Forum - Questions & Answers

Jun 10th, 2009 - bikermama

lab billing

Our question is when
billing the codes 84443, 85007, and 85027 the insurance company changes the code to 80050 which in the CPT book states it is a non covered code and doesn't pay for it.
What should we do?

Thanks

Jun 10th, 2009 - nmaguire   2,606 

panel codes Lab

The codes you submitted should be billed with 80050 if this is a general health screen and includes CMP, CBC, TSH. The General Health Panel (CPT 80050) is not covered by Medicare.
If the patient has signs/symptoms, the codes should be paid separately. Look to your diagnoses codes.
To be a panel code, all tests described in the panel must be performed and medically necessary.

Jun 10th, 2009 -

My answer is a little different

The GHP (general health panel) applies to commercial insurers. They almost always bundle the CBC, CMP and TSH into the one GHP code and pay that, EVEN if each one is linked to a different diagnosis. Again, it may not be right but they make their own twisted rules.



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