Laboratory Question for the Week of May 29, 2017

Laboratory Compliance Question of the Week

Question:

If lab services not related to ESRD are provided to patients in an ESRD facility, can the lab bill separately for them?

Answer:

Laboratory services that are not related to the treatment of end-stage renal disease (ESRD) are separately billable under the ESRD PPS and may be billed by either the ESRD facility or the independent laboratory. The bill must include the modifier AY, which serves as an attestation that the item or service is medically necessary for the dialysis patient but is not being used for the treatment of ESRD. For this information, see section 40.6 at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c16.pdf.

 

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