Lab Coding Alert

Physician Fee Schedule:

See How Medicare's '3-Day Payment Window' Could Impact Your Lab

Published on Fri Jan 13, 2012

Ownership is the key for bundling rule.Did you know that one of the least publicized changes in the 2012 Medicare Physician fee schedule could be one of the costliest if it applies to you? That's the word from Marc Hartstein, deputy director of the Hospital and Ambulatory Policy Group at CMS, who spoke about the "three-day payment window" during the CPT® 2012 Annual Symposium in Chicago.Hospital Ownership Triggers RuleIf a Medicare patient has diagnostic or related non-diagnostic services furnished in a facility wholly owned or operated by a hospital and then gets admitted to that hospital within three days, those prior services are bundled into the patient's hospital stay. This rule has been in place since June 2010 -- however, CMS tweaks the rule effective July 1, 2012, and now it may impact you more.Here's why: Medicare considers those services "operating costs of inpatient hospital services," which are included in [...]
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