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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: 11-28-18


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.

ICD-10-CM Updates Effective Nov. 28, 2018

2019 Medicare Physician Fee Schedule (MPFS) Final Rule

The 2019 Medicare Physician Fee Schedule (MPFS) was published on Nov. 23, 2018. The adopted 2019 conversion factor of $36.0391 will result in up to a minus 2% payment rate change to pathology groups and independent laboratories based on work and practice expense RVU adjustments.

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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