Pediatric Coding Alert

Question: Our state requires that a newborn metabolic screen must be performed on all newborns. The test is performed at the state lab, and in some cases the state lab charges us for the testing. We would like to pass on the cost to the patient's insurance company; but we don't know which code(s) to use. Should we use S3620 (Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state), or can we use all the individual lab codes (such as 84030 [Phenylalanine], 83498 [Hydroxyprogesterone], and others) even though we did not perform the test?

Colorado Subscriber

Answer: None of those codes would be appropriate for your practice to report since you did not do the test or provide the services in your office. In this situation, the company or facility doing the test should not be able to pass on the cost of the test to the primary care physician.

The lab should be doing the billing independent of the practice.