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APF Pathology Service Coding Handbook

January, 2019 APF Pathology Service Coding Handbook - Version 19.1

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Subscriber Special Bulletin: 1-9-19


This alert is provided as a service to APF Pathology Service Coding Handbook subscribers. It provides important information of immediate interest to pathologists, independent laboratories, hospitals, and support entities.

Hospital Outreach Laboratories PAMA Data Reporting Change Adopted

The 2019 MPFS expanded the number of laboratories that may be required to report private payer payment data to CMS under the PAMA rule by changing the definition of applicable laboratory to include the receipt of at least $12,500 in Medicare Clinical Laboratory Fee Schedule revenues billed on the 14X bill type, the CMS1450 billing form typically used by hospitals for outreach services (also known as non-hospital patients).

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Subscriber Special Bulletin: 2-7-19


This alert is provided as a service to APF Pathology Service Coding Handbook subscribers. It provides important information of immediate interest to pathologists, independent laboratories, hospitals, and support entities.

Guidance on Coding and Billing Date of Service on Professional Claims

On Feb. 1, 2019. CMS released a revised version of MLN Matters SE17023. Guidance on Coding and Billing Date of Service on Professional Claims. Interestingly, the article states that the information “reiterates current Medicare policy.”

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