decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2003 / AB-03-104
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Article Overview
This article explains a CMS Program Memorandum on updates to the laboratory National Coverage Determination edit software effective October 1, 2003. It is relevant to laboratory billing, compliance, and claims processing teams that need to track quarterly NCD software revisions, ICD-9-CM coverage list changes, and related provider education timing. The memorandum also notes implementation and effective dates, as well as the general scope of the affected laboratory test categories.
Why This Topic Matters
Laboratory claims processing depends on current NCD edit software and diagnosis list updates. This memorandum helps providers and billing staff recognize which laboratory-related coverage edits were revised for the October 2003 release and when those revisions took effect.
Article Sections
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Purpose
Introduces the quarterly CMS update to laboratory NCD edit software and explains the general context for the release.
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Policy
Summarizes the categories of laboratory NCD lists affected by the update and the types of diagnosis and coverage list changes included in the release.
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Provider Education
Describes contractor communication and dissemination expectations for notifying affected provider communities about the update.
What You Will Learn
- How CMS organized the October 2003 laboratory NCD software update
- Which broad laboratory coverage categories were revised
- What kinds of ICD-9-CM edit-list changes were included
- How provider education and dissemination were addressed
- The effective and implementation timing for the memorandum
Who Should Read This
- Medical coders
- Laboratory billing staff
- Compliance teams
- Revenue cycle professionals
- CMS intermediary and carrier staff
- Healthcare providers ordering or billing laboratory tests
Codes Discussed
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