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Note from Hugh

Medicare Weekly Update, June 17, 2008

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Hospitals and other laboratory providers have long awaited an update to the Laboratory National Coverage Determinations Manual, which was last updated in April 2007. The manual provides coverage edits for many of the most common laboratory tests provided by hospitals. The manual was maintained on a separate Web site from the “internet only” National Coverage Determinations Manual.

Previously this manual had been republished each quarter with the changes effective for the highlighted quarter. However, CMS had not made any updates to the manual since April 2007, and callers on the Hospital Open Door Forum had asked CMS if there would continue to be updates. This week, CMS published a MLN Matters article (a companion to Transmittal R1531CP, published June 6) detailing the updates made to the software to incorporate coding and other changes since April 2007.

Unfortunately, CMS did not incorporate these changes into a new version of the Laboratory National Coverage Determinations Manual, but rather refers to this update as an update to the Laboratory National Coverage Determinations edit software. CMS did not discuss this change to how the edits are published in the transmittal or the accompanying MLN Matters article. 

However, CMS has not posted the July 2008 version of the manual to the Web site. Additionally, the transmittal and the MLN Matters article both refer to an “edit module” or “software” rather than a manual. This perhaps indicates that CMS will no longer maintain a separate manual for download with these changes incorporated.

~ Kimberly Anderwood Hoy, Esq.

Editor's Note: Kimberly Anderwood Hoy, director of Medicare and compliance for HCPro, is the author of this week's "Note from Hugh" in Mr. Aaron's absence.

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