Forum - Questions & Answers
Billing Medicare For Clia Waived Labs -- AMCC Panel Payment Algorithm
We're considering doing some in-house clia waived labs. But I'm confused about getting paid by Medicare. For one panel, they pay what's on the fee schedule for that panel (if medically necessary, of course). But for more than one panel (or one panel + additional tests), they use some sort of Automated Multichannel Chemistry Code Payment Algorithm... which is completely confusing me. How can I find out how much I'll be getting paid if I order a Comprehensive Metabolic Panel (80053QW) Plus a Lipid Panel (80061QW)? Please help.
Abaxis provides it for you
https://www.codemap.com/abaxis/userhome.cfm
Medicare Labs
Thanks for that... Is there anywhere I can look up combinations that Abaxis doesn't give me? (Like a BMP + Lipid Panel?) Or a list of just how much they pay for AMCC tests? Do you know if other insurances are this wacky about billing labs or if it's just Medicare? Thanks a lot!
Don't know
call the Piccolo rep
lab allowances
Lab allowances from Medicare are on the lab fee schedule, which you can find on their site. It is not part of the physician fee schedule. Other insurances will have their own allowances.