Billing for indeterminate results

sab001

Networker
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41
Location
Pasadena/LaPorte Texas Chapter
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If a lab is unable to finalize a report due to poor sample quality, can the lab report out as 'mutation status indeterminate due to poor sample quality' in order to seek reimbursement for costs incurred?

My opinion is that the lab cannot bill unless the test can be completed in its entirety.

I'd appreciate any guidance on this as it is the second time I've been asked this in the past month.
 

danachock

Guru
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214
Location
Brainerd, MN
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Hi, Just because a facility gives you a specimen that is not diagnostic for whatever reason - you still need to bill it out. If the specimen is labeled and not in the container that is totally different...... But if your pathology team "tried" to process the specimen and it didn't survive or it wasn't deep enough for margins or whatever reason .... you bill this out just like they would with any other specimen. The work was still done and is very much still billable.
The pathology report should read macro and micro with the findings ... unable to provide a definitive diagnosis because of this or that....
That insures they did the work of their capacity to the fullest. You will assign the code for the reason why the pathology was provided. Refer maybe to a lab requisition.
Hopefully this helps,
Dana Chock, CPC, CCA, CANPC, CHONC, CPMA, CPB
Anesthesia, Pathology & Laboratory Coder
 
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