Blackhorse
Guru
Patient goes to Lab A for covid-19 testing, but Lab A referred PT to Lab B. Can Lab A bill U0003 with modifier 90?
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Wiki modifier 90
- Thread starter Blackhorse
- Start date
SharonCollachi
Guest
So Lab A didn't actually perform any services?
Blackhorse
Guru
I have to check with my colleague exactly what Lab A did. What if Lab A didn't actually perform any service?
SharonCollachi
Guest
Well, if the lab didn't actually do anything, then what exactly would you be billing??
Blackhorse
Guru
I found out that Lab A did collect the specimen and sent it to Lab B for testing.
notatthebeach@gmail.com
Contributor
You can bill for a 99000 for sending a specimen to an outside lab. Is it a nasal swab or is it blood that you are sending out? And, only about 30% of insurances will pay on the 99000.
Blackhorse
Guru
Thank you.
If lab specimen was done at X office and transmitted to our in house lab (different location) can we bill 99000?
What is the charge to insurance?
What dx code is used?
Do we require a modifier?
Do all insurance payor reimbursement code?
Please advise
What is the charge to insurance?
What dx code is used?
Do we require a modifier?
Do all insurance payor reimbursement code?
Please advise
Blackhorse
Guru
We got paid by billing U0003-90. We pay our reference lab to do the testing and they don't file claims to any insurance. However I heard Blue Shield will not pay for out of state reference lab testing, you need to appeal in order for them to pay you.