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Medicare覆蓋和編碼指南

Medicare has limited coverage policies (MLCPs) for certain laboratory tests. Tests subject to an MLCP must meet medical-necessity criteria in order to be covered by Medicare. MLCP tests ordered without a supportive ICD-10 code will not satisfy medical necessity and therefore will not be covered by Medicare. These orders must be submitted with an Advance Beneficiary Notice signed by your patient, which confirms they are responsible for payment.

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Medicare對某些實驗室測試有限的覆蓋政策(MLCPS)。MLCP的測試必須符合醫療必要標準,以便由Medicare涵蓋。未經支持性ICD-10碼訂購的MLCP測試將不滿足醫療必要性,因此醫療保險不會覆蓋。必須提交這些訂單,並通過患者簽署的預先受益通知,確認他們負責付款。

導航Medicare政策的複雜性可能是複雜的,但Quest就在這裏提供幫助。

We’re pleased to provide Medicare Coverage and Coding Reference Guides to help you more easily determine test coverage and find ICD-10 diagnosis codes to submit with your test order. By doing so, you can ensure your Medicare patients’ lab tests are performed without delay and prevent disruptions to your office.

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To get started, identify your state below where your Quest testing is performed and select the corresponding color in the legend. 

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我們很高興提供Medicare覆蓋範圍和編碼參考指南,以幫助您更輕鬆地確定測試覆蓋範圍,並找到ICD-10診斷代碼以使用您的測試訂單提交。通過這樣做,您可以確保您的Medicare患者的實驗室測試毫不拖延,防止您的辦公室中斷。

要開始,請在下麵識別您的Quest測試的狀態,並在圖例中選擇相應的顏色。

Local Coverage Determinations are issued by Medicare administrative contractors (MACs), and National Coverage Determinations are issued by the Centers for Medicare and Medicaid Services (CMS). The map above shows the regional MACs that have jurisdiction over testing.

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To view the full coverage policy for any National Coverage Determination from the CMS website, which will include a complete list of medically supportive ICD-10 codes, click here.

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本地覆蓋範圍確定由醫療保險行政承辦商(MAC)發布,國家覆蓋範圍由Medicare和Medicaid Services(CMS)的中心頒發。上圖的地圖顯示了對測試具有管轄權的區域MAC。

要查看CMS網站的任何國家覆蓋範圍確定的完整覆蓋策略,其中包括醫學支持ICD-10代碼的完整列表,點擊這裏

有關Quest如何幫助您簡化您的練習的更多信息,請下載我們的Medicare Ruckage手冊。

下載

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