Wiki Diarrhea Pathogen Panel

[Tara0513]

Hello Fellow Coders:

Independent Lab coding for a 25 target diarrhea pathogen panel PCR. What code should we be using? 87507 has restrictions like must have an immunocomprised code. I know we should be billing what is performed, but is there any other way we can code this without immuno dx code? Trying to get some research to present to boss. I see other threads where some companies are using 87798? I have in the past had issues getting this code processed.

 

[srgarrick]

Chapter 1 of the NCCI Coding Policy Manual
In this manual, many policies are described using the term “physician”. Unless indicated differently, the use of this term does not restrict the policies to physicians only but applies to all practitioners (including dentists), hospitals, or providers eligible to bill the relevant HCPCS/CPT codes pursuant to Medicaid program rules in each state. In some sections of this manual, the term “physician” would not include some of these entities because specific rules do not apply to them.
Physicians must report services correctly. This is true even in the absence of specific edits in the Medicaid NCCI program or their implementation in individual states. There are certain types of improper coding that physicians must avoid.
Procedures shall be reported with the most comprehensive CPT code that describes the services performed. Physicians must not unbundle the services described by a HCPCS/CPT code.
Medicaid NCCI Policy Manual | CMS

Medicare NCCI Policy Manual | CMS

www.cms.gov