Laboratory Claims Submitting with a CLIA Number
June 13, 2022Starting June 24, 2022, claims submitted with more than one CLIA number will be denied as un-processable.
CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 16, Section 70.10
Laboratory claims submitted without the required CLIA number are returned as un-processable. If the CLIA number is submitted on the claim, but is inconsistent with the CLIA format, the A/B MAC (B) returns the claim as un-processable. If more than one CLIA number is submitted on the claim, except when a reference laboratory is on the same claim, the A/B MAC (B) returns the claim as un-processable. If the tests on one claim have been performed in more than one Physician Office Laboratory (POL) by the same physician, the appropriate CLIA number should be associated with the test that was performed in each laboratory. In such a case, the physician must submit a separate claim for each location (CLIA number) where a test was performed.