Dana Posted Mon 25th of April, 2016 13:15:52 PM
Our pulmonologist is seeing patients in the hospital in an inpatient setting. We are billing out the hospital visits or a consult. He is ordering Pulmonary function test some with spirometry some without spirometry. The hospital is performing the test and the physician is looking at the results in treating the patient. Can he be paid for the pulmonary function test in any way with any modifier or just the hospital consult/visit?
SuperCoder Answered Tue 26th of April, 2016 03:51:21 AM
Thanks for your questions. As per CMS, “Reviewing results of laboratory tests, phoning results to patients, filing such results, etc., are Medicare covered services. Payment is included in the physician fee schedule payment for the evaluation and management (E&M) services to the patient.”
For more info, please see - Medicare Claims Processing Manual, Chapter 16 - Laboratory Services