Wiki General Health Panel - CPT 80050

[dcarr]

Since this is a non-covered lab by Medicare, and individual tests cannot be billed separately, how are your physicians handling this situation? Are most clinics/labs/etc. obtaining an ABN from the patient?

 

[ARCPC9491]

Yes, a valid ABN would need to be on file

 

[jlwatson]

I code for lab services and we unbundle the panel for Medicare and bill each included test individually. We bill for the Comprehensive Metabolic Panel, the CBC and the TSH. We have no issues with getting paid when billing this way.

 

[cheermom68]

80050

Medicare allows you to unbundle this code to each individual code, however you must show medical necessity for each code separately. If they are just for screening or an uncovered diagnosis you would need the abn. Check the national coverage determinations for covered diagnosis for each lab as applicable.

 

[jamcculley]

Someone in our office said Medicare will not allow us to bill code 80050 to other insurance companies because "we have to bill everyone the same way." Can someone give me some guidance on this? Thank You