Billing for Transfusion Reaction Workup

[DawnS]

Hello, 

I searched the forum but the last time this topic was covered was in 2010. I am helping to build a blood bank system and am reviewing all of the charges associated with testing. I noticed that this organization only bills for the professional fee associated with a reaction. I have been told that we cannot charge for the actual workup due to CMS reimbursement but others have stated that we should be charging for testing. If so, should we charge a flat fee or charge for each test? 

[David Saikin]

How you bill for it is up to you.  I have 2 policies:  Investigation and Advanced Workup.  I've bundled the testing fees into each.  Reimbursement is the purview of higher pay grades than mine.

[cthherbal ★]

we bill CPT 86078

from AABB website: Billing for Blood and Transfusion Services- Frequently Asked Questions and Answers (aabb.org)

Billing for Transfusion Reactions

Question: What is the appropriate billing date for CPT code 86078 Blood Bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report?

Answer: The date the transfusion reaction workup specimen(s) was collected should be the billed date of service. This includes all services performed in conjunction with the transfusion reaction regardless of date of completion.

Reference

1. 68 Fed. Reg. 74607, at 74611 (Dec. 24, 2003)
2. Negotiated Rulemaking: Coverage and Administrative Policies for Clinical Diagnostic Laboratory Services