Billing and Coding: Respiratory Pathogen Panel Testing

Respiratory pathogen panel testing is covered when performed as a single outpatient service from a single specimen and is reasonable and necessary per LCD L38918, including when performed in a Medicare Part B setting that can deliver timely results that influence patient management. Panels must be billed as one unit (UOS=1), must not be unbundled into component tests, are not applicable to institutional claim forms, and require complete, legible medical record documentation supporting diagnosis coding, billing codes, and that results affect clinical management.

"Respiratory pathogen panel testing is covered when performed as a single service from a single biologic specimen in the outpatient setting on a single date of service and is reasonable and necessar..."

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