decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 9 (September)
Two tests check whether Medicare’s anti-markup rules apply to your dx tests
Subscribe or sign in to view the full article.
Article Overview
This article explains Medicare’s anti-markup framework for purchased diagnostic test components and outlines the CMS tests used to determine whether an arrangement is subject to the limitation. It is aimed at physician practices, diagnostic suppliers, and billing staff who handle professional and technical components of diagnostic testing. The piece also summarizes related requirements for purchasing, performing, and documenting test components under Medicare guidance.
Why This Topic Matters
Anti-markup rules can affect how diagnostic test services are billed when a practice or supplier purchases a component from another party. Understanding the CMS tests and associated administrative requirements helps billing teams assess compliance and avoid improper claim handling.
What You Will Learn
- The Medicare anti-markup issue as it applies to purchased diagnostic test components
- The two CMS tests used to evaluate whether the rule applies
- General billing and documentation considerations tied to purchased test components
- The types of provider and facility relationships discussed in the guidance
Who Should Read This
- Physician practices
- Diagnostic testing suppliers
- Billing and coding professionals
- Compliance staff
- Practice managers
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com