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11/18/2021 2020 Part B Utilization Data Loaded
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Friday Compliance Briefing: Medical Necessity Requirements for Chemistry Panels

Editor's Welcome:

This week's Compliance Briefing continues the discussion we started last week regarding how automated test panels may be coded and billed when one of the component tests is not medically necessary. More discussion is warranted because of the number of questions we received concerning the unbundling of automated test panels. Hopefully this briefing will clear up some of the confusion. Keep the questions and comments coming.

Sincerely,

Charles B. Root, Ph.D.

Medical Necessity Requirements for Chemistry Panels

Last week we stated that the best option for billing a basic metabolic panel, or any automated test panel, that contained a medically unnecessary glucose test would be to make sure you receive an ABN, bill the tests individually and then bill the beneficiary for the glucose test when it is denied.

Several readers questioned whether unbundling an automated test panel code, such as the basic metabolic panel, is an a....

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