Laboratory Question for the Week of November 23, 2015

Laboratory Compliance Question of the Week

Question:

How are HCV adult screening tests performed in the hospital outpatient department paid under Medicare? 

Answer:

In a transmittal issued on November 5, 2015, the Centers for Medicare & Medicaid Services (CMS) added type of bill (TOB) 014x (hospital other Part B) as an applicable TOB for the screening of HCV when submitted for a non-patient laboratory specimen (HCPCS Code G0472). CMS will implement this change on April 4, 2016 but it will be effective for dates of service on or after June 2, 2014. Payment for these services will be based on the laboratory fee schedule. For this transmittal, go to https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3393CP.pdf.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.