# Professional or Institutional claim?



## robertjsenese (Sep 12, 2015)

The lab is performing the testing and billing, 
and there is an ordering medical director for the test.

Therefore, should I, lets say, for BCBS, 
be billing on an institutional claim, or a professional claim,
as an out of network lab?

And Neurotin (gabapentin) is a frequently abused drug by people in recovery,
they often steal a roommates medication, or take large amounts of the medication to experience a high. 

80355	Gabapentin, non-blood, does not crosswalk with a substance abuse ICD code, since it is used for primarily for epilepsy and nerve damage. should I just use 304.90, although it doesn't crosswalk? or should I use
V72.60 Laboratory examination, unspecified, which does.


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## genenut (Sep 14, 2015)

What type of provider is billing for the lab test? 

Hospital - UB04 facility/institutional claim

Doctors office (non provider based billing to medicare) - Everything on the 1500 hcfa form (lab test + office visit)

Free standing lab - depends on your contract.

(15 yrs exp billing)


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## robertjsenese (Sep 14, 2015)

Hi gene.

Its a free standing lab. 
The taxonomy code is 291U00000X Clinical Medical Laboratory 
with an organization ownership

right now I'm using hcfa 1500
electronic with collaborate md


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