What does IDTF stand for in medical terms?
Independent Diagnostic Testing Facility (IDTF) This Medicare Learning Network® (MLN) booklet explains the requirements for an Independent Diagnostic Testing Facility (IDTF) to enroll in the Medicare program. This booklet will also tell you of IDTFs key billing issues. Page 1 of 12 MLN909060 November 2021. Centers for Medicare & Medicaid Services logo
What is an independent diagnostic facility (IDTF)?
Oct 01, 2015 · An Independent Diagnostic Testing Facility (IDTF) is an entity independent of a hospital or physician’s office in which diagnostic tests are performed. It was created by regulation (42CFR§410.33) as published in the Federal Register, Vol. 62, number 211, October 31, 1997.
Can an entity be an IDTF for its own patients?
This Medicare Learning Network® Fact Sheet provides details of the requirements for an Independent Diagnostic Testing Facility (IDTF) to be enrolled in the Medicare program. Deinition An IDTF is a facility that is independent both of an attending or consulting physician’s ofice and of a hospital. However, IDTF general coverage and payment policy rules apply when an IDTF …
What are idtfs required to submit to Medicare provider enrollment?
Oct 01, 2015 · An Independent Diagnostic Testing Facility (IDTF) is an entity independent of a hospital or physician’s office in which diagnostic tests are performed. It was created by regulation (42 CFR §410.33) as published in the Federal Register, Vol. 62, number 211, October 31, 1997.
Document Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
CMS National Coverage Policy
This LCD supplements but does not replace, modify or supersede existing Medicare applicable National Coverage Determinations (NCDs) or payment policy rules and regulations for independent diagnostic testing facilities. Federal statute and subsequent Medicare regulations regarding provision and payment for medical services are lengthy.
Coverage Guidance
Compliance with the provisions in this policy may be monitored and addressed through post payment data analysis and subsequent medical review audits.
What is an IDTF?
Independent Diagnostic Testing Facility (IDTF) View guidance regarding types of entities that may or may not be sufficiently independent from a physician office or hospital to require enrollment as an IDTF. Generally, an entity should not be considered independent from a physician office or hospital if it has the below characteristics.
What is a CPT code?
CPT code is a 5-digit code that is added to IDTF enrollment. CPT Code is added for each machine that an IDTF will be working with that uses that code. If IDTF plans on billing globally. Bill only CPT itself.
What is a physician practice?
It is a physician practice that is owned, directly or indirectly, by one or more physicians or by a hospital. It primarily bills for physician services (e.g., evaluation and management (E/M)) and not for diagnostic tests. It furnishes diagnostic tests primarily to patients whose medical conditions are being treated or managed on an ongoing basis by ...
What is diagnostic testing?
It furnishes diagnostic tests primarily to patients whose medical conditions are being treated or managed on an ongoing basis by one or more physicians in the practice. Diagnostic tests are performed and interpreted at same location where practice physicians also treat patients for his/her medical conditions.
What is global billing?
Global billing means IDTF intends to bill for both technical component (modifier TC) and professional component or interpretation (modifier 26). Both components are combined in global code. This is not common scenario. IDTF s most often enroll as either global or TC.
Does IDTF require a certification?
If an IDTF performs diagnostic mammography, it must have a Food and Drug Administration (FDA) certification to perform mammography; however, an entity that only performs diagnostic mammography should not be enrolled as an IDTF. Portable X-ray Service.
What is an IDTF?
Independent Diagnostic Testing Facilities (IDTFs) must have the proper technical staff on duty with the appropriate credentials to perform tests. Each non-physician who performs IDTF diagnostic testing must be listed on the IDTF 's enrollment record ( CMS -855B). If the IDTF is billing for the interpretation, all the interpreting physicians need to be listed. A Supervising Physician needs to be on the enrollment record as well. The below CPT codes do not imply coverage of the procedure. All of the procedure codes are subject to Medicare rules and regulations, applicable Local Coverage Decisions ( LCD 's), and medical necessity. This list was compiled based on current billing patterns. Therefore, some codes may have been inadvertently omitted.
Is Noridian Medicare copyrighted?
Some of the Provider information contained on the Noridian Medicare web site is copyrighted by the American Medical Association, the American Dental Association, and/or the American Hospital Association. This includes items such as CPT codes, CDT codes, ICD-10 and other UB-04 codes.