Billing and Coding: Respiratory Pathogen Panel Testing

Respiratory pathogen panel testing is covered for outpatient, non-institutional Part B patients when performed from a single biologic specimen on a single date of service (not as a reflex) and when the facility can provide timely results that can change clinical management and improve outcomes. The panel is a single service (UOS=1) that must not be unbundled or billed as individual component tests; institutional claim forms are excluded. Medical records must be legible, include patient identifiers and provider signature, support the chosen ICD-10-CM and CPT/HCPCS codes, and document that testing occurred in an appropriate Part B setting.

"Respiratory pathogen panel testing is covered when performed in an outpatient, non-institutional Part B setting from a single biologic specimen on a single date of service and the order is not a re..."

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