CPT Knowledgebase - Jul 7, 2022

When certain laboratory tests that are part of a comprehensive test panel, which has a designated code, are billed to Medicare, they are reported as individual tests. For example, a comprehensive metabolic panel (CMP), complete blood cell count (CBC), and thyroid-stimulating hormone (TSH) test are reported to Medicare with codes 80053, 85025, and 84443, respectively; however, non-Medicare payers require these laboratory tests to be reported with code 80050. For purposes of data analyzed, should these tests be counted as three tests for all payers or only for Medicare? Or should they be counted as only one test ordered for all payers because there is an assigned CPT code for all three tests combined as one test panel, even though this code isn't used by Medicare?

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