In 2017, the Medicare fee-for-service improper payment rate for blood counts was 19.2 percent with projected inaccurate payments of $56.6 million. Improper payments resulted from:
- Insufficient documentation – 89 percent
- Incorrect coding – 8.3 percent
- No documentation – 2.7 percent
Prevent denials by reviewing the Provider Compliance Tips for Laboratory Tests – Blood Counts Fact Sheet, which details coverage and documentation requirements.
Also, a revised Clinical Laboratory Fee Schedule Fact Sheet is available. Learn about:
- Coverage requirements
- How payments rates are set