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Pediatric Coding Alert

Influenza:

87804: Follow These Tips to Avoid Denials for Second-Strain Flu Testing Claims

Published on Fri Mar 18, 2011

When determining whether a patient has both A and B strains, look to your insurer regarding whether modifier 59 is required.If you perform two tests to screen for two different strains of the flu, do you report two line items of the same code? That's the issue in question as pediatric practices struggle to collect for multiple units of 87804 (Infectious agent antigen detection by immunoassay with direct optical observation; influenza).The answer, of course, depends on your insurer's policy, but in lieu of a written directive from your payer, the following tips can help you get your flu test coding on the straight and narrow.Report 87804-QW for Optical AnalysisCode 87804 describes the rapid flu test approved by the FDA requiring Clinical Laboratory Improvement Act (CLIA)-waived status. Use this code for detection by visual identification. Reporting tip: Many Medicaid states require you to follow Medicare modifier guidelines and append modifier QW [...]
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