Wiki Todays options denial of 80053 when billed with 85025 only

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bicoastalbassetmom

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Todays Options Medicare Alternative plan keeps denying 80053 when billed with 85025. We are not running a TSH 84443 so the way I am reading the CPT book we cant use 80050 panel code. But somewhere I heard that if only 2 or more of the labs performed are in a given panel the panel codes should be used. So my questions is should I be billing 80053 and 85025 separate or as panel 80050 anyway. Thank you in advance for your help and assistance.
Laura Ripley, CPC, CMRS, CMBS
 
85025, 84443 and 80053 are bundled into 80050 lab panel

look under general health panel in the CPT Book code 80050
hope this helps
 
Yeah, so we billed 80053($32), 85025($25), 84443($55) and what happened was UHC added a seperate 80053 with a charge of all the charges that were submitted ($112) and paid that code. And the billed codes had the denial "97: THE BENEFIT FOR THIS SERVICE IS INCLUDED IN THE PAYMENT /ALLOWANCE FOR ANOTHER SERVICE"
 
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