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Retired provider

C

chsccrfrk

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Hello,
I have a situation where a provider has retired from a group practice and still has his license. Is it okay for the lab to accept the order or does the provider taking over the patient's care need to reorder the labs? Please provide sources if possible. The group physician lab feels it's better safe than sorry and to get a new order and the provider's office is not wanting to do that. The provider's office is using continuity of care as the reason. There is a provider assigned to review the results and treat.
Thanks
 
See 42 CFR 410.32 a):
Ordering diagnostic tests. Except as otherwise provided in this section, all diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests must be ordered by the physician who is treating the beneficiary, that is, the physician who furnishes a consultation or treats a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary's specific medical problem. Tests not ordered by the physician who is treating the beneficiary are not reasonable and necessary (see § 411.15(k)(1) of this chapter).

The ordering provider must be the one that is treating the patient else the test is considered not reasonable and necessary (and you will be filing a false claim). Granted this is Medicare but difficult to apply different rules.
 
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