Lab Billing

This GI group will have a Pathologist in 90 days so they are outsourcing their professional read of pathology codes 88305; 88312; 88313 and 88342. They have a Histotech who performs the technical piece. They will be billing the Tech fee and the outsourced lab will bill the professional fee. They were not sure who to bill the Tech fee under and I told her I believe they can elect their President of the Corp as Lab Director and can use his name on the billings.



They also are using the outsourced company’s requisition for technical and professional ordering of the lab. The order is also done on their EMR system. The req has the outsourced lab’s name on it and a biller of theirs said they cannot use that. I believe they can because they also document the order in their EMR system. They are in the process of developing an office lab requisition form.

What a mess!

You can bill for the technical component as long as your CLIA license allows that level of service. As to the requisition, I would imagine as long as there is a clear "paper" trail of what was done where, you should pass an audit. Can they put on the requisition "specimen prep preformed at XYZ GI office by Tom Jones, cytotechnologist"?

Where is that edit button???

Of course I meant "performed by" - sometimes the fingers move faster than the brain.