Compliance Question of the Week – Laboratory

To follow-up on last week’s question, what functions do processing and storage costs include?

For our outpatients, we procure blood and blood products from a community blood bank that charges us only the processing and storage costs it has incurred. How do we bill for this?

When submitting an electronic claim for testing, is it the performing lab’s CLIA number included or the referral lab?

Could you provide billing guideline for microscopic examination of a urine sample without macroscopic observation?

Please advise how hospital laboratories can be paid for outpatient susceptibility studies (CPT® 87181–87190) for positive cultures. This is an issue due to medical necessity; however, the provider doesn’t have a diagnosis at the time of the order. This is not paid if the organism is not identified. Most laboratories automatically perform this test as part of routine culture work-ups.

How many times per year does Medicare allow code 84443 (thyroid stimulating hormone) to be performed?

Can all laboratories use revenue center codes?

Is a screening code assigned when the reason for performing a test is because the inpatient has had contact with, or exposure to, a communicable disease?

When analyzing multiple genes (a panel) for simultaneous reporting, should a single code be used or multiple Tiers 1 and 2 codes?

How does CMS define a “group” test?

When does the new laboratory DOS policy take effect?

Does CMS provide a list of the conditions that it considers medically necessary for a urinalysis?