Wiki Attending Provider for Outpatient Lab Claims

[Sjburke3]

This question is regarding billing but has come to me as an auditor. For outpatient hospital laboratory claims, those which were drawn in a physician's office and sent to the hospital (same health system), which provider needs to be in the UB Form field 76-attending provider? We've seen claims with field 76 as the ordering provider and others with the lab supervisor. Per Medicare guidelines, The attending provider is the individual who has overall responsibility for the patient’s medical care and treatment reported in this claim/ encounter. I'm overthinking, but would the lab supervisor have the overall responsibility for lab result accuracy, and need to be in field 76 on the UB form? Or would it be something else? Looking for input from the billing experts out there, thanks!

 

[thomas7331]

I would put the provider who ordered the tests in that field. The provider supervising the lab is not involved in the patient's care and does not meet the definition given for the attending provider. But I don't think it matters too much on a lab claim - the term 'attending provider' is only really used for inpatient admissions. On an outpatient or ancillary services claim it is really just informational. I don't think that this information would ever affect the claim payment in any way. I used to audit claims for several payers, and most of them didn't even bring this information into their claims system.