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Wiki What TOS For CMP?

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ABridgman

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Ok, I have a very rare occurrence here, I do not normally bill for labs.

I got one for a CMP (comprehensive metabolic panel) CPT 80053.

This is for a new provider I have not yet billed for.

My question is this: My billing software default to
Type Of Service (TOS) 1 - Medical Care

should this be billed this way...or
Type Of Service (TOS) 5 - Diagnostic Laboratory

This is being done in the doctor's office, he has his own lab.

Which is why I am uncertain if the TOS would be 5...or 1.
 
I am not 100% certain of my answer, so it will need verification from other sources, but I believe it would only qualify for TOS 5 if the lab is an Independent Laboratory. A physician based lab is still POS 11 and should be TOS 1. Can anyone confirm or deny this?
 
Walker22 said:
I am not 100% certain of my answer, so it will need verification from other sources, but I believe it would only qualify for TOS 5 if the lab is an Independent Laboratory. A physician based lab is still POS 11 and should be TOS 1. Can anyone confirm or deny this?
Click to expand...

That was my own thought...and I was looking for confirmation on this.

This is why I specified this is a doctor who has a lab in his office.
 
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