decisionhealth Newsletters, Coder Pink Sheets - 2008 Issue 10 (October)
Physicians may need to enroll as IDTFs to offer diagnostic tests
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Article Overview
This article summarizes a proposed Medicare physician fee schedule change that could require certain practice locations performing diagnostic tests to enroll under independent diagnostic testing facility standards. It is relevant to ophthalmology practices, physicians, nonphysician practitioners, and billing/compliance staff who need to understand the general scope of the proposed enrollment, performance, and licensure requirements discussed in the rule.
Why This Topic Matters
The proposal could affect whether diagnostic testing performed in the physician office setting remains billable to Medicare and whether practices must align with additional Medicare enrollment and operational standards.
Article Sections
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Proposed 2009 physician fee schedule update
Introduces the Medicare proposal and the practice settings potentially affected by the change. It frames the article around diagnostic testing performed in physician offices.
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IDTF enrollment and performance standards
Summarizes the types of enrollment, staffing, supervision, equipment, and regulatory expectations discussed in the proposed rule. The section focuses on the broad categories of compliance requirements mentioned by CMS.
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Claims denial implications and excluded standards
Addresses the article's discussion of possible billing consequences and notes that some IDTF-related requirements are not expected to apply in the same way to physician practices. This section distinguishes between the standards discussed without detailing them.
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Official resource
Points readers to the Federal Register source cited in the article for further review of the proposed rule. It identifies the general location of the referenced CMS material.
What You Will Learn
- The general Medicare policy issue affecting diagnostic tests in physician office settings
- The broad categories of enrollment and compliance requirements discussed for diagnostic testing locations
- The potential billing and operational impact of the proposed rule on practices
- Where the cited CMS/Federal Register information is located
Who Should Read This
- Physicians
- Ophthalmology practices
- Nonphysician practitioners
- Medical coders
- Billing and compliance staff
- Practice administrators
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