decisionhealth Newsletters, Coder Pink Sheets - 2007 Issue 1 (January)
Rapid streps vs. cultures: Don't confuse 87880 and 87070
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Article Overview
This article reviews coding and compliance issues around strep testing in physician offices, with emphasis on rapid tests versus throat cultures, CLIA-waived versus higher-complexity lab requirements, and practical laboratory reporting considerations. It is aimed at coding professionals and medical office staff who need to understand how laboratory certification and payer expectations affect billing and test workflows.
Why This Topic Matters
Strep testing is common in office practice, and confusion between related laboratory codes can lead to denied claims or noncompliant billing. The article also highlights CLIA requirements that affect which tests can be performed and reported in an office setting.
Article Sections
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Rapid strep testing and throat culture billing
Introduces the comparison between office-based rapid testing and throat culture billing in routine practice. It also frames the payer and compliance issues associated with these laboratory services.
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About CLIA rules for lab testing
Summarizes general CLIA laboratory compliance concepts, including waiver status, manufacturer instructions, and reporting expectations. It also discusses basic operational considerations for office laboratories performing waived testing.
What You Will Learn
- How the article distinguishes rapid strep testing from throat culture services
- Why CLIA certification status matters for office laboratory testing
- What general laboratory compliance topics are addressed for waived tests
- How reporting and documentation expectations are discussed for point-of-care testing
Who Should Read This
- Medical coders
- Billing staff
- Physician office laboratory staff
- Pediatric practice administrators
- Compliance personnel
Codes Discussed
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