How many times has your
practice absorbed the cost of a necessary laboratory test because the specific
diagnosis you listed was not covered? Up until now, there have been no national
guidelines to determine, exactly, when a lab test is covered or not. Some
clinicians have even had to pay outside labs for their patient's lab bills that
weren't covered! (see below). Recently, CMS published a 200+ page document
listing specific diagnoses and ICD-9-CM codes that regional Medicare carriers
must cover for 23 common tests. We have formatted these lists for easy lookup by
clinicians at the point of care. STAT NCD Lab Coverage allows the user to
quickly scan diagnosis categories and codes which Medicare will definitely cover
for any of these tests. It uses a format very similar to STAT ICD-9 Coder and
runs on the TealInfo database program. Recovering payment for even a single lab
test will pay for this software. Now, you never have to wonder exactly when
Medicare will cover a CEA test, for example. Since this is the first time that
these coverage rules have been specifically determined by consensus, many
commercial insurance carriers are expected to adopt these same rules for their
plans.