Noridian processes lab services based on the CMS established regulations.
Diagnostic X-ray, laboratory, and other diagnostic tests, including materials and the services of technicians, are covered under the Medicare program. Some clinical laboratory procedures or tests require Food and Drug Administration (FDA) approval before coverage is provided.
A diagnostic laboratory test is considered a laboratory service for billing purposes, regardless of whether it is performed in a physician's office, by an independent laboratory; by a hospital laboratory for its outpatients or nonpatients; in a rural health clinic; or in an Health Maintenance Organization (HMO) or Health Care Prepayment Plan (HCPP) for a patient who is not a member.
Access the below lab related information from this page.
- ESRD Laboratory Services
- Home PT/INR Monitoring (G0249) Billing and Coding [PDF]
- Incorrect Laboratory Services Billing Identified by MR and CERT
- Laboratory Orders Over 12 Months Old
- CMS Clinical Labs Center
- CMS Clinical Lab Fee Schedules
- CMS Internet Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 16
Last Updated Feb 28, 2020
The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.