tci Medicare Compliance & Reimbursement - 2017 Issue 20

Industry Notes: Consider New DOS Guidance for Lab Tests From CMS

Plus: IMPACT Act elements shouldn't impact you in 2018. The date of service (DOS) for clinical lab tests and the technical component of pathology specimens is the collection date, according to The Medicare Claims Processing Manual, Chapter 16, Section 40.8. However, with no current specific DOS guidance for the professional component of pathology specimens, most labs use the same (collection) date for technical and professional billing: A single DOS allows global billing when a single entity performs both services, as opposed to billing twice, once using modifier TC (Technical component) and once using modifier 26 (Profes­sional component)...

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