When it comes to panels, does Medicare allow labs to substitute one test for another?
The test composition of the panels at your facility must be exactly as stated in the CPT manual. You may not substitute one test for another, nor add to or subtract from those listed. Performance of fewer than the specified tests listed in the panel whose code you report is considered up-coding and a major compliance issue. Performance of more than the specified tests listed for a panel could lead to concerns about inducement or questions concerning the tests’ medical necessity.