87102 is a CPT code, not HCPCS.
87101 Culture,fungi(mold or yeast)isolation,with presumptive
identification of isolates;skin, hair,or nail
87102 other source(exceptblood)
independent laboratories and place of service (POS) codes.
"The Medicare Claims Processing Manual, Chapter 26, Section 10.6 states the following:
If the physician bills for a lab service furnished by an independent lab, the code for "Independent Laboratory" is used. Items 21 and 22 on the Form CMS-1500 must be completed for all laboratory work performed outside a physician's office. If an independent lab bills, the place where the sample was taken is shown. An independent laboratory taking a sample in its laboratory shows "81" as place of service. If an independent laboratory bills for a test on a sample drawn on an inpatient or outpatient of a hospital, it uses the code for the inpatient (POS code 21), off campus-outpatient hospital (POS code 19), or on campus-outpatient hospital (POS code 22), respectively.
The Medicare Claims Processing Manual, Chapter 26 can be found at:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c26.pdf.
For additional information, please visit the Medicare Learning Network website below:
40.4 - Special Skilled Nursing Facility (SNF) Billing Exceptions for Laboratory Tests
(Rev. 1, 10-01-03)
SNF 541, A3-3137.1, HO-437, B3-5114.1
When a SNF furnishes laboratory services directly, it must have a Clinical Laboratory Improvement Act
(CLIA) number or a CLIA certificate of waiver, and the laboratory itself must be in the portion of the facility
so certified. Normally the A/B MAC (A) makes payment under Part B for clinical laboratory tests only to the
entity that performed the test. However, the law permits SNFs to submit a Part B claim to the A/B MAC (A)
for laboratory tests that it makes arrangements for another entity to perform on the SNF’s behalf. Section
1833(h)(5) of the Act (as enacted by The Deficit Reduction Act of 1984, P.L. 98-369) requires the
establishment of a fee schedule for clinical laboratory tests paid under Part B and also requires that, with
certain exceptions, only the entity that performed the test may be paid.
The fee schedule applies to all SNF clinical laboratory services.
Where a SNF operates a laboratory that provides laboratory services to patients other than its own patients, it
is functioning as a clinical laboratory. The billing for these laboratory services depends upon the HCPCS code
as defined in the CMS annual fee schedule releases (laboratory and MPFS), and the arrangements made for
payment with the referring entity (e.g., does the SNF or the referring entity bill under the agreement between
the two). The SNF is responsible for ascertaining the necessary information for billing the A/B MAC (A).
Any questions must be referred to the A/B MAC (A).
40.4.1 - Which A/B MAC (A) or (B) to Bill for Laboratory Services Furnished to a
Medicare Beneficiary in a Skilled Nursing Facility (SNF)
(Rev. 1, 10-01-03)
Inpatient Part A beneficiary - SNF bills the A/B MAC (A) under Part A. The service is included in SNF
PPS payment.
Inpatient Part B beneficiary (benefits exhausted or no Part A entitlement) - SNFs may provide the service
and bill the A/B MAC (A), may obtain the service under arrangement and bill the A/B MAC (A) under Part B,
or may have agreement with a reference laboratory for the reference laboratory to provide the service and have
the reference laboratory bill the A/B MAC (B) under Part B. Regardless of who bills, CMS policy requires
that the service be paid under the fee schedule, whether or not the beneficiary is in a Medicare certified bed.
Outpatient Part B - See inpatient Part B beneficiary (benefits exhausted or no Part A entitlement),
immediately above.
HCPCS Codes
Pathology and Laboratory Services
HCPCS Code range P2028-P9615
The HCPCS codes range Pathology and Laboratory Services P2028-P9615 is a standardized code set necessary for Medicare and other health insurance providers to provide healthcare claims.
HCPCS Code range (P2028-P9615), Pathology and Laboratory Services, contains HCPCS codes for pathology and laboratory medicine services, Cephalin floculation blood, Congo red blood, Thymol turbidity, Mucoprotein blood, Cryoprecipitate, Platelets, Red blood cells.
HCPCS Code Range P2028-P9615
P2028-P9615 Pathology and Laboratory Services
P2028-P2038 Laboratory Tests of Blood and Hair
P3000-P3001 Pap Smears
P7001-P7001 Urine Bacterial Culture and Sensitivity Studies
P9010-P9100 Blood and Blood Products, with Associated Procedures
P9603-P9604 Specimen Collection, Travel Allowance
P9612-P9615 Specimen Collection, Catheterization
Please see this free resource:
Place of Service Code Set Place of Service Codes for Professional Claims Database (updated September 2021) Listed below are place of service codes and descriptions. These codes should be used on professional claims to specify the entity where service(s) were rendered. Check with individual...
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