Q/A: Which Code Should I Use for a Lab Interpretation Fee?

January 24th, 2019 - Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP
Categories:   CPT® Coding   HCPCS Coding   Modifiers  
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Question

Which code should I use for a lab interpretation fee? Specifically, I have ordered a female hormone saliva test, and would like to charge a fee for time spent on the interpretation and consult.

Answer

This type of service generally does not involve a third party, so it may be acceptable to just bill the patient with an internal code you created for this purpose. However, you might consider the HCPCS codes S3650 or S3652 if they apply to the situation you are describing. Unfortunately, these codes do not allow you to add the modifier 26 to separate the professional component of the service from the technical component.

Perhaps the best option for you is to use 99199 "Unlisted special service, procedure or report."  

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