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
Fingerstick Charging
Viewed 1372 times since Tue, Apr 26, 2011
Pap smear and Urine Cytology
Viewed 1927 times since Tue, Jun 14, 2011
STAT Lab Test
Viewed 4514 times since Wed, Nov 17, 2010
Bill type 141-Non Patient
Viewed 5267 times since Thu, Apr 21, 2011
Difference in Antibody Screen (86850) and Indirect Coombs (86885)
Viewed 3532 times since Wed, Nov 17, 2010
Different Charges for Same CPT Code in Reflex Tests
Viewed 1325 times since Wed, May 16, 2012
Lab Charges With Edit Not Allowed
Viewed 1795 times since Wed, Sep 14, 2011
Occult Blood Codes
Viewed 1687 times since Wed, Nov 17, 2010
Amnisure Test
Viewed 2022 times since Wed, Nov 17, 2010
GZ Modifier
Viewed 1309 times since Wed, Nov 17, 2010
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506