Federal (United States) · Agency guidance
Chapter 16
94 sections
94 sections
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 10Background
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 10.1Definitions
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 10.2General Explanation of Payment
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 20Calculation of Payment Rates - Clinical Laboratory Test Fee Schedules
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 20.1Initial Development of Laboratory Fee Schedules
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 20.2Annual Fee Schedule Updates
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 20.3Clinical Laboratory Fee Schedule Based on Protecting Access to Medicare Act
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 30Special Payment Considerations
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 30.1Mandatory Assignment for Laboratory Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 30.1.1Rural Health Clinics
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 30.2Deductible and Coinsurance Application for Laboratory Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 30.3Method of Payment for Clinical Laboratory Tests - Place of Service Variation
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 30.4Payment for Review of Laboratory Test Results by Physician
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40Billing for Clinical Laboratory Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.1Laboratories Billing for Referred Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.1.1Claims Information and Claims Forms and Formats
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.1.1.1Paper Claim Submission to A/B MACs (B)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.1.1.2Electronic Claim Submission to A/B MACs (B)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.2Payment Limit for Purchased Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.3Hospital Billing Under Part B
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.3.1Critical Access Hospital (CAH) Outpatient Laboratory Service
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.4Special Skilled Nursing Facility (SNF) Billing Exceptions for Laboratory Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.4.1Which A/B MAC (A) or (B) to Bill for Laboratory Services Furnished to a
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.5Rural Health Clinic (RHC) Billing
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.6Billing for End Stage Renal Disease (ESRD) Related Laboratory Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.6.1Automated Multi-Channel Chemistry (AMCC) Tests for ESRD Beneficiaries
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.6.2Claims Processing for Separately Billable Tests for ESRD Beneficiaries
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.6.2.1Separately Billable ESRD Laboratory Tests Furnished by Hospital-Based
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.6.2.2Reserved
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.6.2.3Skilled Nursing Facility (SNF) Consolidated Billing (CB) Editing and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.7Billing for Noncovered Clinical Laboratory Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 40.8Date of Service (DOS) for Clinical Laboratory and Pathology Specimens
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50A/B MAC (B) Claims Processing
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.1Referring Laboratories
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.2Physicians
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.2.1Assignment Required
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.3Hospitals
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.3.1Hospital-Leased Laboratories
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.3.2Hospital Laboratory Services Furnished to Nonhospital Patients
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.4Reporting of Pricing Localities for Clinical Laboratory Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.5Jurisdiction of Laboratory Claims
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.5.1Jurisdiction Of Referral Laboratory Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.5.2Examples of Reference Laboratory Jurisdiction Rules
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 60Specimen Collection Fee and Travel Allowance
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 60.1Specimen Collection Fee
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 60.1.1Independent Laboratory Specimen Drawing
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 60.1.2Coding Requirements for Specimen Collection
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 60.1.3Specimen Drawing for Dialysis Patients
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 60.1.4Coding Requirements for Specimen Collection
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 60.2Travel Allowance
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70Clinical Laboratory Improvement Amendments (CLIA)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.1Background
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.2Billing
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.3Verifying CLIA Certification
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.4CLIA Numbers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.5CLIA Categories and Subcategories
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.6Certificate for Provider-Performed Microscopy Procedures
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.7Deleted - Held for Expansion
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.8Certificate of Waiver
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.9HCPCS Subject To and Excluded From CLIA Edits
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.10CLIA Number Submitted on Claims from Independent Labs
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.10.1Physician Notification of Denials
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.11Reasons for Denial - Physician Office Laboratories Out-of-
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 80Issues Related to Specific Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 80.1Screening Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 80.2Anatomic Pathology Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 80.2.1Technical Component (TC) of Physician Pathology Services to
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 80.3National Minimum Payment Amounts for Cervical or Vaginal
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 80.4Oximetry
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 90Automated Profile Tests and Organ/Disease Oriented Panels
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 90.1Laboratory Tests Utilizing Automated Equipment
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 90.1.1Automated Test Listing
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 90.2Organ or Disease Oriented Panels
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 90.3Claims Processing Requirements for Panel and Profile Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 90.3.1History Display
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 90.3.2Medicare Secondary Payer
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 90.4Evaluating the Medical Necessity for Laboratory Panel CPT
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 90.5Special Processing Considerations
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 100CPT Codes Subject to and Not Subject to the Clinical Laboratory
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 100.1Deleted - Held for Expansion
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 100.2Laboratory Tests Never Subject to the Fee Schedule
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 100.3Procedures Not Subject to Fee Schedule When Billed With Blood
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 100.4Not Otherwise Classified Clinical Laboratory Tests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 100.5Other Coding Issues
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 100.5.1Tests Performed More Than Once on the Same Day
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 100.6Pricing Modifiers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 110Coordination Between A/B MACs (B) and Other Entities
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 110.1Coordination Between A/B MACs (B) and A/B MACs (A)/RRB
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 110.2Coordination With Medicaid
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 110.3Coordination With A/B MACs (A) and Providers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 110.4A/B MAC (B) Contacts With Independent Clinical Laboratories
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 120Clinical Laboratory Services Based on the Negotiated Rulemaking
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 120.1Negotiated Rulemaking Implementation
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 120.2Implementation and Updates of Negotiated National Coverage