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Content Section

Clinical Labs Center

Spotlights

Try the NEW Guided Pathways (DEC2008) Medicare Learning Network (MLN) products! These three booklets incorporate existing Medicare Learning Network (MLN) products and other CMS resources into well organized sections that can help Medicare Fee-for-Service (FFS) providers and suppliers find information to understand and navigate the Medicare Program. The three Guided Pathways booklets guide learners to resources that provide a fundamental overview of Medicare knowledge, as well as detailed FFS policies and requirements. Click here to access the Guided Pathways educational web guide and booklets. (Posted 01/08/09)

2009 New Clinical Laboratory Fee Schedule Test Codes and Final Determinations [PDF, 31KB]

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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