Internet Only Manual Update to Pub 100-04, Chapter 16, Section 40.8 – Laboratory Date of Service Policy

CR 11574 updates the Laboratory Date of Service (DOS) Policy in the Medicare Claims Processing Manual, Chapter 16, Section 40.8. Make sure your billing staffs are aware of these updates.

In the calendar year (CY) 2020 Medicare hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule published on August 9, 2019, Centers for Medicare Services (CMS) sought comments on excluding blood banks and blood centers from the laboratory DOS exception at 42 CFR 414.510(b)(5). In response to comments, CMS finalized excluding blood banks or centers from the laboratory DOS exception at 42 CFR 414.510(b)(5) in the CY 2020 OPPS/ASC final rule published on November 12, 2019. CMS also adopted a definition of “blood bank or center” and clarified that this policy change categorically excludes molecular pathology testing performed by laboratories that are blood banks or blood centers from the laboratory DOS exception at 42 CFR 414.510(b)(5).

Note: A “blood bank or center” means an entity whose primary function is the performance or responsibility for the performance of, the collection, processing, testing, storage and/or distribution of blood or blood components intended for transfusion and transplantation. CR11574

Source: https://www.cms.gov/files/document/mm11574.pdf