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Lab Coverage Description |
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How many times has your practice absorbed the cost of a necessary laboratory test because the specific diagnosis you listed was not covered?
Up until now, there have been no national guidelines to determine, exactly, when a lab test is covered or not. Some clinicians have even had to pay outside labs for their patients lab bills that werent covered! (see below).
Recently, CMS published a 200+ page document listing specific diagnoses and ICD-9-CM codes that regional Medicare carriers must cover for 23 common tests. We have formatted these lists for easy lookup by clinicians at the point of care.
STAT NCD Lab Coverage allows the user to quickly scan diagnosis categories and codes which Medicare will definitely cover for any of these tests. It uses a format very similar to STAT ICD-9 Coder and runs on the TealInfo database program.
Recovering payment for even a single lab test will pay for this software. Now, you never have to wonder exactly when Medicare will cover a CEA test, for example.
Since this is the first time that these coverage rules have been specifically determined by consensus, many commercial insurance carriers are expected to adopt these same rules for their plans. |
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