decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 9 (September)
Make sure you are following new CMS rules for purchased tests
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Article Overview
This article explains Medicare’s updated anti-markup rules as they relate to purchased diagnostic test components in orthopedic settings. It focuses on when the rules may apply, how existing arrangements with outside interpreters may be affected, and what general compliance areas practices should review. The piece is aimed at orthopedic practices, billing staff, and compliance professionals who handle diagnostic test billing under Medicare.
Why This Topic Matters
Practices that purchase diagnostic test components and bill Medicare need to understand whether their current workflow or contractor relationships create anti-markup exposure. The article helps readers identify the broad compliance issues tied to purchased professional and technical services without substituting for the full premium guidance.
What You Will Learn
- How Medicare anti-markup rules affect purchased diagnostic test components
- What kinds of practice arrangements may need review
- Which broad compliance areas are discussed for purchased professional and technical services
- How existing interpretation arrangements may be impacted at a high level
Who Should Read This
- Orthopedic practices
- Medical billers and coders
- Practice managers
- Compliance staff
- Healthcare attorneys
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