Pathology/Lab Coding Alert

Question: Why do some codes, such as 80050 and 80051, not have an associated RVU value on the Medicare fee schedule -- does that mean the test isn't covered?Wisconsin SubscriberAnswer: No, lack of relative value units (RVUs) on the Medicare Physician Fee Schedule (PFS) doesn't necessarily mean the test isn't covered. RVUs are based on the pricing established by CMS. If a CPT® procedure code does not have an RVU, it may mean that Medicare does not cover the service, or it may mean that the agency uses another avenue to pay for the test. You can find out where Medicare stands on the payment status of any particular code by checking the PFS.Key: When perusing the PFS, check the "Status Code" column (Column D). If a code with zero RVUs assigned to it has an "N" in column D, you won't collect Part B payment from any Medicare contractors for [...]