Claim processing issues for outpatient lab codes

For outpatient claims paid by the Ambulatory Payment Classification (APC) grouper, clinical lab codes billed using the L1 modifier are not processing correctly. Medicaid Oregon continues to work on a solution to this claim processing issue. (On July 1, 2014, CMS made an operational change to their policy and instructed providers to bill separately billable lab tests using TOB 13X adding modifier L1 (separately payable lab test) to the procedure code for dates of service on or after Jan. 1, 2014.)

Source: https://public.govdelivery.com/topics/ORDHS_175/feed.rss