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Billing and Coding for Patient Education and Counseling

With the understanding that pre-test education is a crucial part of genetic susceptibility testing, the following information may be useful in determining how you will bill for the patient education session.

BILLING OPTIONS FOR PATIENT EDUCATION
Option A: INSURANCE CLAIMS
As with other billable services your practice offers, patient education for genetic susceptibility testing may be billed to the patient's insurance. CPT and ICD.9 codes are required for all patient insurance billing. A complete list of CPT and ICD.9 codes may be obtained from the American Medical Association at (800) 621-8335.

Option B: POINT-OF-SERVICE PAYMENT
Another billing option is to bill the patient directly for the education session and the patient pays the fee at the time of the initial session. Typically, offices charge $100-$300 for this session. The patient may wish to submit the claim to his or her own insurance company with the understanding that it may or may not be a covered benefit under the insurance plan.

Option C: FEE WAIVED
The office waives the education fee and there is no charge to the patient.

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© 2004-06, Myriad Genetic Laboratories, Inc.


Introduction
Billing for Patient Education
Coding for Patient Education
Myriad Reimbursement Assistance Program (MRAP)
Protections Against Insurance Discrimination