Snag Lab Test Reimbursement With These Swine Flu Fast Facts

Posted on 19. Aug, 2009 by Editor in Hot Coding Topics

Experts reveal the best ICD-9 coding move, plus what you need to do beginning October 1.

If you’re one of the many labs performing influenza testing spurred by the World Health Organization’s (WHO) June 11 pandemic declaration for novel influenza A (H1N1), you need to read this.

Despite the Centers for Disease Control and Prevention (CDC) guidelines that involve fee-exempt testing for surveillance purposes, your lab can expect to see increased billable flu testing. That’s why you need to bone up on how to code tests your lab might perform.

Stick With Your Influenza A/B Billing

If your lab processes specimens for suspected swine flu cases by performing existing lab tests and panels, your procedure coding and billing will remain the same.

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Example: “Our lab performs a respiratory viral panel that physicians may order for patients with certain flu-like symptoms,” says Peggy Slagle, CPC, billing compliance coordinator at the University of Nebraska Medical Center in Omaha. “We bill for the panel using three codes that describe the test processes:”

• 87252 — Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect

• 87253 — … tissue culture, additional studies or definitive identification (e.g., hemabsorption, neutralization, immunofluorescence stain), each isolate

• 87798 x 8 — Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism.

“If the panel is positive for influenza A and the polymerase chain reaction (PCR) nucleic acid tests indicate a possible H1N1 infection, then we send the specimen on to the Nebraska Public Health Lab for confirmatory testing,” Slagle says.

If your lab performs different influenza A or B tests from respiratory specimens, you should use the appropriate code based on the lab method, such...

Tags: 487.x, 488.1, 87252, 87253, 87276, 87400, 87798, 87804, clinical laboratory, H1N1, PCR, swine flu, test