Non-Patient Facility Laboratory Services Policy - Reimbursement Policy - UnitedHealthcare Commercial Plans

Overview

This policy describes how UnitedHealthcare reimburses non-patient laboratory services when submitted with Type of Bill (TOB) 014X for providers that are not reimbursed according to a fee schedule.

Policy Codes

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* COMM-Non-Patient-Facility-Laboratory-Service-Policy.pdf
Click to Download: Non-Patient Facility Laboratory Services Policy - Reimbursement Policy - UnitedHealthcare Commercial Plans

Questions and Answers

Q:  If TOB014Xis not reimbursable, can I submit the lab chargesfor a Non-Patient Laboratory Specimenunder TOB013X?

A:  No,providers may only submit TOB 013X for outpatient hospital services, not non-patient laboratory services.

Q:  Is it appropriate to use TOB 012X to bill laboratory services done as an outpatient?

A:  No, laboratory services are not ancillary services and should not be billed under TOB012X.