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billing for lab

  1. Question billing for lab
    Medical Coding Books
    I work for a billing company and do coding for an urgent care facility. We draw blood for different laboratory testing. Some we do in office such as a CBC or 85025, but other test are sent to an outside lab, we draw the blood there and then send the blood for the actual test. My question is do we charge for the test that are being sent out. I am just a little bit confused on this one. I have done some research and haven't came up with a definite answer. Thank you.

    Winter Williams, CPC-A

  2. Default
    You can bill for them, the lab will bill you for the test. In cases where the patient is self-pay, you'd probably be better off having the lab bill the patient directly and you would only bill for the venipuncture (collection) thereof. The lab forms need to be sent appropriately instructing them to either bill the practice or the patient. And some insurance companies require that certain labs be utilized and in those cases, the lab should bill the insurance company, not you. Does that help?

  3. Default
    It depends on the contract you have with the lab you are sending out to. If they are billing the patient for the lab work done ... you would only bill for the venipuncture. If they are billing you then you would bill the patients insurance for the lab and the venipuncture.

    I have worked in situations where we billed the patient and the lab billed us. But where I work now we just draw the blood and send it out and the lab bills for the services provided and we just bill the blood draw.

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