Positives and Inconsistencies per CMS

rbordes

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I am confused and can not find a clear answer. I do Laboratory billing for Toxicology, and I need to know what the rules/law is on billing tox tests. Are we only suppose to bill positives, inconsistencies, and prescribed medications only, or are we allowed to bill what a physician orders? I have been told "yes", and then I was told "well they would prefer", and have been told it depends on the payer, as to whether you bill only positives, inconsistencies and prescribed meds. I need assistance in finding my answer, and is this one of the cases where what you bill to one you have to bill to all, or is this a payer by payer billing policy around each CPT code. I hope I am being clear.. Thanks! Please advise
 
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