Ga. Medicaid Part II Policies & Procedures for Hospital Services, Appendix D

Services available through the State Laboratories are not reimbursable through the Hospital program. The

following policies and procedures on Public Health Laboratory services must be followed:

A. Newborn Screens

The following follow up tests are allowed on infants less than three (3) months of age when the

initial screenings are positive. These claims must be billed with diagnosis code ICD 9 CM 796.6

(ICD 10 CM P09). However, neonatal metabolic screens are required by the State on all infants

24 hours after birth or by the seventh day of life. The initial screening specimen shall continue to

be sent on filter paper (DHR Form 3491) to the Public Health Laboratory, Central Facility in

Atlanta only.

Procedure Codes

82016 82017 82127 82131 82261 84150

82776 83020 83498 83788 83789

84030 84436 84437 84442 84443

Specimens for the above battery of tests may be on a full blood sample (not filter paper) and must

be performed by any CLIA certified participating laboratory.

B. Hemoglobin Testing

The Division will not make payment for the following test for sickle cell detection, confirmation

or follow-up for infants and family members of infants suspected of sickle cell anemia or trait.

Diagnosis codes include ICD 9 CM 282.6 – 282.69 (ICD 10 CM D57.1 through D57.812).

83020 include SS, SC, SE, S Beta Thalassemia, SO, and SD.

All blood specimens with a sickle cell indicator must be forwarded in an appropriate sickle cell

outfit to the Albany or Waycross laboratories.

The Division will provide reimbursement for hemoglobin tests for possible diagnosis other than

sickle cell.

C. Gonorrhea and Syphilis Testing

The Department will not provide reimbursement for diagnosis codes ICD 9 CM 098-099.9 (ICD

10 CM A54.00 – A64) with the following procedure codes:

Procedure codes

For diagnosis codes ICD 9 CM 090-097.9 (ICD 10 CM A50.09 – A53.9), the Division will not

reimburse for:

86592 86593

All blood/serum specimens for gonorrhea and syphilis must be routed in outfits provided by the

State laboratory. Specimens for VDRL’s and RPR’s may be routed to any of the three State

laboratories. Specimens for VDRL’s and FTA’s must be routed to the laboratory in Atlanta only.

Under no conditions will the Division reimburse for gonorrhea or syphilis testing.

Patients requiring dark field exams must be referred to their local Health Department.

D. Tuberculosis Testing

The following procedures are for tuberculosis (diagnosis codes ICD 9 CM 010.00-018.96

(ICD 10 CM A15.7 – A19.9) testing:

87116 87118

All sputum with a tuberculosis indicator must be forwarded in the sputum outfit provided by the

State to the State laboratory in Atlanta only. Under no condition will the Division reimburse for

tuberculosis testing.

E. Salmonella and Shigella Testing

Diagnoses included are ICD 9 CM 003.0 to 004.9 (ICD 10 CM A02.0 – A03.9). The procedures

are: 87045, 87081, and 87084.

Stool culture (87045) is often used for the detection of salmonella and/or shigella. Therefore, all

stool cultures with a salmonella or shigella indicator must be forwarded in a stool culture outfit

(provided by the State) to the State laboratory in Atlanta. Under no condition will the Division

reimburse for salmonella or shigella testing

F. HIV/AIDS Test Procedures:

All blood specimen and test requests are no longer restricted to the state laboratory. (Rev 2014)

The State Laboratory Locations and Telephone Numbers are listed below:

Decatur Central Public Health Laboratory

Georgia Department of Public Health Laboratory Services & Supply

86592 86593 87070 87081 87205

1749 Clairmont Road

Decatur, Georgia 30033-4050

Phone # (404) 327-7920

Fax # (404) 327-7922

Waycross Public Health Laboratory

Georgia Department of Public Health Laboratory Services & Supply

1751 Gus Karle Parkway

Waycross, Georgia 31503

Phone # (912) 388-7050

Fax # (912) 338-70611.

Specimen outfits for testing to be done in the Regional Laboratories are available from the preceding

addresses; however, the outfits for the tests in the Atlanta Central Laboratory must be obtained from:

Laboratory Services and Supply

1749 Clairmont Road

Decatur, Georgia 30033-4050

Phone # (404) 327-7920

Fax # (404) 327-7922