HomeMy WebLinkAboutMH-210 Reimbursement for Laboratory Procedures1
FRANKLIN/FULTON COUNTY
MENTAL HEALTH/INTELLECTUAL & DEVELOPMENTAL
DISABILITIES/EARLY INTERVENTION
425 Franklin Farm Lane
Chambersburg, PA 17202
(717) 264-5387
MH/IDD/EI PROCEDURE STATEMENT
PROCEDURE SUBJECT: Reimbursement for Laboratory Procedures
PROCEDURE NUMBER: MH-210
Effective Date: January 1, 2016
Date Revised: June 20, 2018
Reference: 55 PA Code Chapter 4220, Reimbursement for Medication, August 1985
PURPOSE:
This statement establishes policies and procedures for prescribing and payment of laboratory
procedures used solely for the treatment of diagnosed mental illness, for individuals funded by
the MH/IDD/EI Program.
PROCEDURE:
Prescription:
A laboratory procedure needed to monitor the dosages and organ functions must be:
prescribed by a Practitioner licensed by the State to; and be specifically for mental health
diagnosis under treatment for it to be reimbursed by the MH/IDD/EI Program. The
MH/IDD/EI Administrator can approve exceptions with a clear clinical rationale from the
prescriber. Requests for exceptions are to be submitted in writing to the MH/IDD/EI
Administrator.
All third party revenues must be exhausted before MH/IDD/EI funds can be used for
laboratory procedure reimbursement.
All laboratory procedures must be licensed by the Department of Health to receive
reimbursement.
Limitations:
A listing of MH/IDD/EI approved reimbursable laboratory procedures is attached.
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Individuals Eligible to Receive MH/IDD/EI Laboratory Services:
Individuals must not be eligible for any other insurance plan/reimbursement, full or
partial.
Any individual who has a liability abatement and/or diagnostic abatement by the
MH/IDD/EI Administrator. (A diagnostic liability abatement may be requested by a
clinician/ psychiatrist/ physician in writing to the MH/IDD/EI Administrator, if it is
determined that the individual should not be held responsible for his/her liability prior to
getting laboratory procedures. See MHIDD-302 Individual Financial Liability, for more
information.)
Eligible individuals will have an order for laboratory procedures identifying
Franklin/Fulton MH/IDD/EI as payer. A laboratory procedure completed for someone
without a liability will not be reimbursed without a prior authorization letter.
MH/IDD/EI Responsibilities:
It is the responsibility of the Service Access and Management or True North Wellness
Services Case Manager to see that all third party payees have been exhausted and
proof is in the individual’s case file, in the form of a letter from his/her insurance
company or other proof before authorizing for MH/IDD/EI paid laboratory
procedures.
For the Prescribing Psychiatrist or Physician:
For any individual eligible for MH/IDD/EI payment of laboratory procedures, the
physician may prescribe any laboratory procedure, but only those on the attached
laboratory procedures will be paid unless an exception is made. If there are any
questions regarding an individual’s eligibility, the provider should contact the
MH/IDD/EI office prior to prescribing a laboratory procedure.
For the Laboratory:
MH/IDD/EI will not pay for any laboratory procedure that is not listed on the
attached laboratory procedures.
In addition, per Center for Medicare and Medicaid Services (CMS) regulation as
documented in MA Bulletin 99-11-05, Provider Screening of Employees and
Contractors for Exclusion from Participation in Federal Health Care Programs and the
Effect of Exclusion on Participation, we are unable to make payment to any provider
who has not followed the bulletin.
ATTACHMENT:
MH/IDD/EI Laboratory Procedures
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FRANKLIN/FULTON MH/IDD/EI LABORATORY PROCEDURES
The following laboratory procedures will be covered.
80050 Comp metab panel
80061 Lipid Panel
80178 Lithium
80076 Hepatic Function Panel
80104 Drug Screen 11 Panel
80156 Carbamazepine (Tegretol)
80164 Dipropylacetic Acid (Valproic Acid)
82565 Creatinine; Blood
84443 Thyroid stimulating hormone
84450 Transferase; Asparatate Amino
84460 Transferase; Alanine Amino
84520 Urea Nitrogen Quantitative
85025 CBC Automated w/auto diff