jhoffer
New
We are a health system based in Ohio with RHC provider based clinics in WV. (We are on the state line). Our RHC's send labs they are unable to process in the clinic to the parent WV CAH. From there, if there are labs they cannot process, they send them to our main (acute) hospital in Ohio for processing. This has caused a lot of confusion as we are in 2 different states with 2 different MACs. We are trying to decipher if the 90 modifier is to be used on these claims. Is the Ohio hospital (acute) lab considered an "independent lab, reference lab or outside lab" since it's all part of the same health system? We have been billing them all out of the WV CAH but don't believe this is correct since they are getting processed in the main hospital in Ohio and all revenue is going to WV.
Any help would be greatly appreciated.
Any help would be greatly appreciated.