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 1969 times since Fri, Oct 14, 2011
Amnisure Test
Viewed 2059 times since Wed, Nov 17, 2010
Combining Lab Panels?
Viewed 836 times since Thu, Jun 16, 2011
Pathology
Viewed 670 times since Wed, Jul 25, 2012
# of Units Rejecting
Viewed 2726 times since Fri, Sep 30, 2011
New Drug Screen HCPCS Code
Viewed 3803 times since Wed, Nov 17, 2010
Nuclear Matrix Protein 22
Viewed 642 times since Wed, Sep 12, 2012
Fingerstick Charging
Viewed 1406 times since Tue, Apr 26, 2011
ER Charging P9612
Viewed 1190 times since Wed, Aug 3, 2011
STAT Lab Test
Viewed 4571 times since Wed, Nov 17, 2010
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506