decisionhealth Newsletters, Answer Books - 2009 Issue 9 (September)
Diagnostic Testing / Check your payment arrangements
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Article Overview
This premium article reviews Medicare billing issues tied to purchased diagnostic test components and the anti-markup framework that may apply to them. It is aimed at practices, physicians, and billing staff who handle diagnostic testing arrangements, and it discusses the broad background, operational concerns, and official Medicare resources relevant to these services.
Why This Topic Matters
Diagnostic testing arrangements can affect how a practice bills Medicare and whether its payment structure aligns with anti-markup requirements. Understanding the article helps readers assess whether their current contracts and billing workflow involve services that need review.
What You Will Learn
- How Medicare distinguishes professional and technical components of diagnostic tests
- Why purchased diagnostic test arrangements may require review under anti-markup rules
- What broad types of billing arrangements are discussed for practice-based diagnostic services
- Which official Medicare resources are referenced for further policy review
Who Should Read This
- Physicians
- Medical billing staff
- Practice managers
- Coding professionals
- Revenue cycle teams
Codes Discussed
Modifiers Discussed
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