Clinical Laboratory Date of Service Policy: Complexities in Billing for Personalized Laboratory Medicine - On-Demand

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Clinical Laboratory Date of Service Policy: Complexities in Billing for Personalized Laboratory Medicine - On-Demand

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Clinical Laboratory Date of Service Policy: Complexities in Billing for Personalized Laboratory Medicine - On-Demand

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Available ON-DEMAND

Presented on:
Thursday, May 17, 2018

Presented by:
Valerie A. Rinkle, MPA
Laura Lindeman-Lorenz, JD, MHA, MT(ASCP)

Level of Program:

The 2018 OPPS final rule changed the current clinical laboratory date of service (DOS) policies for outpatient molecular pathology tests and advanced diagnostic laboratory tests (ADLT), since they are now excluded from the OPPS packaging policy for laboratory tests. Although CMS has not yet designated any tests as ADLTs, it is critical for facilities to begin working through operational and reference lab contracting issues to implement the required changes for molecular pathology tests. These tests are paid separately under the Clinical Laboratory Fee Schedule (CLFS) rate and are not packaged into outpatient hospital Ambulatory Payment Classification (APC) payment rates, even when they are performed on the same date of service and/or billed on the same outpatient claim.

During this webinar, experts Valerie Rinkle, MPA, and Laura Lindeman-Lorenz, JD, MHA, MT(ASCP), will review CMS’ current hospital “prohibition of unbundling hospital services” rules as well as the current laboratory DOS policies. They will also explain how to bill for outpatient molecular pathology tests and discuss the differences in inpatient and outpatient billing for these tests.

At the conclusion of this program, participants will be able to:

  • Explain the changes to the clinical laboratory DOS policies
  • Describe the reason the change is applicable to the outpatient but not inpatient setting
  • Define the tests impacted by the DOS policy changes
  • Outline next steps for implementing DOS-related changes
  • Recognize nuances that may impact successful implementation

Who Should Listen?

  • Revenue cycle directors, managers, and staff
  • Revenue integrity directors, managers, and staff
  • Compliance officers and professionals
  • Laboratory directors, managers, and staff
  • Billing directors, managers, and staff
  • Finance directors, managers, and staff


  • Explanation of changes to the clinical laboratory DOS policies
    • Outpatient molecular pathology tests
    • Advanced diagnostic laboratory tests
    • Background between what was proposed and finalized
  • Implications of the new DOS rule
    • Inpatient vs. outpatient laboratory billing
  • Context of the new rule
    • Impact on laboratory billing
    • Tracking inpatient and outpatient tests
  • Operational challenges
    • Operational and reference lab contracting issues
  • Case studies
    • Tissue sample vs. blood-based pathology tests
  • Live Q&A


  • List of tests under the DOS policy that use Status Indicator A

Continuing Education

(Live + On-Demand) - This program has the prior approval of AAPC for 1.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Ability to claim credits for this webinar expire on: 5/16/19

(Live + On-Demand) - This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Ability to claim credits for this webinar expire on: 5/16/19

Meet the Speaker

Valerie A. Rinkle, MPA

Valerie A. Rinkle, MPA, is a lead regulatory specialist and instructor for HCPro's Revenue Integrity and Chargemaster Boot Camp®, as well as an instructor for HCPro’s Medicare Boot Camp®—Hospital Version and Medicare Boot Camp®—Utilization Review Version. Rinkle is a former hospital revenue cycle director and has over 30 years in the healthcare industry, including over 12 years of consulting experience in which she has spoken and advised on effective operational solutions for compliance with Medicare coverage, payment, and coding regulations.

Laura Lindeman-Lorenz

Laura Lindeman-Lorenz, JD, MHA, MT(ASCP), is the CEO of Triple L Health Services Consultants in Newport, Kentucky. She has more than 20 years of broad healthcare experience and deep expertise in clinical laboratory operations. She has led initiatives to improve operations for laboratories ranging from complex academic medical centers to smaller community hospital labs. Lindeman-Lorenz has collaborated with physicians to reduce utilization and supply costs for high-dollar items, blood products, and reference lab services. She has also led performance improvement initiatives that reduced staffing costs while improving key metrics such as turn-around-times. Lindeman-Lorenz has led successful performance improvement projects for virtually every area of hospital operations, including radiology, respiratory care, outpatient surgery, rehab services, admissions/pre-admission testing, and support services.

Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

No problem. The On-Demand version is also available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $259 value! 

Participation in the webinar is just $259 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email if you have questions.