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Content Section

Clinical Labs Center

Spotlights

Transmittal 94 [PDF, 117 KB] of the Medicare Benefit Policy Manual, entitled "Physician Signature Requirements for Diagnostic Tests," was released on 8/29/08. This instruction affects Clinical Diagnostic Laboratories.

Medicare Learning Network (MLN) Spotlights

Go to the What's New page for the latest MLN products and announcements!  Check it often!


Important Links


Billing / Payment
  • Clinical Laboratory Fee Schedule
  • Electronic Data Interchange (EDI)(Billing)- Medicare information on electronic transactions under HIPAA

Demonstration
  • Demonstration Project For Competitive Bidding of Clinical Laboratory Services

Coverage
  • Medicare Coverage
  • Medicare Coverage Database
  • Medicare National Coverage Determinations Manual
  • Laboratory National Coverage Determinations (NCDs) Overview
  • Laboratory National Coverage Determinations (NCDs) Index

Policies/Regulations
  • Medicare Modernization Update
  • Negotiated Rulemaking: Coverage and Administrative Policies for Clinical Diagnostic Laboratory Services
  • Pages 58788 - 58836
  • Pages 58837 - 58886
  • Pages 58887 - 58890
  • Medicare Claims Processing Manual, Chapter 16 - Laboratory Services
  • Medicare Benefit Policy Manual, Chapter 15, Sec. 80.1
  • Quarterly Provider Update
  • CLIA: Clinical Laboratory Improvement Amendments
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Social Security Act: 1833(h)(1)(A)
    Social Security Act: 1833(h)(5)(A)
  • Code of Federal Regulation Citations
  • Physician Self-Referral

Education
  • Medicare Learning Network (MLN)
  • MLN Educational Web Guides
  • MLN Matters Articles (Search)
  • MLN Products     
Coding
  • National Correct Coding Edits - Physicians
  • Column 1/Column 2 Pathology and Laboratory Services - CPT CODES 80000-89999 
  • Mutually Exclusive Pathology and Laboratory Services - CPT CODES 80000-89999
  • HCPCS General Information
  • Alpha-Numeric HCPCS
  • ICD-9-CM Diagnosis and Surgical Codes
  • Claim Adjustment Reason and Remittance Advice Remark Codes The latest HIPAA codes are available at the Washington Publishing Company (WPC) Website.

Program Transmittals
  • Clinical Laboratory Specific Program Transmittals
  • CMS Program Transmittals

Program Integrity/Medical Review
  • Medicare Medical Review Program

Medicare Secondary Payer
  • Medicare Coordination of Benefits

Enrollment/Participation
  • Enrollment
  • CMS 855 Enrollment Applications
  • Conditions of Participation
  • Information for Medicare Fee-for-Service Providers for the National Provider Identifier

Contacts
  • Contact Your Carrier/FI
    via Toll-Free Numbers and Websites -- A listing of the toll-free numbers that CMS has installed at Medicare FFS contractor sites.
  • Quality Improvement Organizations (QIO)
  • CMS Regional Offices
  • Contacting the Coordination of Benefits Contractors  (COBC)

How to Stay Informed
  • Clinical Laboratories Open Door Forum
  • Press Releases: CMS Media Release Search
  • Subscribe to the Provider/Supplier listserv that fits your needs!

 

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