"CPT Copyright 2016 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.""

Featured Post

2018 New CPT codes

00731  Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified ...

Florida BCBS - Reimbursement for Lab services


In-Office Laboratory Services

Only the laboratory (“lab”) services listed below are eligible for payment when performed in the office by a participating NetworkBlue or Health Options physician for BlueCare, BlueOptions, BlueMedicare HMO and BlueMedicare PPO members. Other lab services performed in the office will be denied for payment and the member may not be billed.

36415* Collection of venous blood by venipuncture
80048 Basic metabolic panel
80051 Electrolyte panel (CO2, Cl, K, Na)
80076 Hepatic function panel (7)
81000 Urinalysis, by dip stick or tablet reagent, non-automated with microscopy
81001 Urinalysis, by dip stick or tablet reagent, automated with microscopy
81002 Urinalysis, by dip stick or tablet reagent, non-automated without microscopy
81003 Urinalysis, by dip stick or tablet reagent, automated without microscopy
81005 Urinalysis, qualitative or semiquantitative, except immunoassays
81015 Urinalysis; microscopic only
81025 Urine pregnancy test, by visual color comparison methods
82150 Amylase
82247 Bilirubin; total
82270 Blood occult, by peroxidase activity (e.g., guaiac), qualitative; feces, 1-3 simultaneous determinations
82272 Blood occult, by peroxidase activity (e.g., guaiac), qualitative; feces, single specimen
(e.g., from digital rectal exam)
82565 Creatinine; blood
82803 Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3
(including calculated 02 saturation)
82946 Glucagon tolerance test
82947 Glucose; quantitative, blood (except reagent strip)
82948 Blood, reagent strip
83036 Hemoglobin; glycosylated (A1C)
84703 Beta hCG, qualitative
85013 Spun microhematocrit
85014 Hematocrit (Hct)
85018 Hemoglobin (Hgb)
85025 Complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count
85060 Blood smear, peripheral, interpretation by physician with written report
85097 Bone marrow, smear interpretation
85610 Prothrombin time
86308 Heterophile antibodies; screening
86580 Tuberculosis, intradermal
87210 Wet mount for infection agents (e.g., saline, India ink, KOH preps)
87220 Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites
(e.g., scabies)
87400 Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative,
multiple step method; Influenza A or B, each
87420 Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative,
multiple step method; respiratory syncytial virus
87425 Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative,
multiple step method; rotavirus
87430 Infectious agent antigen detection by enzyme immunoassay technique, Streptococcus, group A
87804 Infectious agent detection by immunoassay with direct optical observation; influenza
87880 Infectious agent detection by immunoassay with direct optical observation; Streptococcus, group A
89051 Cell count, miscellaneous body fluids, except blood; with differential count
89060 Crystal identification by light microscopy with or without polarizing lens analysis, any body fluid (except urine)
89190 Nasal smear for eosinophils
89300 Semen analysis; presence and/or motility of sperm including Huhner test

* indicates Draw fees are only eligible for payment when lab services are sent to an outside laboratory.
• If you perform some lab services in the office and send others to an independent laboratory on the same day of service, add a modifier 90 to code 36415.
• The draw fee is not eligible for separate reimbursement for lab tests performed in the office; it is included in the allowance for the lab service(s).

For more details please refer
BCBSFL Manual for Physicians and Providers – Coding and Filing Claims

Popular Posts