CPT Codes
The CPT codes listed in our online test directory attempt to provide the most up-to-date information available. The codes are provided as a guide to describe the services but are subject to change and interpretation.
For tests with multiple components, our directory provides a comprehensive CPT list. Please note that only a subset of the tests may be performed on any particular specimen. The CPT codes used for billing need to reflect the tests actually performed.
Please consult the CPT Coding Manual published by the American Medical Association to verify the accuracy of the codes listed.
Coding questions may be directed to the AMA’s CPT nomenclature and Coding department, or to the local Medicare carrier.
Marshfield Labs assumes no responsibility for billing errors due to reliance on information listed in our clinical test directory.
Clients are responsible for determining the appropriate codes, coverage, and payment policies for individual patients.
Billing Policy
Marshfield Labs offers weekly, bi-monthly, or monthly invoicing options to fit your needs. Clients may view their statements anytime using the account portal. All billed charges are due and payable NET 30 days of billing. Itemized statements include the following information:
- Date of service
- Patient's name
- Individual test name
- CPT Code (Current Procedural Terminology)
- Individual test fee
When submitting payment, please ensure your Marshfield Labs account number appears on the payment remittance to ensure your account is properly credited. Failure to include your account number may delay timely posting to your account.
If requested, Marshfield Labs will bill patients directly or may bill third party carriers directly if complete billing information is provided. Your patient will be billed for amounts not covered or paid by their insurance carrier. Required information needed to direct bill patients or third party carriers is:
- Patients name
- Full address
- Telephone number
- Date of birth
- Sex
- Referring physician name
- Referring physician NPI
- Diagnosis code
- Responsible party's name and relationship to patient
- ID or policy number and group number
Additional Information
Medicare patients should be informed prior to testing when Medicare will not cover a test. Patients must sign an Advanced Beneficiary Notice (ABN) for those tests not covered by Medicare. Failure to obtain a valid ABN prior to testing will result in the charges being billed to the client.
Medical Assistance and Family Planning Waiver Program patients need to be notified in writing when a laboratory test is not covered. Failure to obtain this will result in the charges being billed to the client.
