Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 70.3
Verifying CLIA Certification
70.3 - Verifying CLIA Certification
(Rev. 865, Issued: 02-17-06; Effective: 01-01-06; Implementation: 07-03-06)
CWF edits A/B MAC (B) claims to ascertain that the laboratory identified by the CLIA
number is certified to perform the test. (CWF uses data supplied from the certification
process.) See Chapter 27 for related specifications.
Providers that bill A/B MACs (A) are responsible for verifying CLIA certification prior
to ordering laboratory services under arrangement. The survey process validates that
these providers have procedures in place to insure that laboratory services are provided
by CLIA approved laboratories.
Refer to the Medicare State Operations Manual for information about CLIA license or the
CLIA licensure exemptions.