Links | Medicare Limited Coverage Guide
The lists of covered diagnosis codes for National and Local Medicare Limited Coverage Tests are provided as a guide for determining if the test is reimbursable by Medicare based on the patient's symptoms or medical condition as indicated by the appropriate ICD-9-CM code. Please note diagnosis codes are required for all Medicare orders to document medical necessity of the testing.
If the diagnosis you provide does not meet the reimbursement rules, or if the frequency limit on test procedures has been exceeded, payment may be denied. In that case, SwedishAmerican Reference Laboratory can only seek reimbursement from the patient if they have been notified in advance that Medicare is likely to deny payment for these services. If the patient chooses to have the test, they must sign an Advance Beneficiary Notice (ABN) BEFORE SPECIMEN COLLECTION confirming their understanding that they will be responsible for payment. This program provides you with access to such a form.
Access to our Medicare limited coverage guide (referred to as “LMRP”) requires the use of a user name and password. These are only provided to customers of SwedishAmerican Reference Laboratory. To attain access to our LMRP program, please contact Laboratory Customer Service at (815) 966-2689 to be connected with Sales and Service.
If you already have a username and password, click here to proceed.