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26.4.3.1 Chemistry Tests
Laboratory Paneling
Medicare policy pertaining to laboratory paneling procedures was implemented by the Texas Medicaid Program. Organ and disease panel codes 5-80048, 5-80051, and 5-80053 must be used instead of the general multichannel automated panel codes.
Procedure code 5-84078 is considered a component of the multiple chemistry panels. Procedure code 5-85595 is considered a component of any hemogram with a platelet panel. Hemogram or CBC with platelet panel codes 5-85025 to 5-85027 must be billed when two or more components of a CBC and a platelet count are performed. When two or more components of a CBC and a platelet count are billed separately on the same day, all components are denied with explanation of benefits (EOB) 00559, "These tests must be combined and billed as a CBC/panel. Resubmit with signed claim copy, R&S report copy, and appropriate code (5-85025 and 5-85027)."
The following chemistry tests must be billed individually unless a complete panel is performed on the same day:
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