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CodeMap® Compliance Briefing: 07/17/2009


 

Editor's Welcome:

Many CodeMap Compliance Briefings have discussed the complexities of the direct billing rules of Medicare and how they apply to clinical laboratories. This week, we are revisiting the issue because recently one of our subscribers brought to our attention a little-known provision tucked away in the Medicare Benefits Manual that sheds new light on our discussions. This provision more fully defines when a hospital laboratory should classify a patient as an outpatient vs. a non-patient. This is an important distinction because the classification ultimately determines when, or if, a hospital can bill for referred testing. As this briefing demonstrates, we all benefit when subscribers contribute questions and suggestions, so keep your inquiries coming.

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