Primary Care Coding Alert

Question: Should we bill insurance carriers for nasal swabs? We perform them in the office, but the lab does the interpretation. Should we bill for specimen handling?

Arizona Subscriber

Answer: Because the laboratory analyzes the nasal pharyngeal swab test, you cannot code for it. But you may bill for collecting the specimen.

Physicians may recoup the cost of obtaining, handling and conveying a specimen to a lab with 99000 (Handling and/or conveyance of specimen for transfer from the physician's office to a laboratory). You may use the code when the physician incurs extra transportation costs, such as expedited service. Code 99000 also reflects the costs of preparing the specimen, such as centrifuging a specimen, separating serum, labeling tubes, packing the specimen for transport, filling out lab forms, and supplying necessary insurance information and documentation.

Medicare considers 99000 a bundled service and makes no separate payment for it. Some commercial payers, however, may cover the service.