Medicare Claims Processing Manual (Pub. 100-04), Ch. 18 § 30.3
Deductible and Coinsurance
30.3 - Deductible and Coinsurance
(Rev. 1, 10-01-03)
B3-4603.4, A3-3628.1.A.3
Neither the Part B deductible nor coinsurance apply for services paid under the laboratory fee
schedule. The Part B deductible for screening Pap smear and services paid for under the physician
fee schedule is waived effective January 1, 1998. Coinsurance applies.
A. A/B MAC (B) Action for Submitting Claim to CWF and CWF Edit
B3-4603.4, B3-4603.6, B3-4603.1.B
When a A/B MAC (B) receives a claim for a screening Pap smear, performed on or after January 1,
1998, it must enter a deductible indicator of 1 (not subject to deductible) in field 67 of the HUBC
record.
CWF will edit for screening pelvic examinations performed more frequently than allowed
according to the presence of high risk factors.