Payment with Specimen
When patient payment (check or credit card) accompanies the specimen, PROFESSIONAL PRICES are charged. A receipt is mailed to the patient confirming payment and specifying the number of tests performed.
If the Physician or clinic chooses to be billed for the cost of the tests, payment may be rendered upon receipt of monthly statement.
Serolab will bill the patient’s insurance company or accept assignment from Medicare and Medicaid (states in which Serolab is contracted) if:
- The appropriate Insurance/Medicare/Medicaid information is submitted with the specimen.
- The diagnosis code (ICD-10) is provided.
- The patient is informed of the PATIENT PRICE
- The patient signs the form acknowledging he/she is responsible for any amount not paid by insurance and providing a medical release authorization for this billing.
COMMON CPT CODES FOR INSURANCE CLAIM SUBMISSION
|New Patient Work-up||99201
|History, examination, evaluation and management of new patient (specific code used depends on time Physician spends with patient; generally, interpretation of lab results is included in these codes)|
|Blood Collection||36415||Routine venipuncture or finger/heel/ear stick for collection of specimen(s)|
|99000||Handling and/or conveyance of specimen for transfer from Physician’s office to a laboratory|
|Allergens – IgG||86001||Allergen specific IgG; quantitative or semi-quantitative, each allergen|
|Allergens – IgE||86003||Allergen specific IgE; quantitative or semi-quantitative, each allergen|
|Micro-Screen||86005||Qualitative, multi-allergen screen (dipstick, paddle or disk)|
|Total IgE||82785||Gamaglobulin IgE|
|Gamaglobulin G,A,M||82784||Gamaglobulin; IgA, IgD, IgE, IgM, each|
|IgG Subclasses||82787||Immunoglobulin subclasses (IgG 1, 2, 3 and 4)|
|Treatment Set||95165||Professional services for the supervision and immunotherapy; single or multiple antigens, multiple dose vial(s), (specify number of doses) provision of antigens for allergen|
|Maintenance Dose Vial||95165||Professional services for the supervision and provision of antigens for allergen immunotherapy; single or multiple antigens, multiple dose vial(s), (specify number of doses)|
|Vial Test||95024||Intracutaneous (intradermal) tests with allergic extracts, immediate type reaction, specify number of tests|
|Allergy Injection||95115||Professional services for allergen immunotherapy not including provision of allergic extracts; single injection|
|Allergy Injections||95115||Multiple injections|
|Treatment||99211||Evaluation and management of established patient; that may not require the presence of a Physician|
|History, examination, evaluation and management of an established patient (specific code used depends on time Physician spends with patient)|
*CPT Codes are subject to change without notice. Please contact Serolab for current codes.
Suggestions For Claim Submissions
Indicate to the third party being billed if the RAST test was performed for the following reasons:
- Skin testing was deemed unsatisfactory due to any of the following patient conditions:
- Generalized Dermatitis
- Atopic Dermatitis
- Eczamatoid Dermatitis
- Non-Specific Dermatitis
- Hyperactive Skin
- Hyporeactive Skin (aged or infant)
- Discordant response to skin testing controls
- Discordant results from previous skin testing technique
- Previous immunotherapy failure based on skin testing
- Previous history of false positive/negative skin test response
- Skin testing is traumatic to patient
- Pharmacotherapy is interfering with skin test response:
- Chronic antihistamine use (all classes)
- Long acting antihistamines (Allegra, Clarinex, Zyrtec)
- Psychotrophic drug with antihistamine effects (Phenothiazine/antidepressants)
- The patient is undergoing pharmacotherapy potentially interfering with skin test response:
- Beta agonist
- RAST is the Physician’s procedure of choice.
- RAST is the patient’s preference.
- There is a need for specificity as well as sensitivity in diagnosis.
- There is a need to eliminate non-IgE disease as the offender (i.e., vasomotor rhinitis, asthma, infectious asthma, sinusitis, El asthma, frequent URI etc,).
- The patient has a condition which would render skin testing impossible.
It is suggested that a thorough and comprehensive account of the above conditions be submitted with the insurance claim in order to enhance third party reimbursement.