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Pathology/Lab Coding Alert

READER QUESTIONS:

Unravel This Flow Mystery

Published on Tue Mar 24, 2009

Question: We-ve started using modifier GD to override the MUE limits for flow cytometry when medically necessary. We recently received a denial from our carrier for a panel with 24 markers when we used the modifier with 88185. The denial said that the GD modifier is not recognizable. How can we report this flow panel so that we can get paid? Tennessee Subscriber Answer: You should not need to use a modifier to report a single flow cytometry panel with 24 markers. The correct coding is as follows: - 88184 -- Flow cytometry, cell surface, cytoplasmic or nuclear marker, technical component only; first marker - +88185 x 23 -- - each additional marker (List separately in addition to code for first marker) - 88189 -- Flow cytometry, interpretation; 16 or more markers. You can see from the code definition that you should list one unit of add-on code +88185 for each marker beyond [...]
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