Wiki Laboratory Day of Billing

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inc1961

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Good morning,

We bill for a pain management physician who also owns his own laboratory analysis machine for urine drug testing.

We are running into an issue with the date that we bill the lab portion of the process. The patient typically comes into the office on one day for an office visit at which time a urine sample is obtained. The sample is frozen until the tests are run at a later date.

Should we be billing the lab portion on the same DOS as the office visit or on the date the test is actually run (which could be several days later)?

Thank you in advance for any insight!
 
Lab DOS

The quick answer is; if the specimen is stored less than 30 days the DOS is the collection date! I have provided the Medicare Reg for your reference. :)
40.8 - Date of Service (DOS) for Clinical Laboratory and Pathology Specimens
(Rev. 1515, Issued: 05-23-08, Effective: 01-01-09, Implementation: 01-05-09)
The DOS policy for either a clinical laboratory test or the technical component of physician pathology service is as follows:
General Rule: The DOS of the test/service must be the date the specimen was collected.
Variation: If a specimen is collected over a period that spans two calendar days, then the DOS must be the date the collection ended.
Exceptions: The following two exceptions apply to the DOS policy for either a clinical laboratory test or the technical component of physician pathology service:
A. DOS for Tests/Services Performed on Stored Specimens:
In the case of a test/service performed on a stored specimen, if a specimen was stored for less than or equal to 30 calendar days from the date it was collected, the DOS of the test/service must be the date the test/service was performed only if:
? The test/service is ordered by the patient?s physician at least 14 days following the date of the patient?s discharge from the hospital;
? The specimen was collected while the patient was undergoing a hospital surgical procedure;
? It would be medically inappropriate to have collected the sample other than during the hospital procedure for which the patient was admitted;
? The results of the test/service do not guide treatment provided during the hospital stay; and
? The test/service was reasonable and medically necessary for treatment of an illness.
If the specimen was stored for more than 30 calendar days before testing, the specimen is considered to have been archived and the DOS of the test/service must be the date the specimen was obtained from storage.[/FONT][/SIZE]
 
Is there any other documentation that supports this? That an in office lab is supposed to bill on the collection date if the test is run within 30 days? I can't find anything else besides this CMS regulation.

Thanks
Ashley Kinsey
 
Every payer will have their own guidelines. The CMS regulation is only for Medicare. Having said that, I've never seen anyone use a different date of service other than the day the sample was collected.
 
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