(Medicare Claims Processing Manual Crosswalk)

Medicare Claims Processing Manual Chapter 16 - Laboratory Services Crosswalk New Chap New Sect Int Pub. 13-3 Carrier  Pub 14 Program  Memo Other Sources Title 16                                      10 B3-2070,B3-2070.1, B3-2020.1, B3-5114 Background16 10.1 B3-2070.1,B3-2070.1B  RHC-406.4  Definitions16 10.2   AB-03-076  General Explanation of Payment  (no X ref, new section added to summarize subject) 16 20 A3-3628 B3-5114.1 AB-98-7 Calculation of  Payment Rates - Clinical Laboratory Fee Schedules 16 20.1 A3-3628 B3-5114.1 AB-98-7  Initial Development of Lab Fee Schedules 16 20.2 A3-3628 B3-5114.1 AB-98-7  Annual Fee Schedule Updates 16 30 A3-3628 B3-5114,B3-5114.1  HO-437 Special Payment Considerations 16 30.1  B3-5114.1   Mandatory Assignment for Laboratory Tests 16 30.1.1 A-99-8,A-00-30 RHCs16 30.2 A3-3215 B3-2462,B3-5114.1  HHA-160 Deductible and Coinsurance Application for Laboratory Tests  New Chap New Sect Int Pub. 13-3 Carrier  Pub 14 Program  Memo Other Sources Title 16 30.3 A3-3628 B3-5114  A-01-03 HO-437 Method of pa yment for Clinical Laboratory Tests - Place of Service Variation 16 30.4  B3-5114 .2   Payment for Review of Laboratory Test Results by Physician 16 40     Billing for Clinical  Laboratory Tests 16 40.2  B3-15048   Payment Limit for Purchased services 16 40.3 A3-3628  A-01-31 HHA-437 Hospital Billing Under Part B 16                                 40.3.1 A3-3137.1 B3-5114.1 HHA-437,SNF-541, Critical Access Hospital Outpatient Laboratory Service 16 40.4 A3-3137.1 B3-5114.1 SNF-541,HO-437 Special SNF Billing Exceptions for Laboratory Tests 16 40.4.1 A3-3137.1 B3-5114.1 SNF-541,HO-437 Which Contractor to Bill for Laboratory Services Furnished to a Medicare Beneficiary in a SNF 16 40.5 A3-3628    Rural Health Clinic Billing 16 40.6  B3-4270.2 AB-98-7 PRM1 2711 Billing for ESRD related Laboratory Tests - Hemodialysis, Intermittent Peritoneal Dialysis, and Continuous Cycling Peritoneal Dialysis Tests 16 40.6.1 B3-4270.2 AB-98-7,A-03-033 PRM1 2711 Claims Processing for Separately Billable Tests for ESRD Beneficiaries 16 40.6.1.1  B3-4270.2 AB-98-7 PRM1 2711 Automated Profile Tests 16 40.6.1.2  B3-4270.2 AB-98-7 PRM1 2711 Separately Billable ESRD Lab Tests Furnished by Hospital-Based Facilities 16 40.6.13 B3-4270.2 AB-98-7 PRM1 2711 Separately Billable ESRD Laboratory Tests Furnished to Patients of Independent Dialysis Facilities 16 40.7  B3-5114.1   Billing for Noncovered Clinical Lab Tests New Chap New Sect Int Pub. 13-3 Carrier  Pub 14 Program  Memo Other Sources Title 16                                                50 B3-4110,B3-5114.1 Claims Processing16 50.1 B3-5114.1 Referring Laboratories16 50.2 B3-4110.2 Physicians16 50.2.1 B3-4110.2 Assignment Required16 50.3 B3-4110.1 Hospitals16 50.3.1 B3-4110.1 Hospital-Leased Laboratories16 50.3.2  B3-4110.5  HO-460 Hospital Laboratory Services Furnished to Non-hospital Patients 16 50.4   B-97-12  Reporting of Pricing Localities for Clinical Laboratory Services 16 50.5  B3-3102   Jurisdiction of Laboratory Claims 16 50.5.1 B3-3102,B3-5114   Referral Laboratory Services 16 50.5.2  B3-3102   Examples of Independent Laboratory Jurisdiction 16 60  B3-5114.1   Specimen Collection Fee and Travel Allowance 16 60.1 A3-3628 B3-5114.1   Specimen Collection Fee 16 60.1.1 A3-3628 B3-5114.1  HO-437 Physician Specimen Drawing 16 60.1.2 A3-3628 B3-4110.4  HO-437 Independent Lab Specimen Drawing 16 60.1.3 A3-3644.1 B3-4270.2  PR 2711.1,  RDF-322 Specimen Drawing for Dialysis Patients 16 60.1.4 A3-3644.1 B3-4270.2  PR 2711.1,  RDF-322 Coding Requirements for Specimen Collection New Chap New Sect Int Pub. 13-3 Carrier  Pub 14 Program  Memo Other Sources Title 16                                   60.2 A3-3628.F B3-5114.1 AB-99-49 HO-437 Travel Allowance16 70 A3-3628.2 B-97-3 RHC-640,ESRD-322,  HO-306,  HHA-465,  SNF-541,  HO-437.2 Clinical Laboratory Improvement Amendments (CLIA) Requirements 16 70.1 A3-3628.2 B-97-4 Background16 70.2 A3-3628.2 B-97-4 Billing16 70.3 A3-3628.2    Verifying CLIA Certification 16 70.4 A3-3628.2D CLIA Numbers16 70.5 A3-3628.2    CLIA Categories and Subcategories 16 70.6 A3-3628.2E    Certificate for Physician-Performed Microscopy Procedures 16 70.7     Deleted - held for expansion 16 70.8 A3-3628.2F  AB-01-95  Certificate of Waiver 16 70.9 A3-3628.2F    CLIA License or Licensure Exemption 16 70.10 A3-3628.2F    CLIA Number Submitted on CMS-1500 Form 16 70.10.1 A3-3628.2F    Physician Notification of Denials 16 70.11 A3-3628.2F    Reasons for Denial - Physician Office Laboratories Out-of-Compliance 16 80     Issues Related to Specific Tests - Header only  16 80.1      Screening Services New Chap New Sect Int Pub. 13-3 Carrier  Pub 14 Program  Memo Other Sources Title 16                           80.2 A3-3628.1 B3-4603.1,B3-4180 AB-98-22,  B-98-16,  A-98-6,  AB-97-24 SNF-541.1,  HO-437.1,  RHC-437, CIM 50.20.1,  R103.CIM Anatomic Pathology Services 16 80.2.1   AB-02-177  Technical Component (TC) of Physician Pathology Services to Hospital Patients 16 80.3 PM AB-99-84,AB-99-99  National Minimum Payment Amounts for Cervical or Vaginal Smear Clinical Laboratory Tests  16 80.4 B3-5114.1 Oximetry16 90   B3-5114   Automated Profile Tests and Organ/Disease Oriented Panels 16 90.1 A3-3628 B3-5114  HO-437 Laboratory Tests Utilizing Automated Equipment 16 90.1.1 A3-3628 B3-5114 AB-97-5, AB-97-7, AB-97-17 HO-437 Automated Test Listing 16 90.2 A3-3628 B3-5114  HO-437 Organ or Disease Oriented Panels 16 90.3   AB-97-17  Claims Processing Requirements for Panel and Profile Tests 16 90.3.1 AB-97-17 History Display16 90.3.2   AB-97-17  Medicare Secondary Payer  90.4   B-98-1  Evaluating the Medical Necessity for Laboratory Panel CPT Codes 16 90.5   AB-97-17  Special Processing Considerations 16 100 A3-3628 B3-5114.1  HO-437 CPT Codes Subject to and Not Subject to the Clinical  Laboratory Fee Schedule New Chap New Sect Int Pub. 13-3 Carrier  Pub 14 Program  Memo Other Sources Title 16 100.1     Deleted - held for expansion 16                   100.2 A3-3628 B3-5114.1 HO-437 Laboratory Te sts Never Subject to Fee Schedule 16 100.3 A3-3628 B3-5114.1  HO-437 Procedures Not Subject to Fee Schedule When Billed With Blood Products 16 100.4 A3-3628 B3-5114.1  HO-437 Not Otherwise Cl assified Clinical Laboratory Tests 16 100.5     Other Coding Issues - Header only 16 100.5.1   AB-98-7  Tests Performed More Than Once on the Same Day 16 100.6 A-03-033 Pricing Modifiers16 110     Coordination between Carriers and Other Entities - Header only 16 110.1  B3-5114.1   Coordination between Carriers and Intermediaries/RRB 16 110.2  B3-5114.1   Coordination with Medicaid 16 110.3 A3-3628   HO-437 Coordination with Intermediaries and Providers 16 110.4  B3-2070.1F   Carrier Contacts with Independent Clinical Laboratories 16 120   AB-02-129  Clinical Laboratory Services Based on the Negotiated Rulemaking 16 120.1 AB-02-129,B-03-045  Negotiated Rulemaking Implementation