Home » Categories » Laboratory Coding

General Health Panel Code 80050


Question

Can we charge CPT 80053, 85025, and 84443 separately even though the General Health Panel (80050) includes these tests?  Medicare will not reimburse for the GHP, but if we charge them separately, would this be considered "unbundling?"

Answer

Medicare does not use code 80050.  The reason it’s not used is because Medicare can not set appropriate reimbursement since the code can contain different items. It can include 85027 or 85027 and 85004 or 85027 and 85007 or 85009.  Because each of these codes has a different reimbursement amount, Medicare can’t set a total price for the panel.  You must bill the components separately.

Disclaimer: All articles intended for general guidance only and not as a recommendation for a specific situation. Readers should consult an official source (AHA, AMA, etc.) or a qualified attorney for specific legal guidance.
Attachments Attachments
There are no attachments for this article.
Related Articles RSS Feed
GZ Modifier
Viewed 1465 times since Wed, Nov 17, 2010
Pap smear and Urine Cytology
Viewed 2097 times since Tue, Jun 14, 2011
Pathology
Viewed 711 times since Wed, Jul 25, 2012
Different Charges for Same CPT Code in Reflex Tests
Viewed 1411 times since Wed, May 16, 2012
# of Units Rejecting
Viewed 2996 times since Fri, Sep 30, 2011
Combining Lab Panels?
Viewed 886 times since Thu, Jun 16, 2011
Bill type 141-Non Patient
Viewed 5645 times since Thu, Apr 21, 2011
86580 TB Skin Test
Viewed 8857 times since Fri, Feb 11, 2011
Amnisure Test
Viewed 2144 times since Wed, Nov 17, 2010
Glucose Monitoring
Viewed 1642 times since Thu, Jan 6, 2011
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506