Forum - Questions & Answers

Dec 5th, 2016 - csmith 2 

Lab eval in nursing faciltiy

In the Nursing Home Facility regular labs are ordered on the residents. Example (CBC, CMP, Lipid Panel every 6 months) When the labs are drawn and result can a visit be done and billed for evaluation of the labs?

Mar 1st, 2018 - ChrisW   256  1 

re: Lab eval in nursing faciltiy

According to the Medicare claims processing manual, the review of lab tests are included in the payment for the evaluation and management service.

30.4 - Payment for Review of Laboratory Test Results by Physician (Rev. 1, 10-01-03)
Reviewing results of laboratory tests, phoning results to patients, filing such results, etc., are Medicare-covered services. Payment is included in the physician fee schedule payment for the evaluation and management (E and M) services to the patient. Visit services entail a wide range of components and activities that may vary somewhat from patient to patient. The CPT lists different levels of E and M services for both new and established patients and describes services that are included as E and M services. Such activities include obtaining, reviewing, and analyzing appropriate diagnostic tests.

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