On the CMS-1500 claim form, Box 20 tells the payer whether any of the billed services were purchased from an outside laboratory. This guide explains what the box means and how Pabau handles it.
NOTE: This article is part of the US Insurance Billing Additional Resources series, which walks through every box of the CMS-1500. If you are new to claims in Pabau, start with Creating a US Professional (CMS 1500) Claim.
Box 20 — Outside lab? / $ Charges
Box 20 carries a YES / NO pair of checkboxes and a $ CHARGES cell. Marking YES means a service on the claim — typically a lab test — was performed by an entity other than the billing provider and purchased from it, with the outside lab's charge reported in the amount cell. Marking NO means every service was performed by the billing provider.
How Pabau fills it
Pabau always marks NO on the printed form and never sends outside-lab charges on the electronic claim. Billing for purchased services is not supported — the same stance most practice management systems take — and there is no field for it in the claim editor. For the typical claim, where your practice performed everything it is billing, NO is exactly right and there is nothing to do here.
If you do need to report a purchased service to a payer, correct the claim in the Claim.MD portal after sending it (open the claim there and use Manage Claim), or hand-fill Box 20 on the printed form before mailing it.
To follow your claim after it is sent, see Tracking Electronic Claim Submissions.