Thursday, August 12, 2010

Medicare cpt code - Organ- or Disease-oriented

Organ- or Disease-oriented Panels

When the following organ- or disease-oriented panel codes are used, all included tests must be performed. Medicare reimbursement for these panels is equal to the sum of the fee schedule amounts of the individual tests included. Medicare does not consider the general Health Panel (80050) and the Obstetric Panel (80055) to be covered services.
  • 80049 BASIC METABOLIC PANEL: new automated test panel
  • 80050 GENERAL HEALTH PANEL: not reimbursed by Medicare
  • 80051 ELECTROLYTE PANEL: new automated test panel
  • 80054 COMPREHENSIVE METABOLIC PANEL: new automated test panel
  • 80055 OBSTETRIC PANEL: not reimbursed by Medicare
  • 80058 HEPATIC FUNCTION PANEL: new automated test panel
  • 80059 HEPATITIS PANEL
  • 80061 LIPID PANEL
  • 80072 ARTHRITIS PANEL
  • 80090 TORCH ANTIBODY PANEL
  • 80091 THYROID PANEL
  • 80092 THYROID PANEL WITH THYROID-STIMULATING HORMONE
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download