Q&A: Which tests does CMS' lab date of service policy affect?

Q: CMS' laboratory date of service rules are only for molecular labs and advanced diagnostic laboratory tests (ADLT), correct? Or does it also apply to other lab tests?

A: Correct. If you're having to send out a specimen for some other type of testing that is not molecular pathology or ADLT, then that testing still falls under the overarching umbrella of the prohibition on unbundling and the hospital is still going to be required to include those charges and tests on its claims. But for outpatient molecular pathology and ADLTs, that is where this new date of service exception applies.

Editor's note: Valerie Rinkle, MPA, CHRI, regulatory specialist for HCPro, a Simplify Compliance brand, answered this question during the HCPro webinar, “New Lab Date of Service Billing Requirements: Strategies for Success,”

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

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