Wiki Panel Question

mjm41795

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Are there any rules for billing a panel or billing each lab separately? I am reviewing a claim and the provider has billed each lab separate but all the labs make up the 80053 panel?
 
Are there any rules for billing a panel or billing each lab separately? I am reviewing a claim and the provider has billed each lab separate but all the labs make up the 80053 panel?

The answer I gave you on the other post is still applicable, but the codes are different: if you billed 80047 or 80048 (or all of the labs that make those panels) + 80076 (or the labs that make that panel), then you billed an 80053. And yes, there is a rule on it; it's actually considered an 'abusive' billing practice to unbundle labs that can be described as a single panel. If you performed all of the components, bill the panel. If any part of the panel is missing, then the insurer shouldn't have rebundled it, and you need to appeal. Hope that helps! ;)
 
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