tci Part B Insider - 2014 Issue 2

Reader Question: Know the Hospital Rules Before Billing Testing

Question: Our ENT completed allergy testing for a patient in the outpatient clinic, which is located in the hospital’s emergency department. The physician is employed by the hospital and his clinic is also hospital-owned. Can he bill for the allergy testing?   Answer: Whether your physician can bill for the testing depends on the situation. Outpatient facility allergy services are covered under APCs (ambulatory payment classifications). If this is a hospital-based outpatient clinic, then you can report the service. An employee of the hospital (including the physician, if that’s the case) can administer the test and the...

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