RE: Date of Service for Medicare B

From:"Weems, Joyce"

Date of Service for Medicare B

This is a BIG problem for all of us, I’m sure. We are late with many charges as we only have 3 days for in patients and 5 days for outpatients to get the charges in. Some of our paps are late before we get them!


What I do as much as I can – even for a recent case, is register the patient for the new DOS (I have access to the hospital system) – and bill only the stains (immunos/specials) ordered for that date. In the case of years old specimens – I obtain recent insurance information and a written order from the clinician, and register for the new DOS.


I hope someday we can get the powers that be to listen to us………


Joyce Weems

Pathology Manager

Saint Joseph’s Hospital of Atlanta


404-851-7831 - fax


-----Original Message-----
From: Tom McNemar []
Sent: Thursday, October 17, 2002 9:58 AM
To: 'Histonet ('; Lorei Reinhard
Subject: Date of Service for Medicare B


Hello all,

We are struggling here to comply with the new Medicare ruling that says testing dates must match the date of service with the date of service being defined as the date of collection.  I would like to know how others are handling this so I have several questions.....

When a specimen is registered, they are using the collection date as the registration date.  When we put the specimen into the Meditech pathology module, we are using the registration date as the date of collection,  ok so far.

The problems (or questions) arise when it comes time to enter procedures.  The initial procedures are based upon the complexity of the specimen and are assigned by the pathologist when they do the micro.

Q:  Since this specimen was collected yesterday, grossed today, and signed out tomorrow, how do I keep the procedure date and the collection date the same?  Do I have to worry about it since this is initial testing?

Q:  What about special stains that are ordered after reviewing the slides?  Consults?

Q:  If I were to change the date of collection every time another procedure was done, it would look as if there were multiple biopsies done, yes?

The other big question revolves around stored specimens.  Medicare says that for stored specimens, the date of collection is the date the specimen was retrieved from storage.  As you know, blocks are stored for a long time.

Q:  If I pull a block from the file today on a previous case (may be a month old or a year for that matter), how can I change the collection date to that day?  I can't.

I would certainly appreciated any thought you folks may have regarding this.  How do you interpret it.  What have you done to comply?  Thanks in advance.


Tom Mc Nemar HT(ASCP)
Histology Supervisor
Licking Memorial Hospital
Newark, Ohio

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