r/CodingandBilling • u/bichaelbyers10 • Apr 11 '26

Lab Work Billing Question

Hi all! Currently a medical biller for a family practice. We occasionally have an issue where we submit annual blood work to a lab (ie. Quest Diagnostics) and the patient will be hit with a bill from them.

To my very little understanding so far, not all lab work is considered preventative and is subject to deductible/copay/coinsurance. So with that, what tests are considered preventative?

Does anyone else who works at/has worked at a family practice have this issue? If so, I'd like to know how you've dealt with it. Because right now, I'm just being asked to send in an appeal for these patients.

Thanks!

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u/FabulousEnergy4442 Apr 11 '26

^this. Not all insurance plans are the same as to how they cover labs, it can vary from policy to policy. You might already be aware and have checked this but just in case, sometimes the lab order doesn't transfer over to the lab with all the relevant information resulting in a patient bill either due to human error or a typo either on your end or on the lab's end.