Bmp; Basic Metabolic Panel

cmac

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Does anyone know how to find or if there is an LCD for BMP? The GGT 82947 portion gets denied in our office quite a bit and I'm looking to find diagnosis that are covered for BMP and all it's components. I cannot find this information on the Medicare website. Any suggestions? Thanks
 

tammyboyer

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Bmp

82947 is included in the BMP code. You should be using 80048 for your BMP code and that it is it. You would not separately bill out 82947. If you were to go to your CPT book, look at 80048, you will see all the lab tests that are included in it, 82947 is one of them. That is why you are getting denied, it's already being paid for by using the 80048.

My CPT 2008 book is at work, and i only have a 2007 CPT book at home, i am assuming in the 2008 book it will state what i just quoted you.
 

jsth10

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as far as LCD, i think those may be found under Part A for labs? not part B
For the LCD for labs try looking it up on the NCD. Go to website http://www.cms.hhs.gov/CoverageGenInfo/. The box on the left will have some options for you to choose. Click on Lab NCDs. Then scroll down until you get to NCD Coding Policy Manual and Change Report it will say July 2008 choose the the PDF file and it will list each lab code and the payable diganose with it. That is where I go and get my diagnose codes for labs. For the BMP I would use the 80048 code also. I hope that helps you. Let me know if you have any question about finding the lab ncds.:)
 

Anna Weaver

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ggt

The GGT (gamma glutamyl transferase) does have an NCD, and you will find it on the CMS web site.
The 82947 is a glucose not the GGT, that is 82977.
Now, it's my understanding, that when a test is included in the panel, there is not a separate LCD/NCD, it's all included in the panel and I do not believe the panels are listed in the NCD/LCD yet, just the individual tests. So you should not get denials for the panels. But I know it's happened. If you do separate tests than what is in the panel at another time during the day, then you would use the 91 modifer on that test. (i.e. 80048 [BMP] done in a.m. and 82947 [glucose] done at noon, and a 84132 [potassium] done at 1600, you would add the 91 to the glucose and the potassium.)
Any other thoughts on this?
 

dmaec

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you're looking for (and needing the NCD) you'll find it here: http://www.cms.hhs.gov/CoverageGenInfo/04_LabNCDs.asp#TopOfPage
most recent one is July 08 I believe. (we should have an October update soon, but we waiting a VERY long time for the July one so we'll see what happens there).
I agree with Anne and her scenario also - but will add the panel will be denied if you don't have a covered dx.

{that's my opinion on the posted matter}
 
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