Q. I need more clarification on 99000. I would like more information regarding the phrase “centrifuges the specimen, separates the serum, and labels and packages the specimens for transport to the laboratory” in the finger lead capillary lead test and collection example. My provider does not cover either the cost of transportation or the use of centrifuging. My question to bill 99000 is, does the labeling and packaging be accepted only, although it is rarely reimbursed?

A. First, it should be said that 99000 is a status “B” code and does not have any RVUs assigned to the code. Therefore, Medicare does not allow payment for this code and considers it bundled into ANY other service performed on the date of service. Essentially, the clinical responsibility for 99000 involves any work your practice has to perform to prepare a specimen for transportation to a laboratory per your practice’s agreement with that lab. This could include:

  • Separating a fluid layer using a centrifuge;
  • Filling out any paperwork required by the lab;
  • Labeling and packaging the specimen per the lab’s instructions; and/or
  • Costs incurred by your practice to transport the specimen to the lab if these, or any other costs, are not already absorbed by the lab.

The author states, “my provider doesn’t pay for the transportation nor the use of centrifuging,” inferring there is no additional cost of “handling and/or conveying of the specimen” beyond what may be expected for evaluation and management of a condition. There is an OIG Special Fraud Alert: Laboratory Payments to Referring Physicians https://oig.hhs.gov/documents/special-fraud-alerts/866/OIG_SFA_Laboratory_Payments_06252014.pdf the author may find useful, that suggests reporting 99000 for data purposes, rather than reimbursement.