Wiki Billing labs on CMS 1500 claim form

[klnastasi.kn@gmail.com]

I work at an OON OP substance abuse facility who bills their labs on a UB-04. Seems we're running into a problem now where insurance companies are starting to deny them as inclusive to our PC, IOP, and OP treatment. We perform and read all of our labs on site (ie. UA, BA) and was curious if we could bill these services on a 1500 being that it's being read by our Dr.s at the facility?

Thanks,
-Kristin

 

[CodingKing]

Only labs that are eligible for modifier 26 reporting can be billed on CMS-1500. They would be billed with 26 as the TC is covered under the UB billing. Drug testing for example is not eligible for modifier 26. I really cant think of any labs done for substance abuse that are eligible for modifier 26.