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help 80101

  1. Default help 80101
    Medical Coding Books
    In our office (Pain Mgmt office) we bill 80101 QW for our commerical payers and I was wondering if anybody knew if the Dr can bill the insurance co. for reviewing and interpreting the lab report once he receive the results?
    Last edited by; 05-07-2011 at 07:42 PM.

  2. #2
    The Dr is billing the insurance for interpreting and reviewing the lab results. It's included in the office visit E/M code.

  3. #3
    will join Pasadena,Ca
    Default Drug Assay
    FYI as of 4/2010 Medicare will not reimburse 80101,You must code either G0431 or G0434..Check with your payor if they are following Medicare Guidelines..Also you are only allowed 1 unit per DOS

  4. #4
    St. Joseph County, Indiana
    I think the question you were asking is how does the doctor get reimbursed for reading the confirmation lab report not the qualitative report. The only answer I have is...he/she doesn't. Technically, you can't add the physician reviewing the results to the original date of service since it wasn't on the same day. Don't feel bad. Primary Care doctors get screwed out of this decision making effort for lab results every day. It's not fair either way.

    NOTE: It is important to note in the chart that the physician has read the report (i.e. initial report). Simply placing the report in chart isn't enough.

    Brock Berta

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