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CodeMap Compliance Briefing: 5/2/03: Reimbursement for Pathology Services III

Editor's Welcome: This week we complete our series on pathology coding, billing, and reimbursement by discussing consultations and the review of referred slides and specimens.

Next week, be on the lookout for a special annoucement concerning major improvements to our online complaince training services. As always, please feel free to forward any questions, comments, or ideas for future CodeMap Compliance Briefings.

Sincerely,

Charles B. Root, Ph.D.

Clinical Laboratory Consultations

Medicare will reimburse for clinical consultations if the consultation:

1. is requested by the patient's attending physician;

2. relates to a test result that lies outside the clinically normal or expected range relative to the condition of the patient;

3. results in a written report included in the patient's medical record; AND

4. requires the exercise of medical judgement by the consultant physician.

If the information provi....

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