We’re making updates to Medicare Advantage Physician Office Laboratory List

The Medicare Advantage Office Physician Laboratory List, or POLL, is being updated to reflect changes in CPT coding. The procedures on the list are those that we believe are appropriate to be provided in an office setting. If you provide lab services that aren’t on this list, you won’t be paid. Also, you may not bill the member for a lab service that’s not on this list.

There are 69 codes payable from a provider’s office that are being added to the MA POLL. These include two codes (*80306 and *80307) that were effective for claims submitted with dates of service on or after Jan. 1, 2017. The remainder of the newly added codes will be effective for claims submitted with dates of service on or after April 1, 2019. To view the updated list, click here.

Keep in mind that certain lab procedures may be performed in your office without referring the patient or the specimen to a Medicare Advantage PPO lab network provider if specific conditions are met. They may be performed in your office if:

• The results are needed at the time of service to support making real-time therapeutic decisions.
• The services can be performed economically and accurately.
• The services are medically necessary.