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Medical coverage policies (LMRPs)
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The page below is a sample from the LabCE course
Medicare Compliance for Clinical Laboratories (retired)
. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.
Learn more about Medicare Compliance for Clinical Laboratories (retired) (online CE course)
Medical coverage policies (LMRPs)
LMRPs
(Local Medical Review Policies)
are published by Medicare for some laboratory tests.
Developed for tests that can be used for screening or diagnosis of disease.
CPT codes describe laboratory tests and ICD-9CM codes determine when coverage is allowed.
If an LMRP test is ordered by a physician, an ICD-9CM code that is included in the LMRP must be given to the laboratory or the Medicare program will not pay for the test.
It is against the law for laboratory to change or add an ICD-9 code submitted by a physician.
The Balanced Budget Act of 1997 made it illegal for physicians to order LMRP tests and not supply an ICD-9CM code with the order.
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