Physician Notes: CMS Adds Three Lab Tests to CLIA-Waived Status

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This brief industry update summarizes CMS-related guidance for Part B practices and hospice providers. It discusses a CMS transmittal and MLN Matters article concerning CLIA-waived status for certain lab tests and modifier usage, and it also highlights Medicare payment documentation concerns for hospice services that may be considered unrelated to a patient’s terminal diagnosis. The article is relevant to coders, billers, and compliance staff who follow Medicare policy updates.

Why This Topic Matters

The article is useful for readers tracking Medicare billing updates because it combines a lab testing policy change with a hospice documentation and payment issue. It helps practices and compliance teams recognize which parts of the update affect reporting, coverage, and documentation expectations.

Article Sections

  1. CMS update on CLIA-waived laboratory tests

    A CMS transmittal and related MLN Matters guidance are summarized for Part B practices. The section focuses on the general scope of the laboratory testing update and reporting considerations.

  2. Hospice documentation and terminal diagnosis-related services

    This section addresses Medicare hospice payment concerns when services are viewed as unrelated to a terminal diagnosis. It summarizes the compliance and documentation issue discussed by CMS officials and providers.

What You Will Learn

  • How the article frames a CMS laboratory testing update for Part B practices
  • What broad reporting and compliance topics are tied to CLIA-waived status
  • Why hospice documentation may need to distinguish services related to a terminal diagnosis from those that are not
  • What Medicare policy concern CMS officials are highlighting for hospice providers and nursing home settings

Who Should Read This

  • Medical coders
  • Medical billers
  • Compliance staff
  • Hospice providers
  • Part B practice administrators
  • Laboratory billing staff

Codes Discussed

Modifiers Discussed


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