Wiki Lab Billing Question

[nnittler]

Hello
First time asking for help on this forum - thank you for having it

I have a client who wants to use a laboratory that does not bill insurance - thy lab wants us to bill all insurance including Medicare and pay them with direct doctor billing - stating we can do this as a purchased service. As I recall you can not do this, - the Lab must bill Medicare although I search the CMS website and I can find documentation to bill purchased services for pathology but not chemistry laboratory basic CBC's etc.... Am I right in telling my client no not for Medicare and if so can someone point me to where I can find that from CMS.

Thanks very much :

Nancy

 

[ccardella]

Is your client a SNF? A hospital? The lab isn't required under the law to bill Medicare. I work in a genetics lab as a CPC and we often invoice the facilities who send the labwork to us for medicare patients, ESPECIALLY if there is no ABN with the sample. Hope this helps!

Christina Cardella, CMAA, CPC
Billing, Coding and A/R Supervisor
Center for Human Genetics, Inc.