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Let me make it clear about CMS Publishes Revision to Laboratory “14-Day Rule”

Let me make it clear about CMS Publishes Revision to Laboratory “14-Day Rule”

The Centers for Medicare and Medicaid solutions (CMS) recently finalized changes towards the reimbursement policy for laboratory tests for Calendar 2018 year. The date of solution (DOS) policy, or the “14-day rule” since it is commonly described within the laboratory industry, governs who is able to look for reimbursement from Medicare for clinical laboratory diagnostic tests (CLDTs) carried out on saved specimens. The revisions towards the DOS guideline may have an impact that is significant the partnership between hospitals and laboratories that perform specific higher level diagnostic tests.

The DOS Policy

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Generally speaking, CMS bundles the re re payment for the laboratory test utilizing the re re re payment for a medical center solution if the date of solution for the laboratory test falls during an outpatient or stay that is inpatient. The standard date of solution for a laboratory test could be the date the specimen was collected. But, the DOS guideline is definitely an exclusion for this policy. The exclusion enables a clinical laboratory to move the date of solution to whenever a test is clearly done from the specimen if particular criteria are pleased. By going the date of solution associated with the test, the laboratory has the capacity to bill Medicare straight when it comes to solution, as opposed to the medical center.

Especially, the DOS policy enables a medical laboratory to look for reimbursement from Medicare for the test carried out for a stored specimen gathered during a medical center medical procedure if the test is bought at the very least 2 weeks after the patient’s release through the medical center.