- An order (or requisition) not signed by the physician does not support physician's intent for the test to be performed.
- Must be documented at both the treating physician's office and the testing facility and placed in the beneficiary's medical record.
- Must be signed within the time frame specified by the state.
Tests not ordered by the physician who is treating the beneficiary are not reimbursable. Although no signature is required on an order form for a clinical diagnostic test paid on the Laboratory Fee Schedule, the physician must clearly document and sign in the medical record, his or her intent to have the test performed. The entity providing the laboratory test results must maintain all documentation, including the physician order and the test findings, to support the claim submitted. Laboratory medical records are requested to determine correct billing and medical necessity.
Resources
- 42 CFR 410.32 (Code of Federal Register)
- CMS Internet Only Manual (IOM), Medicare Benefit Policy Manual, Publication 100-02, Chapter 15, Section 80.6.1
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