Diagnostic Lab Billing and Coding Guidelines

In this article, the Comprehensive Error Rate Testing (CERT) Contractor reported an increase in errors for complete blood counts (CBC) and urinalysis (UA) laboratory services.

Data indicates two types of errors:

• Code selection errors and
• Standard protocol use in place of patient-specific physician orders.

Only lab services ordered by the physician should be provided and billed. A physician’s written order must match the performed service. Providers may not perform additional lab services based on internal standard or implied protocols.