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
CPT code 87177 and 87015
Viewed 2810 times since Sat, Dec 10, 2011
Fingerstick Charging
Viewed 1463 times since Tue, Apr 26, 2011
Different Charges for Same CPT Code in Reflex Tests
Viewed 1384 times since Wed, May 16, 2012
General Health Panel 80050
Viewed 1 times since Wed, Nov 17, 2010
Celiac Panel
Viewed 2071 times since Fri, Oct 14, 2011
Difference in Antibody Screen (86850) and Indirect Coombs (86885)
Viewed 3751 times since Wed, Nov 17, 2010
Occult Blood Codes
Viewed 1785 times since Wed, Nov 17, 2010
Quad Screen
Viewed 833 times since Wed, Nov 23, 2011
Coding for Urine Specimen
Viewed 2788 times since Mon, Nov 19, 2012
Pathology
Viewed 690 times since Wed, Jul 25, 2012
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506