Pneumococcal Ab (23 Serotype)

danachock

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Hi kketchum
I am unsure, was this test performed "in house"? If so, from what location (the medical facility) or was it a send out? If so, again, to which medical facility? I know everyone gets tired of me asking these questions but I have been coding laboratory for a long while and almost every medical facility has a way of doing things their own way so I cannot just simply find the answer from one medical facility's laboratory catalog and tell you it is "wholeheartedly" correct.
When you have a laboratory question this would ideal for posting the question in our forum (completely in my opinion) - "I work for ABC facility and we performed a in house Pneumococcal AB (23 Serotype) - how would you bill this out? That allows someone to do some research for solid answers on the performing facility.
I have worked for a few facilities that utilize the Mayo laboratory for their send outs so I will reference their catalog. (Again, I am not telling you to follow their coding advice, but merely providing you guidance to help you find your answers okay). I'd rather know who actually performed the test to find their laboratory catalog and find out how they are billing this test (what charges they are billing) ~ most medical facilities do have a laboratory catalog (sometimes you just need to hunt and peck the laptop to locate it). This is the link to the Mayo's laboratory catalog for the test you are inquiring about https://www.mayocliniclabs.com/test-catalog/overview/83640#Fees-and-Codes
This their "Fees and Codes" tab that provides the CPT codes they utilize for billing this procedure but you can clearly click on all the other tabs for additional information.
I also checked the MUE (medical unlikely edits) for CPT 86317 and it is 6 with MAI 3 - which is why it will be important for you to locate the actual laboratory catalog that performed this test to support billing those charges if they do bill in excess of 6 units for the same DOS.
I hope at minimum I provided some insight on how to find some information to clear up the billing woes you are having.
If you have any additional questions, please feel free to reach out and have a fantastic evening!
Thank you for listening,
Dana Chock, CPC, CANPC, CHONC, CPMA, CPB, RHIT
 
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