Internal Medicine Coding Alert
Check Each Component Before Submitting 80053
PDF
Question:
Answer: No, you should code each panel individually with 80047 (Basic metabolic [Calcium, ionized]. .) or 80048 (Basic metabolic panel [Calcium, total] ...) for the basic metabolic panel and 80076 (Hepatic function panel ...). Pay special attention to the tests each panel must include before you can report the code:
- Code 80047 includes ionized calcium, carbon dioxide, chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN)
- Code 80048 includes total calcium, carbon dioxide, chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN)
- Code 80076 includes albumin, total bilirubin, direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase (ALT) (SGPT), and aspartate amino transferase (AST) (SGOT).
Now consider 80053 (Comprehensive metabolic panel; this panel must include the following: Albumin [82040], Bilirubin, total [82247], Calcium, total [82310], Carbon dioxide [bicarbonate] [82374], Chloride [82435], Creatinine [82565], Glucose [82947], Phosphatase, alkaline [84075], Potassium [84132], Protein, total [84155], Sodium [84295], Transferase, alanine amino [ALT] [SGPT] [84460], Transferase, aspartate amino [AST] [SGOT] [84450], Urea nitrogen [BUN] [84520]).
Before you can report a comprehensive lab code for several panels, be sure the comprehensive code includes everything covered by the other panels. Code 80053 includes many of the tests covered by 80047, 80048 and 80076, but not all. For example, 80076 includes a test for direct bilirubin, but 80053 does not.
Internal Medicine Coding Alert
- Closures:
12001 or 13100? Consider More Than Tissue Layers to Code Exact Closure Level
Follow these tips to find the differences between 'simple,' 'intermediate,' and 'complex.' All closures aren't [...] - CPT 2011:
New Observation Codes 99224, 99225, 99226 Help Answer the 'Middle Day' Code Dilemma
Expanded choices eliminate payer-to-payer coding variation.2011 brings a new coding option when reporting the middle [...] - Rural Care:
Medicare Lagging on Implementing Preventive Service Fee Waivers
PPACA waived fees starting Jan. 1, but CMS won't until April 4.The Centers for Medicare [...] - You Be the Coder:
Remember Your Anatomy on Sub-Q FBRs
Question: I have a puzzling denial in front of me. The internist used a scalpel [...] - Reader Questions:
Bilateral X-Ray Doesn't Always Mean -50
Question: Our internist x-rayed a patient's symptomatic knee and ordered an x-ray of the other [...] - Reader Questions:
Medical Necessity Could Mean Extra Hemoccult Pay
Question: Preventive care guidelines state that hemoccult slides are covered once each year, but the [...] - Reader Questions:
Dates and Physician Presence Dictate 99221 Alone or With Office Visit
Question: Our physician saw a patient in the office, and then admitted her to the [...] - Reader Questions:
Consider Skin Biopsy Timing, Location, Intent
Question: How do I know when to report skin biopsy separately with, or in place [...] - Reader Questions:
Don't Mix Family History With Personal History
Question: My understanding has been that I cannot bill for "family history of" a condition. [...] - Reader Questions:
Check Each Component Before Submitting 80053
Question: The physician ordered a basic metabolic panel and hepatic function panel for a patient. [...]