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Issue Number - Name
0085 - Lab Services Rendered During an Inpatient Stay
Review Type
Automated
Claim Type
Lab/Ambulance
Region and State
RAC 1-4
All States
Date Approved
2018-02-13

Description

Laboratory services are covered under Part A, excluding anatomic pathology services and certain clinical pathology services, therefore if billed separately should be denied as unbundled services.

Affected Code(s)

  • HCPCS codes: Organ or Disease-Oriented Panels 
  • CPT Codes: 80048-80076, 80150-80203, 80400-80439, 81000- 81050, 82009-84830, 85002- 85810, 86602- 86804, 87003-87905

Applicable Policy References

  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 3, Section 10.4
  • CPT Coding Book