kreish
New
Hoping someone out there has the answer! I have recently started billing for a multi-specialty group where lab panels are regularly billed. We have been receiving payment for one panel, remaining panels denied as already paid. I spoke with Medicare--they stated that they consider one panel, and internally recode the others to the paid code and note that they are paid. For example, the clinic bills 85025 /CBC with a metabolic panel 80053, and 80076-hepatic panel. The panels are for different measures--the clinic is not billing services with duplicate measures. The Medicare rep told me that this is just the way it is, but they do not have any written rules on this (naturally!). There has not been any consistancy with the paid code--sometimes it 80053, sometimes 80076. Color me crazy, but I can't accept "that's just how it is"--there has to be something that backs this up. If anyone can help guide me to any rules or guidelines on this, I would greatly appreciate it! Thanks