99000

dehrensberger1

Contributor
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Hello all! Need some help. We are an OB practice and just recently upgraded our CLIA certificate to moderate and just started performing CT/GC testing inhouse. There is a debate about where or not we can charge the 99000 when we are performing this test. Their argument is we are performing the test and we are the lab when doing this procedure. My argument is that this fee is only intended when you are being charged by the lab. Can anyone clarify this for me? Regardless if we updated our CLIA I don't think it should be charged.

Thanks!
 

thomas7331

True Blue
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I agree with you - this code is for preparing and conveying specimens to a lab - to bill this code you have to be able to show that your practiced incurred some costs to warrant this. Per CPT Assistant, this code is intended to be reported when either 1) "the physician incurs costs to handle and/or transport a specimen to the laboratory (eg, via messenger service)"; or 2) there is "work involved in the preparation of a specimen prior to sending it to the laboratory" such as "centrifuging a specimen, separating serum, labeling tubes, packing the specimens for transport, filling out lab forms and supplying necessary insurance information and other documentation."

So as I read this, it's unlikely you would be able to justify billing this code because the first case would not apply since you are not paying anyone to have the specimen transported out, and the second would likely not apply since your office already has the specimens and the patient information in-house and would not need to do any of these things to prepare it for the lab in advance.
 
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101
Location
Wantagh, New York
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OBGYN practice NY

If we are transporting specimen from office to our lab we would bill 99000? What dx would be used?
What is the fee amount to charge to insurance?
Specimen transported to our lab,
87491,87591
87481,87801
87661,81513
87624,87625
87653

Appreciate the feedback!
 
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