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Instructions For Use Of Informational Remittance Advice: CLFS Data Reporting Changes For CDLTs.pdf

MM11369.pdf
Preview of Instructions for Use of Informational Remittance Advice: CLFS Data Reporting Changes for CDLTs
🔗 Source: cms.gov
📊 Size: 136 KB
👤 Author: cms
⬇️ Downloads: 249

Summary

This MLN Matters document (MM11369) outlines changes to the remittance advice process for Medicare Administrative Contractors (MACs) and laboratories providing Clinical Diagnostic Laboratory Tests (CDLTs). Effective January 1, 2020, MACs will include a new informational Remittance Advice Remark Code (RARC), N817, on all processed claims containing laboratory services.

Key Points:

- Affected Providers: Physicians, suppliers, and billing contractors billing for laboratory services under Medicare.
- Background: Changes are mandated by the Protecting Access to Medicare Act of 2014 (PAMA), specifically Section 1834A of the Social Security Act. Laboratories must report private payor rate information for each HCPCS code to CMS.
- Reporting Timeframes:
- Data collection: January-June 2019
- Data analysis: July-December 2019
- Data reporting: January-March 2020 (with a delayed reporting period for non-Advanced Diagnostic Laboratory Test [ADLT] CDLTs until January 1, 2021 – March 31, 2021)
- RARC Code: N817 - ALERT: Applicable laboratories must collect and report private payor data between January 1, 2020, and March 31, 2020.
- Additional Resources: The official CR 11369 document is available online at https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2019Downloads/R2335OTN.pdf. MACs may provide additional information on their websites.

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Description

This MLN Matters guide (MM11369) outlines updated instructions for submitting laboratory service remittance advice, with a focus on revised data reporting timelines for CDLTs (not ADLTs), effective January 2020. Key changes include a one-year delay in data reporting, now required between January 1, 2021, and March 31, 2021. Target audience: physicians, providers, and suppliers billing Medicare.

Technical Information

  • File Format: PDF
  • File Size: 136 KB
  • Pages: 3
  • Language: EN
  • Author: cms
  • Total Downloads: 249
  • Last Updated: 2 hours ago

Document Overview

This PDF document about Instructions for Use of Informational Remittance Advice: CLFS Data Reporting Changes for CDLTs provides comprehensive information and guidance. Whether you're a beginner or advanced user, this resource offers valuable insights into Instructions for Use of Informational Remittance Advice: CLFS Data Reporting Changes for CDLTs.

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