Medicare Claims Processing Manual (Pub. 100-04), Ch. 2 § 90.5
Definition of Diagnostic Services
90.5 - Definition of Diagnostic Services
(Rev. 1, 10-01-03)
HO-350.E
A service is “diagnostic” if it is an examination or procedure to which the patient is
subjected, or which is performed on materials derived from a hospital outpatient to obtain
information to aid in the assessment of a medical condition or the identification of a
disease. Among these examinations and tests are diagnostic laboratory services such as
hematology and chemistry, diagnostic x-rays, isotope studies, EKGs, pulmonary function
tests, psychological tests, and other tests given to determine the nature and severity of an
ailment or injury. Hospitals may determine whether services are diagnostic from their
internal systems as appropriate.