Clinical laboratories and hospital laboratories for microbiological, serological, chemical, hematological, biophysical, radiobioassay, cytological, immunohematological, immunological, pathological, or other examinations that provide information for evaluating a medical condition or for the diagnosis, prevention, or treatment of any disease. Laboratory panels or chemistry panels are groups of tests that are ordered together for a specified member on a specified day.
Common Chemistry Panels
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Common Chemistry Panels
- Basic Metabolic Panel (BMP) – tests that measure blood sugar (glucose) levels, electrolyte and fluid balance, and provide information about kidney function, respiratory function and liver function.
- Comprehensive Metabolic Panel (CMP) – provides the same information as the BMP as well as the status of the liver and key blood proteins.
- Electrolyte Panel – for detecting a problem with the body’s fluid and electrolyte balance.
- Lipid Profile – to assess the risk of developing cardiovascular disease.
- Hepatic Function Panel or Liver Panel – to screen for, detect, evaluate, and monitor acute and chronic liver inflammation (hepatitis), liver disease and/or damage.
- Renal Panel or Kidney Function Panel – includes tests to evaluate kidney function, such as albumin, creatinine, BUN, eGFR.
- Thyroid Function Panel – to assess thyroid gland function and help diagnose thyroid disorders.
- Providers may bill either a panel code or an individual code.
- Each panel code comprises multiple tests.
- The panel code should be reported when all individual components in the panel have been performed.
- The code or codes to describe the individual tests performed should be reported if any test defined as part of the panel is not performed.
- Two or more panel codes that include any of the same constituent tests performed from the same patient collection should not be reported.
- If a group of tests overlaps two or more panels, the panel that incorporates the greater number of tests to fulfill the code definition should be reported and the remaining tests should be reported using individual test codes.
- Each test billed under the panel must be reasonable and necessary.
Billing and Coding Lab Panels and Their Components
Knowing CPT coding guidelines and payer rules is necessary to report chemistry panels and their components correctly for proper reimbursement.
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