Effective Immediately Lab Services Edit Temporarily Suspended

In May 2012 TrailBlazer implemented an edit for CPT codes 80074© (acute hepatitis panel) and 80076© (hepatic function panel) to address a high Comprehensive Error Rate Testing (CERT) error rate. Since then, they have received several inquiries about the electronic submission of orders for these labs and the necessity of a physician signature for diagnostic tests. Due to the complexity of these issues and feedback received from providers, TrailBlazer has temporarily suspended this edit while they explore the policy and the use of lab protocols to identify providers using secure software for ordering lab tests. They are reviewing how the CERT contractor is considering electronic submission of orders for these tests using secured software. TrailBlazer will also look at how CERT is administering the CMS policy waiving the necessity of a physician’s signature for diagnostic tests. They will review the status of this edit at a later date. Medicare Part A and Part B MAC for Jurisdiction 14; comprised of Colorado, New Mexico, Oklahoma and Texas