Wiki CMS-1500 Questions

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SeriousHistorian

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I am a not clear on a couple of line items on the CMS-1500 Form. Maybe I am reading too much into it! I am still taking courses, so bear with me, please.
Line 20: Outside Lab.
a. If I mark this a Yes and I happen to know the charges, do I write them in?

b. If I do that, is the charge repeated again in 24A? I am dealing with ECG Code 93000.

c. If Line 20 is Yes, but I don't have the Lab's name of address, do I still fill in N/A in box 32 (Service Facility Location Information)?

Appreciate any enlightenment on this question, please.

EveH.
 
If the service you are billing for -EKG- was performed in another location and your doctor is reading it, you would bill the professional component only of the EKG. If you are performing and reading the EKG, you bill for the whole thing.
 
>>Line 20: Outside Lab.
a. If I mark this a Yes and I happen to know the charges, do I write them in?

b. If I do that, is the charge repeated again in 24A? I am dealing with ECG Code 93000.

c. If Line 20 is Yes, but I don't have the Lab's name of address, do I still fill in N/A in box 32 (Service Facility Location Information)? >>

Here is a link regarding the 1500 claim form. http://www.cms.hhs.gov/MLNProducts/downloads/form_cms-1500_fact_sheet.pdf

In it, there is a link to Medicare's manual on completing charges for outside lab. You can easily search the document for "outside" to see all the information related.
See http://www.cms.hhs.gov/manuals/downloads/clm104c26.pdf

If it is truly outside lab and you aren't billing for the charges, then you would NOT put the information in block 24.

Hope this helps you.
 
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