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5 Rules Pinpoint Date of Service for Laboratory Claims

Posted on 28. Aug, 2009 by in Hot Coding Topics

Tip 3: Here’s DOS advice for archived samples.

You can’t afford to get the date of service (DOS) wrong on claims that undergo CMS edits — mistakes could mean you’ll face fraud charges. That’s because Correct Coding Initiative (CCI) edits and Medically Unlikely Edits (MUEs) control payment for procedures on the same DOS.

But for pathologists, choosing the date has never been clear-cut. “For instance, should you use the date the surgeon took the biopsy, the date the lab processed special-stain slides from the biopsy specimen, or the date the pathologist interpreted those slides?” asks Pamela Biffle, CPC, CPC-I, CCS-P, ACS-DE, principal for PB Healthcare Consulting and Education in Fort Worth, Tex.

Do this: If you’re billing for clinical laboratory tests or the technical component (TC) of physician pathology services, you’ll need to adhere to the following five rules.

Rule 1: Use Specimen Collection Date

CMS’s general rule is that the DOS...

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