Question:

I’ve heard that CMS aims to change a DOS exception in the 2019 OPPS. What is this exception?

Answer:

The Centers for Medicare & Medicaid Services (CMS) notes that a Date of Service (DOS) additional exception at § 414.510(b)(5) was previously incorporated into the final rule of the 2018 Outpatient Prospective Payment System (OPPS). Designed for the hospital outpatient setting, the exception intends “that the DOS for molecular pathology tests and certain Advanced Diagnostic Laboratory Tests (ADLTs) that are excluded from the OPPS packaging policy is the date the test was performed (instead of the date of specimen collection) if certain conditions are met.”

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