Pediatric Coding Alert

Question: When is it appropriate to bill 99000 for lab samples? Our office manager believes you can use this code to cover the cost of shipping samples to a lab even when the lab picks the sample up, but I am not so sure this is the correct way to do this.

Pennsylvania Subscriber

Answer: Coders often improperly use CPT^® code 99000 (Handling and/or conveyance of specimen for transfer from the physician’s office to a laboratory). If you are not incurring a charge from the lab for picking up a specimen — in other words, if the collection is bundled into the lab fee — then you cannot use 99000. You can only use the code if your office is incurring the expense of sending the specimen out to be analyzed.

You can also use 99000 if you incur certain expenses preparing the sample, including centrifuging the specimen, separating serum, labeling the specimen, packing the specimen, filling out lab forms, and preparing other relevant documentation.

Even though 99000 carries 0 relative value units (RVUs), some private payers will reimburse for it. However, Medicare carriers consider the collection and handling part of the evaluation and management (E/M) service, and you should not code for it separately.