MLN Matters Number: MM6100 Revised
Related Change Request (CR) #: 6100
Related CR Release Date: August 29, 2008
Effective Date: January 1, 2003
Related CR Transmittal #: R94BP
Implementation Date: September 30, 2008
Note: This article was revised on February 6, 2009, to remove a parenthetical statement from the first paragraph of this article. All other information remains the same.
Provider Types Affected
Physicians and other providers who bill Medicare contractors (Carriers, Fiscal Intermediaries (FI), or Medicare Administrative Contractors (A/B MAC)) for diagnostic laboratory services provided to Medicare beneficiaries.
What You Need to Know
CR 6100, from which this article is taken, updates the Medicare Benefit Policy Manual, Chapter 15 (Covered Medical and Other Health Services), Section 80 (Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic
Tests) Subsection 80.6.1 (Definitions); to incorporate language previously contained in Section 15021 of the Medicare Carriers Manual, but inadvertently omitted when the Medicare Benefit Policy Manual was published.
Specifically, it notes that a physician’s signature is not required on orders for clinical diagnostic tests that are paid on the basis of the clinical laboratory fee schedule, the Medicare physician fee schedule, or for physician pathology services. While a physician order is not required to be signed, the physician must clearly document in the medical record his or her intent that the test be performed.
Make sure that your office, billing, and/or laboratory staffs are aware of this updated guidance regarding the signature requirement for diagnostic tests.
Additional Information
You can find more information about physician signature requirements for diagnostic tests by going to CR 6100, located at www.cms.hhs.gov/Transmittals/downloads/R94BP.pdf (PDF, 117 KB). You will find the updated "Medicare Benefit Policy Manual", Chapter 15 (Covered Medical and Other Health Services), Section 80 (Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests), Subsection 80.6.1 (Definitions) as an attachment to CR 6100.
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Disclaimer: This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.