Claim Edits Effective January 2018- Lab and Pathology

The following claim edits are effective for dates of service on or after January 1, 2018. These policies are derived from CMS, the AMA CPT Manual, HCPCS, ICD-10, nationally accredited societies and Tufts Health Plan policy. The following claim edits apply to Commercial (including Tufts Health Freedom Plan), Tufts Medicare Preferred HMO and Tufts Health Plan Senior Care Options (SCO) products. Tufts Health Plan will implement claim edits on the following: Laboratory and pathology- contains Drug Testing codes for 2018- AMA and HCPCS. These edits are documented in the applicable Commercial, Tufts Medicare Preferred HMO and Tufts Health Plan SCO payment policies.

Source: https://tuftshealthplan.com/documents/providers/payment-policies/laboratory-payment-policy