Laboratory Question for the Week of November 28, 2016

Laboratory Compliance Question of the Week

Question:

What should labs know in regard to documentation required for Medicare payment of diagnostic tests?

Answer:

Medicare usually does not cover or reimburse tests used for routine screening of patients without regard to their individual need. All diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests must be ordered for the treatment of the individual patient. Criteria to establish medical necessity for drug testing must be based on patient-specific elements identified during the clinical assessment and documented by the clinician in the patient’s
medical record.

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.