Redefined Type of Bill (TOB), 14x, for Non-Patient Laboratory Specimens
This Change Request redefines TOB 14x to be used for nonpatient laboratory specimens. Any hospital (including a Critical Access Hospital (CAH))receiving only a specimen is to bill for the lab test on TOB 14x. When lab services are rendered to non-patients by a CAH or a hospital subject to Maryland waiver, laboratory tests for these non-patients are to be paid on the Clinical Diagnostic Laboratory Fee Schedule, unlike lab tests for outpatients of these facilities (as required by regulations at 42 CFR 413.40(b)(2)(iii) for CAHs and by the terms of the Maryland waiver for Maryland hospitals). Laboratory tests for outpatients of a CAH are paid based on reasonable cost; those for outpatients of a Maryland hospital are paid under the State's cost containment plan.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 28, 2005
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