Lab Services Edit for Hepatitis/Hepatic Function Panels

Lab services were identified as having a high error rate through Comprehensive Error Rate Testing (CERT). These services are frequently denied due to lack of signed orders submitted as requested. To prevent payment errors, TrailBlazer has implemented an edit for the following lab CPT codes: • 80074 (acute hepatitis panel). • 80076 (hepatic function panel). The edit was effective May 14, 2012. Medical review will request orders for lab CPT codes 80074 and 80076. The order must include the signature of the ordering physician for the lab to be payable. TrailBlazer Health Enterprises – Medicare Part A and Part B MAC for Jurisdiction 14; comprised of Colorado, New Mexico, Oklahoma and Texas.