decisionhealth Newsletters, Part B News - 2010 Issue 6 (June)
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Article Overview
This article answers a reader question about Medicare billing for laboratory testing in the context of CLIA waiver status and related CPT reporting. It explains the general distinction between waived and non-waived testing, references CMS guidance, and notes related compliance considerations for physician practices and laboratories. The piece is relevant to billing staff, coders, compliance personnel, and laboratory managers who need to understand how Medicare policy affects lab claims.
Why This Topic Matters
Medicare lab billing depends on both the test performed and the laboratory’s certification status. Understanding the article helps avoid denied claims and supports compliance with federal laboratory requirements.
What You Will Learn
- How CLIA waiver status affects Medicare laboratory billing
- Where to look for CMS guidance on waived tests
- Why certain laboratory services require more than a waiver certificate
- What compliance considerations apply to physician offices and laboratories
- How related specimen-handling services are discussed in Medicare billing guidance
Who Should Read This
- Medical coders
- Billing staff
- Compliance officers
- Physician office managers
- Laboratory managers
Codes Discussed
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