Practice Management Alert

Question: Should we report laboratory tests on the date of service or wait until we receive the results and are absolutely positive the test is complete? Which way will ensure our coding is compliant?


Michigan Subscriber

Answer: Most practices and laboratories report lab tests on the front end because there is such a small chance that the lab won't complete the test. Reporting lab codes on the date of service keeps cash flow smooth and eliminates the hassle of having to put claims on hold until lab results come back.

There are rare occasions when a lab specimen is inadequate to complete the test, or a specimen breaks during transit, or outside factors - such as heat or cold - damage the specimen. In such a case, you must be sure to issue a credit to the carrier or patient.

Stay compliant: If you decide to report lab tests on the front end, you should ensure compliance by performing random internal audits to confirm you are billing only for lab services with completed results.

Watch out: Outside auditors will check that the draw date (when the physician obtained the specimen) and the date you report the lab service are the same. The HHS Office of Inspector General recently found that some labs were fraudulently recouping extra payment by splitting up lab panels and reporting half the tests on the draw date and the other half on the following day. If your records show draw dates that differ from billing dates, the OIG may question your coding practices.