Charlene Posted Thu 21st of February, 2019 08:35:41 AM
Our facility (physicians office) now offers CT imaging. Can we bill for POC creatinine testing? Does there need to be an order for this, and does it need to be on the CT order? Based on the criteria for testing, what diagnosis(es) would be best, and does that diagnosis set need to be on the order as well?
SuperCoder Answered Fri 22nd of February, 2019 02:06:35 AM
Thanks for your question.
Contrast media can pose serious health risks to patients with chronic or acute renal insufficiency including potentially fatal nephrogenic systemic fibrosis (NSF) or contrast-induced nephropathy (CIN). Creatinine measurement of renal function is recommended prior to administration of contrast media especially for patients with risk factors such as diabetes, kidney impairment, and advanced age.
Many practices perform the lab service in-house. If this is the case, be sure you have an order from the treating physician for the test. You will need to be sure you are performing a CLIA-waived test, as well. This depends on the equipment you use. If your equipment is CLIA waived, remember to add modifier QW (CLIA waived test) on your Medicare claims.
Experts recommend simplifying the logistical and compliance hassles by having the referring physician order the test from a lab when he feels it is necessary.
On the basis of criteria for testing, the appropriate ICD-10CM code will be Z01.812 (Encounter for preprocedural laboratory examination).