2018 Laboratory Fee Schedule Effective April 1, 2013 and while sequestration is in effect, all CMS payments for services will be reduced by 2%. The fees below do not reflect this reduction. Click here for more information. Atellica® CH
Atellica® IM
ADVIA® 1200, 1650, 1800 and 2400 ADVIA® 2120, 120, 360, 560, 560AL
BN ProSpec®, BNTM II Systems
ADVIA® Centaur®, CP, XP
Coagulation/Hemostasis
Dimension® Vista® 500/1000T, 1500/3000T Dimension® RXL, EXL and EXPand®
IMMULITE®
MicroScan® Microbiology
Molecular Products
Point of Care
PFA-100® System
RAPIDPoint® /RAPIDLab® Systems Stratus® CS
V-Twin®, Viva-ProE®, Viva-E®, Viva-Jr® Systems Research Use Only
Panels
Manual Tests
SYVA RapidTest/RapidCup
epoc® Blood Analysis System
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Please select your state before continuing: MASSACHUSETTS
NCD-A National Coverage Determination Applies LCD-A Local Coverage Determination Applies CCI-A Correct Coding Initiative edit Applies
Coagulation/Hemostasis Medicare MASSACHUSETTS Coverage Reimbursement
SIEMENS INSTRUMENT/TEST
CPT Code
CPT Code Description
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 18.92
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; CA 500; BCS XP
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CCI
$ 16.16
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; CA 500; BCS XP; BFT II
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CCI NCD
$ 7.42
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; CA 500; BCS XP
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CCI
$ 14.63
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; CA 500; BCS XP
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CCI
$ 17.08
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 18.92
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 16.03
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 23.51
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 21.79
CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 22.10
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 22.10
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 22.10
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 22.10
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 23.89
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; CA 500; BCS XP
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CCI
$ 17.49
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 11.83
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 12.56
Manual
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CCI
$ 9.72
Manual
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CCI
$ 8.51
Manual
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CCI
$ 14.02
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; CA 500; BCS XP; BFT II; BN Systems
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CCI
$ 10.49
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP
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CCI
$ 9.51
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; BCS XP; BN Systems
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CCI
$ 8.06
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; CA 500; BCS XP
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CCI NCD
$ 4.85
CS-5100, CS-2500, CA 7000; CA 1500; CA 600; CA 500; BCS XP
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CCI
$ 7.12
CS-5100, CS-2500, BCS XP
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CCI
$ 28.32
National Coverage Determinations (NCD) - Medicare regulations allow the Center for Medicare and Medicaid Services (CMS) to develop coverage policies for Medicarecovered tests and procedures. These coverage policies, called NCDs, provide definitive guidance to providers concerning the medical necessity requirements of a particular test or procedure. Numerous NCDs are in effect for a wide array of tests and services including procedures performed by diagnostic service providers, such as radiologists and clinical laboratories. Local Coverage Determinations (LCD) - Medicare contractors, such as Medicare Carriers, Fiscal Intermediaries, and now Medicare Administrative Contractors (MACs) have the regulatory authority to develop local coverage policies. Unlike NCDs, these policies only apply to a single contractor jurisdiction. In the past, local policies were referred to as Local Medical Review Policies (LMRPs). Correct Coding Initiative (CCI) edits are used by Medicare to deny claims based on inappropriate CPT code usage. CCI edits consist of pairs of CPT codes that Medicare has determined are not payable when performed together. If a provider submits a claim containing two CPT codes that are the subject of a CCI edit, the Medicare carrier or intermediary will deny one of the CPT codes. Many CCI edits may be overcome with the proper use of a CPT code modifier. This information is provided as a convenience for Siemens Healthcare employees and users by CodeMap®. CodeMap® is responsible for the accuracy of all content. While every effort is made to ensure that all payment amounts and regulatory information is current and complete, it is the responsibility of each user to verify specific coverage and payment information with their Medicare contractors. Actual reimbursement for healthcare facilities will vary depending on the specific location, the number and type of clinical procedures performed, and the local carrier coverage and payment policies. Note also that the federal statute known as the Stark Law imposes certain requirements that must be met in order for physicians to bill Medicare/Medicaid or other federal healthcare programs for in-office services provided. In some states, similar laws cover billing practices for all patients. Additional licensure, certificate of need, and other restrictions may be applicable. It is the responsibility of each physician, physician group, and other individuals and entities to consult with their reimbursement manager or healthcare advisor, as well as legal counsel, to ensure all requirements have been met to support appropriate billing for Medicare services provided. All questions regarding this website should be directed to
[email protected]. This website is a private website and is not associated, endorsed or authorized by the Department of Health and Human Services, the Center for Medicare and Medicaid Services or any other public or government organization or agency.
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04/12/2018 09:32:56 185.191.228.245
