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laboratory billing

  1. T

    Wiki Modifier 59 When to use?

    My billing team has been questioning me if we can use modifier 59 for these two different scenarios, and I am really unsure of the answer. Hoping someone can help me. Scenario 1: Gastro referring provider takes two specimens during a procedure. The ordering provider sends one of the specimens...
  2. A

    Wiki Mue

    My laboratory has developed a new panel in which there are 14 pathogens being tested that fall under the non-specific code 87798. The MUE for this code is 13. Can we only bill for 13 units of 87798 even though we are performing 14 units of 87798?
  3. J

    Wiki 59 modifier

    I work for a genetic testing laboratory, we currently bill CPT 81229 (CMA) and 81243 (Fragile-X) together and we have always billed these with a 59 modifier on the 81243 with great success. Recently, we have had a couple of Regence payers deny the 81243 -59 as inappropriate coding combination...
  4. J

    Wiki History of blood transfusion

    Good afternoon! My provider is ordering a hepatitis test for a patient with a PMX of a blood transfusion and she wants to know if that dx would be covered. What I am trying to find out, covered or not, what is the correct way to code for this? The only code I find is Z51.89 encounter for other...
    • jliving77
    • Thread
    • blood born illness family practice history of laboratory billing
    • Replies: 1
    • Forum: Diagnosis Coding
  5. D

    Wiki Bundling Issue with Charges from a Hospital/Hospital-Owned Clinic

    Good Morning, Everyone! I'm coming at this question from a payer's perspective. We have received two separate bills for lab charges. One for a 81003 from a clinic and one for a 81015 from a hospital. The hospital owns the clinic, and both share the same federal tax number, as well as the same...
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