Indicator for the Technical Component of Purchased Diagnostic Services
The purpose of this CR is to provide instructions to Carriers/AB MACs on how to process claims for diagnostic services when there is no entry for the Yes/No Indicator in either Block 20 of the Form CMS-1500, or if the claim does not contain either a claim or line level PS1 segment on the
electronic format to indicate whether the diagnostic services were purchased. Carriers/AB MACs shall assume that the service is not purchased if there is no "Yes/No" indicator on the Form CMS-1500 or lack of claim or line level in the electronic format. Carriers/AB MACs shall adjudicate a claim lacking evidence of purchased services for a diagnostic service as if it were not a purchased service.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: September 08, 2008
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