Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits

The CLIA regulations require a facility to be appropriately certified for each test performed. To ensure that Medicare and Medicaid only pay for laboratory tests in a facility with a valid, current Clinical Laboratory Improvement Amendments (CLIA) certificate, laboratory claims are currently edited at the CLIA certificate level. The codes that are considered a laboratory ... Read More

Emergency update to the 2015 Medicare physician fee schedule database

Effective date January 1, 2015 Implementation date: January 5, 2015 Summary The Centers for Medicare & Medicaid Services (CMS) recently released an emergency update to Medicare physician fee schedule database payment files. With the emergency release, CMS amended those payment files, including an updated conversion factor of $35.7547 for services furnished between January 1, 2015, ... Read More