Wiki Lab Billing

[JESSH0107]

Does anyone know of a good site that has up to date information about the ins and outs of lab billing. I work in a Primary Care Clinic that has 30 physicians and midlevels and they bill out a ton of lab. We are constantly getting denials, but have no information about the guidelines for billing labs to either commercial payers or governement payers. Thank you so much!

 

[npricercm]

Does anyone know of a good site that has up to date information about the ins and outs of lab billing. I work in a Primary Care Clinic that has 30 physicians and midlevels and they bill out a ton of lab. We are constantly getting denials, but have no information about the guidelines for billing labs to either commercial payers or governement payers. Thank you so much!

I found this on the CMS website, it was very helpful. It's a searchable .pdf file. since there have been no changes to icd9 this is as current as it can can get.

http://www.cms.gov/Medicare/Coverage/CoverageGenInfo/Downloads/manual201301.pdf

Always check the LCD if you can't find anything in the NCD, Noridian has an LCD for urinalysis 81001, 81000 and vitamin d test.

Are you a CLIA waived lab? Those would be billed with a QW for the most part....
https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/downloads/waivetbl.pdf


Nancy Price, CPC