Billing Beat

Fiscal Intermediary Standard System (FISS) update for Clinical Laboratory Fee Schedule Upload to Include Kansas Payment Locality Structure

May 24, 2012

CMS discovered that there is an inconsistency in the payment rates for claims for Clinical Laboratory Fee Schedule services that are submitted in the East Kansas locality. In this inconsistency, providers are being paid only one Kansas rate rather than one rate for the West Kansas locality 12 and another for the East Kansas locality 15. CR7815 instructs your FI or A/B MAC to incorporate an additional Kansas Clinical Laboratory Fee Schedule payment locality into their system (effective October 1, 2012) to ensure correct pricing for laboratory services submitted in Kansas. This change will be retroactive to January 1, 2010. Your Medicare contractor will adjust claims paid the incorrect amount if you bring such claims to their attention.

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