The coverage of anatomical laboratory procedures is limited to procedures performed in the following places of service:

21 - Inpatient hospital
22 - Outpatient hospital
31 - Extended care facility, skilled nursing facility
32 - Domiciliary care or nursing home
62 - Comprehensive outpatient rehabilitation facility

Independent Laboratory - Place of Service 81

• Providers are reminded that place of service 81 is to be used by independent laboratories (specialty 69) only. Hospitals, acting as independent labs, must submit the actual place of service where the test was performed. If place of service 81 is submitted, the service will be rejected.

• Physicians must not submit laboratory tests they refer to outside labs. These services must be submitted to Medicare by the outside lab. If submitted, the service will be rejected.

Laboratory Tests Submitted Under Arrangement
Clinical diagnostic laboratory tests performed on hospital inpatients must be submitted by the hospital.

• A laboratory that furnished services to a hospital inpatient must receive payment from the hospital with which it has the arrangement
• The laboratory must not submit a request for payment to either Medicare or the beneficiary for its service
• Laboratories billing in addition to the hospital with which they have an arrangement, may be in violation of federal regulations and may be subject to civil monetary penalties