Pathology/Lab Coding Alert
Don't Double Dip for Metabolic Panels
Question: A patient had a lab outpatient draw in the morning for BMP, and a lab ER draw later in the day for CMP. Can we bill for both of these tests?
Answer: You should not bill together a basic metabolic panel (BMP) and a comprehensive metabolic panel (CMP) for the same patient on the same day using the following codes:
You are correct that the Correct Coding Initiative (CCI) edits bundle these two codes with a modifier indicator of "0," meaning that you cannot override the edit under any circumstances.
Here’s why: You can see from the code definitions that the CMP includes every test from the BMP, so billing both codes means performing all the tests from the BMP twice, with no medical necessity for doing so.
Do this: You can inform the ordering physician that the BMP was already completed, and have the physician fill an order for additional individual tests that he wants, which you can bill in addition to the BMP. If the physician orders all the additional tests for a CMP (Albumin [82040] Bilirubin, total [82247], Phosphatase, alkaline [84075], Protein, total [84155], Transferase, alanine amino [ALT] [SGPT] [84460], and Transferase, aspartate amino [AST] [SGOT] [84450]), you should bill only for the CMP (80053) that day.
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