Laboratory Question for the Week of May 22, 2017

Laboratory Compliance Question of the Week

Question:

Does Medicare reimburse ESRD-related laboratory tests?

Answer:

According to the Medicare Claims Processing Manual (MCPM), chapter 16, section 40.6, all laboratory services related to end-stage renal disease (ESRD) are included in the ESRD prospective payment system (PPS) base rate. They must be reported by the ESRD facility and are not separately paid.

The list of ESRD-related laboratory tests that are routinely performed for the treatment of ESRD can be found in the Downloads section at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ESRDpayment/Consolidated_Billing.html.

 

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.