decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Clinical Lab Services / Clinical lab services prohibited by Stark
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Article Overview
This article covers the Stark physician referral framework as it relates to clinical laboratory services and explains where the relevant CMS code list is maintained and updated. It is relevant to compliance, coding, and revenue cycle teams that need to understand the scope of services affected by Stark and the source of the federal reference list.
Why This Topic Matters
Understanding the Stark laboratory service restrictions is important for compliance review, referral management, and identifying when a service falls within the federal designated health services framework.
What You Will Learn
- How Stark applies to clinical laboratory services
- Where the CMS code list for designated health services is referenced
- Why periodic updates to the federal reference source matter for compliance review
- How the cited federal regulation relates to physician referral restrictions
Who Should Read This
- Medical coders
- Compliance officers
- Revenue cycle staff
- Physician practice administrators
- Healthcare attorneys
Codes Discussed
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