US · guidance
CMS Pub. 100-04, ch. 32, § 350.8
Claims from Hospital-Leased Laboratories Not Meeting Conditions of Participation
Services furnished by a laboratory that does not meet the hospital laboratory conditions of participation and is operated
under a lease arrangement in a domestic emergency hospital are covered only if they are emergency inpatient services
reimbursable under Part A.
A MAC may send a claim from such a laboratory and identify it as an "Emergency Lead." The MAC checks its files to
see if a claim for emergency services was filed and, if so, determines whether the laboratory services were furnished
during the period of emergency. If the emergency claim was forwarded to the appropriate MAC for processing, it enters
the date received on the laboratory claim.
If no emergency claim was filed, or laboratory services were not furnished in the period covered by the emergency
claim, the MAC develops the claim as a possible emergency. It includes the laboratory claim with any subsequent
claim.
If no emergency is alleged, the MAC records on the claim that no emergency existed and disallows it.
History
(Rev. 3287, Issued: 06-30-15, Effective: 04-21-15, Implementation: 04-21-15)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
e08f842a5dbefb5dd18176fc008e06c783142d3aee12a80a0998c123eaad8f46
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