decisionhealth Newsletters, Coder Pink Sheets - 2017 Issue 10 (October)
Draw up a date-of-service primer for imaging, E/M services to get paid
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Article Overview
This article explains how date-of-service rules can vary across common service types, with emphasis on imaging, pathology/lab work, and chronic care management. It is intended for coders, billers, and practice staff who need to align claims reporting with payer and CMS expectations while understanding where flexibility may exist across Medicare contractors and other payers.
Why This Topic Matters
Date-of-service mismatches can lead to claim delays, denials, or rework. The article helps readers understand the broad policy areas that affect reporting consistency and where to look for payer-specific guidance.
Article Sections
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Radiology services: payer-specific date-of-service policies
Discusses how date-of-service handling may vary for imaging professional services across Medicare contractors and other payers. It also addresses documentation and jurisdictional policy considerations.
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Pathology and laboratory specimens
Covers date-of-service treatment for specimen-based services under CMS guidance, including situations where collection and interpretation occur on different dates. It also notes how multi-day specimen collection periods are handled.
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Chronic care management (CCM)
Summarizes date-of-service considerations for chronic care management services and distinguishes between different CCM levels and their timing concepts. It emphasizes calendar-month-based service periods.
What You Will Learn
- How date-of-service rules can differ by service category
- How payer-specific guidance affects imaging claims reporting
- How specimen collection timing affects lab and pathology reporting
- How chronic care management services are tied to service periods and monthly timing
- What types of documentation and contractor guidance are relevant when confirming reporting requirements
Who Should Read This
- Medical coders
- Medical billers
- Radiology practice staff
- Pathology and laboratory billing staff
- Revenue cycle professionals
- Compliance staff
Codes Discussed
Modifiers Discussed
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