decisionhealth Newsletters, Part B News - 2007 Issue 8 (August)
Diagnostic Tests: Payment procedure now based on location; Changes to payments for purchased tests, interpretations
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Article Overview
This article covers Medicare payment changes for purchased diagnostic tests and interpretations, with emphasis on where payment is determined, how claims should reflect service location, and how electronic and paper billing are handled. It is relevant to physicians, group practices, IDTFs, billing personnel, and coders who work with diagnostic services performed across different jurisdictions. The article also discusses related claim-filing details and the distinction between purchased services and reassignment scenarios.
Why This Topic Matters
Billing for diagnostic services can change when the service is performed in a different location than the billing entity, which can affect payment and claim preparation. Understanding the reporting and jurisdictional handling described in the article helps reduce claim errors and supports proper Medicare reimbursement workflows.
Article Sections
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Changes to payments for purchased tests, interpretations
Introduces the Medicare payment update and explains the general shift in how purchased diagnostic services are priced. It also frames the issue in terms of location-based payment handling and jurisdictional differences.
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How to bill for purchased services
Summarizes the claim-submission topics discussed for purchased professional and technical services. This section addresses electronic and paper claim handling, form fields, and service-component reporting at a high level.
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No changes to reassignment
Describes the distinction between purchased interpretations and services billed through reassignment. It also notes that the payment update does not apply equally to all billing arrangements.
What You Will Learn
- How Medicare payment for purchased diagnostic services is tied to service location
- What broad claim-filing elements are discussed for purchased professional and technical services
- How the article distinguishes purchased interpretations from reassigned billing
- Which types of providers and billing entities are affected by the update
Who Should Read This
- Physicians
- Group practices
- Independent diagnostic testing facilities (IDTFs)
- Medical billing staff
- Professional coders
- Practice managers
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