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Outpatient hospitals are subject to corrective action, including the recovery of funds, for laboratory services not specifically ordered by a practitioner.MDHHS does not cover: * Screening or routine laboratory testing, except as specified for EPSDT Program or by Medicaid policy; * "Profiles", "batteries" or "panels" of tests that include tests not necessary for the diagnosis or treatment of the beneficiary's specific condition; or * Multiple laboratory tests performed as a part of the beneficiary evaluation if the history and physical examination do not suggest the need for the tests.Only one Papanicolaou test within a 12-month period is covered for each beneficiary, unless medical necessity or history of abnormal findings requires additional studies.
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PAP SMEAR Pap smear screening by a technologist under the supervision of a pathologist is a covered service.
If a suspect smear requires additional interpretation by a pathologist, this service is also covered.
SQL statements that modify data (such as INSERT, UPDATE, or DELETE) do not return rows.
Similarly, many stored procedures perform an action but do not return rows.
Services performed by an outpatient hospital laboratory or its employees may not be billed to, or by, the ordering practitioner.
PREGNANCY-RELATED LABORATORY SERVICES The obstetric profile must be ordered by the attending practitioner and billed as an allinclusive panel of tests for required prenatal laboratory services.
LABORATORY MDHHS follows Medicare’s current OPPS coverage policies as closely as possible and appropriate.
In those instances where program differences require coverage disparity, the differences will be reflected through the application of the MDHHS specific status indicator.
(Requests for supplies and samples for analysis should be sent to the MDHHS Blood Lead Laboratory.