decisionhealth Newsletters, Part B News - 2023 Issue 7 (July)
Bundling policies likely to block pay for 99000
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Article Overview
This Find-A-Code article discusses billing and reimbursement treatment for specimen handling and conveyance in office-based testing workflows, with attention to when a practice performs tests in-house versus sending specimens to an outside laboratory. It focuses on payer bundling policies, Medicare fee schedule status, and selected commercial payer policy references. The article is relevant to medical coders, billers, and practice administrators seeking to understand how this service is viewed across payer policies.
Why This Topic Matters
Specimen collection, handling, and transport are common workflow tasks, but reimbursement can vary by payer and setting. Understanding how bundling policies affect separate payment helps practices avoid billing denials and align claims with payer rules.
What You Will Learn
- How payer bundling policies can affect reimbursement for specimen handling and conveyance
- How in-house testing workflows differ from outside-laboratory specimen send-outs from a billing perspective
- Which types of payer policy sources are referenced for coverage and bundling status
- How Medicare and selected commercial payers are discussed in relation to separate payment for this service
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice administrators
- Laboratory billing staff
Codes Discussed
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