Pathology/Lab Coding Alert

Question: We received a saliva specimen for a genetic screening test that had been stored for 14 days from August 10, which is the date the buccal swab was taken. I recall something about a “14-day rule” — would that impact the date of service for this test?

Tennessee Subscriber

Answer: The Centers for Medicare & Medicaid Services (CMS) has a date of service (DOS) rule that applies to clinical lab tests such as you describe. The general rule is that the DOS is the date the specimen is taken from the patient. That means the DOS for this case would be August 10.

The only exception that may apply in this case is if the specimen was taken from a hospital inpatient or outpatient, and the test results didn’t guide treatment while in the hospital. When a specimen is stored 30 days or fewer for an inpatient or outpatient, that’s when the “14-day rule” comes into play. If the test was ordered on the 14th (through 30th) day after the hospital patient’s discharge, you should use the date that you perform the test. For the first through 13th day, you’d still use the date the specimen was taken.

In all cases, if a specimen has been stored more than 30 days, the DOS is the date the specimen is obtained from storage.