Navigating Healthcare Claims and Audits for Purchased Diagnostic Testing

Article Overview

This article provides a high-level overview of how purchased diagnostic testing fits into healthcare claim reporting and audit workflows. It discusses Medicare-related payment limitation concepts, the role of documentation review, and the general compliance concerns that auditors and providers consider when services are performed or interpreted outside the ordering organization. The content is most relevant to medical coders, auditors, compliance staff, billing professionals, and providers involved in diagnostic testing reimbursement.