by Jared Staheli, MPP
Jul 9th, 2015
Carriers must:
• Pay for clinical laboratory services provided in the physician’s office only on an assignment basis.
• Treat as assigned any claims for clinical laboratory services provided in the physician’s office even if the claimant submits the claim on a non-assigned basis or if the assignment option is not designated.
• Deny claims where it is apparent from the claims form or from other evidence that the beneficiary or provider refuses to assign. Use MSN notice 16.41 or 16.6 and remittance Remark code PR106 or CO111, as appropriate.