Laboratory Services. Laboratory Procedures
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1 Laboratory Services Laboratory Procedures Anthem is contracted with Laboratory Corporation of America (LabCorp ). All lab work, including Pap tests and routine outpatient pathology, must be sent to LabCorp, with the exception of the procedures listed below: Note: This relationship with LabCorp is specific to national reference lab services and does not affect network hospital-based lab service providers or contracted pathologists, or independent laboratories. Lab Work Provided in the Provider s Office Metabolic panel total Heterophile antibodies (momo spot) Urinalysis, nonauto w/scope Particle agglutination test (Rapid Strep) Urinalysis, auto w/scope Particle agglutination test (Rapid Strep) Urinalysis nonauto w/o scope TB intradermal test Urinalysis, auto, w/o scope Skin Test: tuberculosis, tine testculture screen only (Rapid Strep) Urinalysis Culture, bacteria, other Smear, gram stain Urine screen for bacteria Culture screen only (Rapid Strep) Smear, wet mount, saline/ink Microscopic exam of urine Smear, gram stain Tissue exam for fungi Urine pregnancy test Smear, wet mount, saline/ink Strep a ag, eia (Rapid Strep) Amines, vaginal fluid, qualitative Tissue exam for fungiinfectious agent antigen detection by immunoassay with direct optical observation; Stretococcus, group B Occult blood, feces Strep a ag, eia (Rapid Strep) Influenza assay w/optic Occult blood, other sources Infectious agent antigen detection by immunoassay with direct optical observation; Stretococcus, group BRsv assay w/optic Assay, bld/serum cholesterolgases, blood, any combination of ph, pc02, p02, C02, HC03 (including calculated 02 saturation). This procedure approved for Pulmonologists ONLY InfluenzStrep a assay w/optic Gases, blood, any combination of ph, pc02, p02, C02, HC03 (including calculated 02 saturation). This procedure approved for Pulmonologists ONLY. Glucose; quantitative (except reagent strip) Glucose; quantitative (except blood reagent strip) Glucose; blood reagent strip by glucose monitoring device(s) cleared by the FDA specifically for home use Glucose; blood by glucose monitoring device(s) cleared by the FDA specifically for home use. Bleeding time Rsv assay w/optic Sperm isolation; simple prep (e.g., sperm wash and swim-up) for insemination or diagnosis with semen analysis Strep a assay w/optic Sperm isolation; complex prep (e.g., Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis Sperm isolation; simple prep (e.g., sperm wash and swim-up) for insemination or diagnosis with semen Semen analysis. w/huhner Sperm isolation; complex prep (e.g., Percoll gradient, albumin gradient) for insemination or diagnosis with semen Semen analysis w/count ALL: OCTOBER
2 Lab Work Provided in the Provider s Office Bleeding time Blood count; blood smear, Semen analysis w/huhner, complete microscopic examination with manual differential WBC count Blood count; blood smear, microscopic Semen analysis w/count& motility examination with manual differential WBC count Spun microhematocrit Spun microhematocrit Hematocrit Semen analysis, complete Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test Hematocrit Hemoglobin 89321G0027 Semen analysis & motility Hemoglobin Complete CBC w/auto diff WBC Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test Prothrombin time G0027 Semen analysis Heterophile antibodies (momo spot) Lab procedure codes for procedures that can be performed at the physician s office can be billed as fee-for-service. Anthem will pay for the lab procedure only. The drawing fee is incorporated into the lab procedure; therefore, the physician will not be reimbursed for an additional drawing fee. Anthem will pay a drawing fee to a physician who sends ALL lab work to LabCorp. (Please bill with procedure code routine venipuncture.) Codes on this list are not a guarantee of payment. Coverage may be restricted by member benefits. If the physician performs blood tests in his/her office and also sends additional blood to LabCorp for testing, the physician will NOT be reimbursed for the drawing fee. The handling fee, code 99000, is not allowed in addition to the venipuncture code or the E&M code. Codes and 36416, collection of capillary blood specimen (eg. Finger, heel, or ear stick) are on the Always Bundle/Bundled Services and Supplies policy and are considered part of the overall medical management of the patient and are not allowed separately. Reviewing results of laboratory tests, phoning results to patients, filing such results, etc., are included in Anthem s allowance for the E&M code, even if the E&M code is not on the same day. A charge related to drawing of blood performed by an OB/GYN is payable as a separate service and isn t included in the total obstetrical allowance if the blood is sent to the lab. An appropriate diagnosis to justify the procedure must accompany all lab procedures. Specimen collections: For specimen requirements for various lab tests, collection procedures, specimen preparations and submission protocols, please call LabCorp toll free at Instructions for certain labile specimens are as follows: Routine pediatric specimen collections can be performed at the drawing stations of the independent laboratories contracted with Anthem. Stat: If an emergency situation exists and you can t wait for LabCorp s stat turnaround (three to four hours from the time the lab is called), you can mark STAT on your claim form for that lab procedure. However, Anthem will pay the lab charge only and will not pay for STAT fee charges. If the original claim doesn t denote STAT and is denied for payment because it should have been sent to LabCorp, Anthem will not pay at a later date even if the claim is resubmitted with STAT marked on it. Cerebrospinal fluid/bone marrow aspirate: Due to the labile nature of these specimens, Anthem recommends that they be transported to the nearest hospital for analysis. Please call LabCorp for information or instructions. This also helps with reporting results properly and obtaining written copies of the results. Non-gynecologic cytology: Place specimens such as urine, bladder washing, body fluids (peritoneal, gastric), cyst fluids and cerebrospinal fluids in a clean, leak-proof container with an equal volume of 50 percent alcohol. Histology: Place tissue in leak-proof biopsy bottles containing 10 percent formalin in a volume five times that of the specimen. Do not use a preservative if microbiological cultures are required. LabCorp will contact Providers if it receives inadequate, inappropriate, or improperly prepared or stored specimens. ALL: OCTOBER
3 Lab Services Covered as Part of Preventive Care Benefits When a member s health plan includes preventive care benefits, the following lab tests are covered when billed with a preventive diagnosis code. Any code not listed below requires a medical diagnosis when billing Anthem. These lab tests should be sent to a contracted laboratory provider. Lab Services Covered as Part of Preventive Care Benefits Basic metabolic panel (Calcium, total) Assay of blood lipoprotein General health panel Phenylaline (PKU) Electrolyte panel Assay alkaline phosphatase Comprehensive metabolic panel Assay of serum potassium Lipid panel Assay of psa, complexed Hepatic Function Panel Assay of psa, total Urinalysis, nonauto w/scope Assay of psa, free Urinalysis, auto w/scope Assay of protein, serum Urinalysis nonauto w/o scope Assay of serum sodium Urinalysis, auto, w/o scope Assay thyroid stim hormone Urinalysis Transferase (AST) (SGOT) Assay of serum albumin Alanine amino (ALT) (SGPT) Bilirubin, total Assay of triglycerides Blood, occult feces Assay of urea nitrogen Blood, occult feces Automated diff wbc count Assay of calcium Bl smear w/diff wbc count Assay, blood carbon dioxide Manual diff wbc count b-coat Assay of blood chloride Spun hematocrit Assay, bld/serum cholest Hematocrit Assay of creatinine Hemoglobin Galactose transferase test Complete cbc w/auto diff wbc Assay, glucose, blood quant Complete cbc, automated Glucose tolerance test (GTT) Fluorescent antibody, screen GTT-added samples Fluorescent antibody, titer Hemoglobin electrophoresis Immunoassay, tumor other Lipopro bld, electrophoretic Immunfix e-phorsis/urine/csf Assay of lipoprotein Tb test, cell immun measure Assay of blood lipoprotein TB intradermal test Syphilis test, qualitative Cytopath, c/v, manual Syphilis test, quantitative Cytopath, c/v, auto redo Chlamydia antibody Cytopath, c/v, redo Chlamydia igm antibody Cytopath, c/v, select HTLV/HIV confirmatory test Cytopath, c/v, index add-on HIV Cytopath smear, other source HIV Cytopath smear, other source HIV-1/HIV-2, single assay Cytopath smear, other source ALL: OCTOBER
4 Lab Services Covered as Part of Preventive Care Benefits Rubella antibody Cytopath tbs, c/v, manual Chlamydia culture Cytopath tbs, c/v, redo Cryptosporidium ag, if Cytopath tbs, c/v, auto redo Chylmd trach ag, eia Cytopath tbs, c/v, select Hiv-1 ag, eia Cytopathology eval of fna Hiv-2 ag, eia Cytopath eval, fna, report Chylmd pneum, dna, dir probe Cytopath, c/v auto, in fluid Chylmd pneum, dna, amp prob Cytopath c/v auto fluid redo Chylmd trach, dna, dir probe Cytogenetics, dna probe Chylmd trach, dna, amp probe Cyto/molecular report N.gonorrhoeae, dna, dir prob G0103 Psa, total screening N.gonorrhoeae, dna, amp prob G0123 Screen cerv/vag thin layer N.gonorrhoeae, dna, quant G0124 Screen c/v thin layer by MD Hpv, dna, dir probe G0141 Scr c/v cyto, autosys and md Hpv, dna, amp probe G0143 Scr c/v cyto,thinlayer,rescr Hpv, dna, quant G0144 Scr c/v cyto,thinlayer,rescr N. gonorrhoeae assay w/optic G0145 Scr c/v cyto,thinlayer,rescr Cytopath, c/v, interpret G0147 Scr c/v cyto, automated sys Cytopath, c/v, thin layer G0148 Scr c/v cyto, autosys, rescr Cytopath c/v thin layer redo P3000 Screen pap by tech w md supv Cytopath, c/v, automated P3001 Screening pap smear by phys Cytopath, c/v, auto rescreen Other Considerations A physician or other health care Provider may not bill for services sent to an outside lab. This includes cytopathology services for cervical cancer screening (Pap codes and P3000-P3001). Codes and P3000-P3001 are to be used by the laboratory performing the test, not by the physician obtaining the specimen. Effective with ClaimsXten implementation on or after 11/07/2009, Pap smear codes will be denied when reported with E&M codes. Q0091-Obtaining the specimen for cervical cancer screening is included in the allowance for and is thus incidental to the evaluation and management (E&M) or the preventive care visit service. For members without preventive care benefits billing Q0091 alerts us that a Pap smear was done and the visit code can be allowed. For additional tips on billing pap smears for individual members see the coding tips and lab sections of this document. Specialized Anatomic Pathology LabCorp is a leader in innovative diagnostic testing, with active research and development groups. Some of its specialized services include the following: A.P. triple screens AIDS-related testing, including genotype and phenotype analysis Allergy (RAST and Imunocap) testing Genetic/cytogenetic testing with board-certified cytogeneticists and genetic counselors available for consultation Tumor marker testing DNA probe testing ALL: OCTOBER
5 For information about specialized assays or about requirements for special collection kits and specimen handling, call LabCorp at 888-LABCORP ( ) LabCorp Patient Service Centers To find a LabCorp location near you, go to or call the phone number above. ALL: OCTOBER
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