For non-Medicare-based plans, multi-channel blood chemistry tests are processed differently than organ- or disease-oriented lab panels in that they are first reviewed to determine if, when considered together, some or all of them compose an organ- or disease-oriented panel.
Tests that do constitute a complete panel will be processed as a panel, subject to the eligible charge for the appropriate panel, as shown in Processing and Reporting of Organ- or Disease-oriented Lab Panels - Non-Medicare-based Plans.
The remaining tests, those that are not part of a panel, are bundled into an ATP code (representing the total number of remaining tests, e.g., ATP03 for three tests), and processed as shown in the table:
Blood chemistry laboratory tests
| Codes Billed | Codes Used to Process | Codes Reported | Basis for Payment |
|---|---|---|---|
82947 84132 84520 | ATP03 | 82947 84132 84520 | Payment is based on HMSA's eligible charge for ATP03 ($11.45). If payment is made at 100 percent of the eligible charge, the payment amounts will appear on the RTP as in the example here: 82947 - $11.45 84132 - $0.00 84520 - $0.00 |
Note: In this example, each processed line also will include a message explaining that it was based on the eligible charge for ATP03.
The payment amounts shown in the examples in this section are for illustration purposes and may vary depending on any negotiated arrangements between the provider and HMSA. The percent of eligible charge that is paid also may vary depending on the member's plan benefits.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform |