decisionhealth Newsletters, Part B News - 1999 Issue 7 (July)
HCFA backs off from 1998 diagnostic test supervision rules
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Article Overview
This article covers proposed HCFA updates to diagnostic test supervision policy in the physician fee schedule context, including how the changes relate to billing for services furnished by non-physician practitioners and to other regulatory frameworks. It is relevant to coders, compliance staff, physician practices, and billing professionals who work with diagnostic testing, supervision levels, and Medicare payment policy. The discussion also touches on related issues involving laboratory and pathology services, imaging, cardiac testing, and the Stark self-referral framework.
Why This Topic Matters
Supervision rules affect how diagnostic tests are performed, reported, and billed, especially when services are furnished by non-physician practitioners. The article also highlights a potential mismatch between payment policy and self-referral requirements that can create compliance risk for practices.
Article Sections
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Diagnostic test supervision policy changes
Discusses proposed HCFA revisions affecting supervision requirements for diagnostic tests and the general policy context behind those changes.
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Affected practitioner billing arrangements
Explains how the policy relates to billing under practitioner provider numbers and the broader handling of services furnished by non-physician practitioners.
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Categories of diagnostic tests and supervision levels
Summarizes the major test categories discussed in the proposed changes and notes which areas remain unresolved or unchanged.
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Relationship to Stark self-referral requirements
Addresses the compliance concern created by differences between HCFA payment policy and the in-office ancillary services exception under the Stark framework.
What You Will Learn
- How proposed HCFA supervision policy changes affect diagnostic test billing.
- Which practitioner groups are discussed in connection with the policy update.
- What general categories of diagnostic testing and imaging are covered.
- Why the article raises a compliance concern under another federal physician arrangement framework.
Who Should Read This
- Medical coders
- Billing specialists
- Compliance officers
- Physician practices
- Non-physician practitioner organizations
- Health care attorneys
Code Ranges Discussed
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