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
Celiac Panel
Viewed 2831 times since Fri, Oct 14, 2011
Modifier 90
Viewed 3396 times since Wed, Jan 12, 2011
GZ Modifier
Viewed 1800 times since Wed, Nov 17, 2010
Cortisol Stimulation Test
Viewed 4256 times since Fri, Aug 5, 2011
General Health Panel 80050
Viewed 1 times since Wed, Nov 17, 2010
Correct Modifier for Molecular Testing
Viewed 1656 times since Thu, May 26, 2011
Screening for Hepatitis B
Viewed 14568 times since Wed, Nov 17, 2010
Modifier 59 on Pathology Specimens
Viewed 2507 times since Wed, Oct 5, 2011
Glucose Monitoring
Viewed 1897 times since Thu, Jan 6, 2011
Pap smear and Urine Cytology
Viewed 2423 times since Tue, Jun 14, 2011
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506