Question Lab Date of Service "14-day rule"

otdoc321

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The CMS 14 day rule notes that for lab tests, the date of service is the date the specimen is collected. The 14-day rule says the exception to this is when the order is placed 14 days or more "following the patient's discharge from the hospital." Then the date of service is the date the test is performed. We are getting conflicting opinions on this. For example, if a patient is an inpatient from Nov. 1 to Nov. 4, and the order is placed for a test on a specimen collected during that encounter on Nov. 28, it is clear that the date of service would be the date the test is performed. However, what happens if the patient was re-admitted from Nov. 21-24? We have some people who say that doesn't matter, we only count from the discharge date of the encounter when the specimen was collected and others who say "discharge from the hospital" would include that intervening inpatient stay. Thus, if the patient was re-admitted and discharged on Nov. 24, the 14 day rule does not apply. Has anyone gotten a definitive opinion on this from CMS or from your MAC?
 
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