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
Occult Blood Codes
Viewed 1728 times since Wed, Nov 17, 2010
Coding for Urine Specimen
Viewed 2763 times since Mon, Nov 19, 2012
Cortisol Stimulation Test
Viewed 3307 times since Fri, Aug 5, 2011
Correct Modifier for Molecular Testing
Viewed 1304 times since Thu, May 26, 2011
General Health Panel 80050
Viewed 1 times since Wed, Nov 17, 2010
Gram Stain Orders/Protocol For Cultures
Viewed 1252 times since Tue, Feb 22, 2011
Lab Charges With Edit Not Allowed
Viewed 1849 times since Wed, Sep 14, 2011
Bill type 141-Non Patient
Viewed 5367 times since Thu, Apr 21, 2011
Amnisure Test
Viewed 2067 times since Wed, Nov 17, 2010
Pathology
Viewed 670 times since Wed, Jul 25, 2012
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506