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Wiki Lab panel billing

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vkratzer

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CBC (85025)and comprehensive metabolic panel (80053) is ordered. 80050 is billed because both are included in this panel; however, the laboratory performs the CBC with diff and then needs to do a manual differential (85007), is it appropriate to bill the panel and the 85007. The AMA CPT books states that the panel includes 85025, 85027 and 85004 OR 85027 and appropriate manual differential WBC (85007 or 85009). The billers thought is that because the book states one or the other that it would be appropriate to also bill the 85007 separately because that test resulted from some abnormality of the initial test 85025. I'm thinking it is not appropriate to bill the 85007 in addition to the panel because it would be considered unbundling. Appreciate any thoughts on this.

Vicky Kratzer, CPC, CGSC
 
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