For approval of payment, the laboratory procedure(s) must be specific and appropriate to the beneficiary's documented condition and diagnosis.
If automated instrumentation yields additional test parameters, the results are not reimbursable unless medically necessary and specifically ordered by a practitioner.MICROBIOLOGY STUDIES MDHHS coverage and reimbursement for gram fluorescent/acid fast is included in the reimbursement for microbiology when performed on the same DOS for the same beneficiary.To execute commands that do not return rows, create a Command object with the appropriate SQL command and a Connection, including any required Parameters. Execute the command with the Execute Non Query method of the Command object. LABORATORY MDHHS follows Medicare’s current OPPS coverage policies as closely as possible and appropriate.
In those instances where program differences require coverage disparity, the differences will be reflected through the application of the MDHHS specific status indicator.
Services performed by an outpatient hospital laboratory or its employees may not be billed to, or by, the ordering practitioner.
PREGNANCY-RELATED LABORATORY SERVICES The obstetric profile must be ordered by the attending practitioner and billed as an allinclusive panel of tests for required prenatal laboratory services.
CREATININE BLOOD TESTS Calculate and report the Glomerular Filtration Rate (e GFR) for tests processed for beneficiaries in outpatient settings and for beneficiaries 18 years of age and older.
The e GFR test results must report two values on the lab report for beneficiaries: one for American and one for non-African-American, or one value if race is available and able to be used in calculating the value.
(Requests for supplies and samples for analysis should be sent to the MDHHS Blood Lead Laboratory.