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CodeMap® Compliance Briefing: 12/14/2007
The 2008 Physician Fee Schedule (PFS) contains significant changes to the direct billing rules that apply to physicians and group practices that bill for diagnostic procedures. These changes define diagnostic procedures as not including clinical laboratory procedures. Subscribers should be aware that no direct billing rule exceptions apply to physicians concerning clinical laboratory procedures. The 2008 changes are designed to prevent physicians practices from profiting from billing for diagnostic procedures performed by outside entities, as is often the case in so-called "pod labs." As you will see, the changes included in 2008 PFS effectively eliminate the possibility that any physician practice will financially benefit from billing diagnostic procedures performed outside practice facilities or by unrelated practitioners.
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