Ala. Admin. Code r. 560-X-24-.04

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-24-.04 - Laboratory Services

Laboratory tests listed below are considered routine and are included as part of the composite rate of reimbursement. All other medically necessary lab tests are considered nonroutine and must be billed directly by the actual provider of service.

(a) Hemodialysis

1. Per treatment - All hematocrit and clotting time tests furnished incidentally to dialysis treatments.

2. Weekly - Prothrombin time for patients on anticoagulant therapy; serum creatinine, BUN.

3. Monthly

Serum Calcium Serum Biocarbonate

Serum Potassium Serum Phosphorous

Serum Chloride Total Protein

Alkaline Phosphatase LDH

SGOT

Monthly.

BUN Total Protein

Creatinine Albumin

Sodium Alkaline Phosphatose

Potassium LDH

C02 SGOT

Calcium HCT

Magnesium Hgb

Phosphate Dialysis Protein

(c) All laboratory testing sites providing services to Medicaid recipients, either directly by provider, or through contract, must be Clinical Laboratory Improvement Amendments (CLIA) certified to provide the level of complexity testing required. Providers are responsible to assure Medicaid that all CLIA regulations are strictly adhered to, both now and as regulations change in the future. Providers are responsible for providing Medicaid waiver certification numbers as applicable.

(d) Laboratories which do not meet CLIA certification standards are not eligible for reimbursement for laboratory services from the Alabama Medicaid Program.

Author:

Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. § 405.2163.

Ala. Admin. Code r. 560-X-24-.04

Rule effective October 1, 1982. Amended: Effective January 14, 1987. Amended: Effective May 11, 1993.