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Billing 88291 for a PHD

  1. #1
    Default Billing 88291 for a PHD
    Medical Coding Books
    We are in a delima on who can bill for the genetics interpretation. We have a physician as the director of the lab and a PHD that cultures and interpretates the finds. Since procedure code 88291 falls under the physician fees schedule for Medicare and not on the clinical fee schedule for labs. Can the lab bill for this procedure if the physician did not actually do the work? Is any information on CMS website stating this if answer is yes or no?

  2. Default RE: Billing 88291 for a PHD
    My understanding is that you cannot bill the interpretation performed by the PHD. I don't have a referencing document available though - maybe try looking at the CAP website if you can't locate anything on CMS.

  3. Default
    you cannot bill the PHD interp, you can bill if the physician does an interp

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