Charging for crossmatches

[Mary**]

Due to the recent CLIA requirement that gel crossmatches my not detect ABO incompatibility, we are having to do both immediate spin and IgG crossmatches for patients with antibodies. Has anyone had billing problems by charging for both? I feel if we have to do both, we should charge for both.

[Liz]

If IS is now a routine test with the Major CM, ask to have cost analysis done; you may have to include the extra cost of the IS in the Major CM code.

[LaraT23]

We do charge for both. All Xm have an immediate spin charge, for those with gel XM we had another test in the requisition that is a charge only for the gel testing.

[AFiddler]

The answer lies with your Medicare Administravtive Contractor (MAC) for Indiana. However, neither CPTs 86920 (IS) nor 86922 (AHG) are mutually exclusive, so I would bill for each. For more info on Medicaly Unlikely Edits and Mutually Exclusive Edits, I use cms.gov, then enter NCCI in the search.

[L106]

I believe it is OK to charge for both the Immed Spin CPT code and the AHG CPT code (as AFiddler wrote.)

[AMcCord]

We do charge for both. All Xm have an immediate spin charge, for those with gel XM we had another test in the requisition that is a charge only for the gel testing.

This is what we do.