Wiki Lauren Rush, CPC

[laurenrush]

Hello,
We recently got a new physician in our office and she says that we are able to bill 99000 for the handling of specimens for transfer to the lab. Is anyone else doing this and getting paid? Our office has not been doing this in the past so I'm wondering if we have been missing out on money. She is from NC and we are in SC, not sure if the rules are different in this case or not. Any feedback would be greatly appreciated!

Thanks, Lauren

 

[magnolia1]

Below are two CPT Assistants regarding CPT 99000:

MISCELLANEOUS SERVICES 99000 Handling and/or conveyance of specimen for transfer from the physician's office to a laboratory

For example, a patient collects a 24 hour urine specimen and brings it to the physician's office. The conveyance of the specimen to the laboratory is reported in addition to the code for the office visit in which the need for the test was identified. Code 99000 is not intended for reporting the obtaining of a specimen (eg, pap smear, throat culture). The services to obtain the pap smear or throat culture are inherent in the procedure being performed and are not reported separately. (Obtaining a blood specimen by venipuncture is reported separately from code 99000 if blood was obtained by venipuncture and then sent to the laboratory from the physician's office.)
CPT Assistant © Copyright 1990-2013, American Medical Association. All rights reserved.

Handling and/or Conveyance of Specimen for Transfer from the Physician's Office to a Laboratory In the Coding Consultation section of the February 1999 CPT Assistant, we addressed the use of code 99000; stating that it should be reported when the physician incurs costs for the handling and/or transportation of a specimen to the laboratory (eg, via messenger service). While this is certainly a correct statement, many of our readers pointed out a second use of this code that is also correct, and reflects the most typical use.
Code 99000 is also intended to reflect the work involved in the preparation of a specimen prior to sending it to the laboratory. Typical work involved in this preparation may include centrifuging a specimen, separating serum, labeling tubes, packing the specimens for transport, filling out lab forms and supplying necessary insurance information and other documentation.
Example:
If a physician performs a venipuncture in the office to obtain a blood specimen, code 36415, Routine venipuncture or finger/heel/ear stick for collection of specimen(s), should be reported. Inaddition, code 99000 should be reported when the physician's office centrifuges the specimen, separates the serum and labels, and packages the specimens for transport to the laboratory.
CPT Assistant © Copyright 1990-2013, American Medical Association. All rights reserved

Hope this helps.......

 

[laurenrush]

It does help. Thank you!

 

[Stefanie]

In the medical offices I have worked in, FP and OB/Gyn, we have also coded/billed the 99000. In most cases, the insurance companies denied it as included in other services, not that it's not a billable services, but you are going to have a hard time getting it paid. Balancing the "possible" revenue with the work it would take to get the insurance to pay, which most will have a Reimbursement Policy stating they won't pay it without specific circumstances, is probably the best way to determine if you really are losing/missing any money. Check one of your most predominant payors, look into their Reimbursement Policies and see what they have to say about the 99000. You may find it's not worth it. Just my experience.