A member asked:

Clia certified lab has no cpt codes yet. if sent by a h, what cpt code(s) would my m.d. use when there is or isn't reason for the test?

2 doctors weighed in across 2 answers
Dr. Robert Killian answered

Specializes in General Practice

Fraud?: If there is no reason for a test then the patient has to pay for the test. One cannot bill insurance for testing when there is no medical indication for the test. Please clarify what you mean by "sent by a H"?

Answered 7/1/2014

3.9k views

Thank
Dr. Stephen Southard answered

Specializes in Internal Medicine

Unsure: It's unclear exactly what you are asking. CPT codes are procedural codes. The lab should be requesting ICD codes. These are diagnosis related codes and are what physicians use to justify testing. Unfortunately if there is no reason for testing usually a patient had to pay out of pocket.

Answered 7/1/2014

3.9k views

Thank

Related Questions