US · guidance
CMS Pub. 100-04, ch. 16, § 90.5
Special Processing Considerations
PM AB-97-17
To order any of the 23 automated tests, a physician may select individual tests or the
panel. A physician may order a mix of panels and individual tests. The physician should
review what tests are in each panel and not order individual tests that might duplicate
tests in the panel. Medicare denies duplicate tests.
Specialists are not, based on their specialty, restricted to ordering certain panels or
individual tests. The physician (general practitioner or specialist) should identify which
tests he/she requires; and, if the tests match a grouping, order the appropriate panel.
Claimants should use the QP modifier with the single ordering of tests or when a single
code is available for groupings of tests. This modifier indicates that the claimant has
documentation on file showing that the laboratory test(s) was ordered individually or
ordered as a CPT-recognized panel
History
(Rev. 4299, Issued: 05-03-19, Effective: 01-01-19, Implementation: 10-07-19)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
643bd781e876c383cf4cb4afdd144f4dd7785e7f4f2bb3358bc0f67c4f69834f
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