Thursday, September 15, 2022

Paying Part B Stuff for Part A Inpatients

MolDx has a policy on infectious disease molecular testing, which includes some rules about inpatient (or hospital outpatients) locations of service.  This may seem odd, since Medicare (Part B) doesn't pay for lab tests for inpatients (or hospital clinical or ER outpatients) (except human gene tests).

There are a few rare situations such as when a patient has exhausted Part A benefits.

See the manual chapter here:


https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c06.pdf



https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c04.pdf





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