Medical Billing Forum

Billing => Billing => : jcfenfen March 25, 2010, 06:46:50 PM

: How to bill for tests done by the physician?
: jcfenfen March 25, 2010, 06:46:50 PM

I've been trying to look up the fee schedule on CMS website for tests done by physicians, such as CPT code 84450, 84460, but I can't find those code's fee on the website.  Also, is billing for tests done by the physician the same way for the physician services?  Any advice is greatly appreciated.   

: Re: How to bill for tests done by the physician?
: Yesica March 25, 2010, 07:19:26 PM

in what state are you in. I attached the one from Southern California http://www.palmettogba.com/Palmetto/Providers.nsf/files/2009_southern_california_clinical_lab_fees.pdf/$FIle/2009_southern_california_clinical_lab_fees.pdf

: Re: How to bill for tests done by the physician?
: jcfenfen March 26, 2010, 05:49:32 PM

Thank you so much for the great information.  Just wondering are the tests billed the same way as the physician fee or is there a special procedure I need to pay attention to?

: How to bill for tests done by the physician?
: Michele March 28, 2010, 05:18:31 PM

Some Medicare carriers list the fee schedule for labs separate from the other codes.  Tests are pretty much billed the same way, but some tests require referring dr info, or modifiers.  For example, if it is a CLIA Waived test, you need the QW modifier, or if you are doing the professional component you need the 26 modifier.

Michele