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CMS-1500 Questions

  1. #1
    Location
    AZ East Valley-Kachina Coders
    Posts
    17
    Default CMS-1500 Questions
    Medical Coding Books
    I am a not clear on a couple of line items on the CMS-1500 Form. Maybe I am reading too much into it! I am still taking courses, so bear with me, please.
    Line 20: Outside Lab.
    a. If I mark this a Yes and I happen to know the charges, do I write them in?

    b. If I do that, is the charge repeated again in 24A? I am dealing with ECG Code 93000.

    c. If Line 20 is Yes, but I don't have the Lab's name of address, do I still fill in N/A in box 32 (Service Facility Location Information)?

    Appreciate any enlightenment on this question, please.

    EveH.

  2. #2
    Location
    Bentonville, Arkansas
    Posts
    56
    Default
    If the service you are billing for -EKG- was performed in another location and your doctor is reading it, you would bill the professional component only of the EKG. If you are performing and reading the EKG, you bill for the whole thing.

  3. Default CMS-1500 Questions
    >>Line 20: Outside Lab.
    a. If I mark this a Yes and I happen to know the charges, do I write them in?

    b. If I do that, is the charge repeated again in 24A? I am dealing with ECG Code 93000.

    c. If Line 20 is Yes, but I don't have the Lab's name of address, do I still fill in N/A in box 32 (Service Facility Location Information)? >>

    Here is a link regarding the 1500 claim form. http://www.cms.hhs.gov/MLNProducts/d...fact_sheet.pdf

    In it, there is a link to Medicare's manual on completing charges for outside lab. You can easily search the document for "outside" to see all the information related.
    See http://www.cms.hhs.gov/manuals/downloads/clm104c26.pdf

    If it is truly outside lab and you aren't billing for the charges, then you would NOT put the information in block 24.

    Hope this helps you.
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    www.ambanet.net/AMBA.htm
    AMBACode Coding Software
    http://www.ambacode.net
    2015 AMBA National Medical Billing Conference
    http://www.ambanet.net/2015.htm

  4. #4
    Location
    AZ East Valley-Kachina Coders
    Posts
    17
    Default
    Thank you very much. Appreciated the time and effort and the sites you sent.

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