Lab billing

The ICD-10 code sets allow providers to document more details about their patients’ health conditions and hospital procedures than ever before. These details lead to a better record of a patient’s history, and in turn, lead to better care for patients across different providers. Previously, for example, a provider used an ICD-9 code to indicate a patient has a broken arm. With ICD-10, the provider uses a more specific code to indicate whether it’s the right or left arm broken, providing a better understanding of the patient's injury or condition.

If you would like further information, you can refer to the Centers for Medicare & Medicaid Services (CMS) website.

Centers for Medicare & Medicaid Services

Lab NCD’s ICD-10

Local coverage article (LCA) web links

Previously known as Local Coverage determination (LCD)

Each of the links below will take you to a CMS (Centers for Medicare & Medicaid Services) License Agreement page where you much read and indicate your acceptance of the terms.

CMS is not providing the links to the articles that replaced the LDC’s directly.  However, at the bottom of each LCD, under the Associated Documents header, there is a hyperlink  to the article that lists the CPT and the covered codes.  This is the only way to access these new articles at this time.

 

B-type Natriuretic Peptide (BNP) testing (L33573/A56767)

Biomarker Testing (Prior to Initial Biopsy) for Prostate Cancer Diagnosis (A56609)

Heavy metal testing (L35074/A56767))

Molecular Pathology procedures (L35000/A56199)

Multimarker serum tests related to ovarian cancer testing (L38371/A57020)

Non-covered services (L33629/A57812)*

   * The LCD for Non-covered services (L33629) has been retired as of 07/01/2020 and should only be used for dates of services 06/30/2020 and older.

RAST type tests (L33591/A56844)

Urine drug testing (L36037/A56761)

Vitamin D assay testing (L37535/A57736)

 

NCD web links

Cytogenetics studies

National Coverage Determination (NCD) for Cytogenetics Studies (190.3)

CMS MLN Matters; Coding revisions to National Coverage Determination (NCDs)

In the middle of page 2 of this document, there is a link to downloadable listings. Click on the link, click open, and choose the MM11491 link.

National Coverage Determination (NCD) for Screening for Hepatitis B virus (210.6)

 

Advance Beneficiary Notice (ABN) and Non-covered services waiver

ABN and Non-covered services waiver test list

ABN

ABN form

If you are able to supply a copy of the completed document to the patient, you may print the document from this link. If you are not able to make a copy of the completed form for the patient, multi-copy forms can be ordered from the Allina Health Laboratory Supply Catalog under Forms-Information Pads.

How to complete an Advanced beneficiary notice (ABN)

 

Non-covered services waiver

 
How do I determine CPT codes for billing?


It is your responsibility to determine the correct CPT codes to use for billing. CPT codes provided by Allina Health Laboratory in our test catalog, or by our billing department, are for informational purposes only. This coding is based on the Current Procedural Terminology (CPT) guideline manual published by the American Medical Association and the local and third party payer requirements. Any questions regarding the use of a code should be referred to your local Medicare carrier or the payer being billed.

Allina Health Laboratory assumes no responsibility for reimbursement you may or may not receive based upon the procedure codes listed.

If you are unable to locate a CPT code in our test catalog, or are requesting the fee for a particular test, submit a completed CPT/Fee request form (linked below) and we will respond with the requested information.

Forms & instructions

Clearly print your corrections on the Insurance Adjustment Form

To remove charges from your account and send to patient's insurance, you must provide the following:

  • Patient's full name
  • Date of service
  • Accession number
  • Patient address
  • Insurance group and policy numbers for both primary and secondary policies
  • Diagnosis (ICD-10 code is preferred)
  • Guarantor (if patient is under age 18)

Requests for billing changes must be submitted within 60 days of invoice receipt.

Here is the Insurance Adjustment Form in a fillable PDF format that can be completed printed, and faxed to (612) 863-0460

 

Insurance adjustment form

 

Instructions and examples:

Insurance adjustment form example

 

Questions call: (612) 863-0400

Complete and submit the form below to notify us of the need for Allina Health Laboratory to bill insurance for Molecular testing performed. Please note that all information requested is required in order for your request to be completed.