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Wiki 80053 and 80048

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tlccovert

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I have a question about using 80053 and 80048 together. I know that 80048 is bundled into 80053 and Edits say they can't be billed together even with use of modifier. What if these tests are drawn at 2 separate draws or even 2 different dates (visit over 2 day period)

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80048 with 80053

Hi tlccovert ;
Having both on same DOS isn't always billable together because 80048 is part of 80053.
When I see both done on same DOS (at the same time) I will ALWAYS contact my lab supervisor to review to see if it's appropriate to bill together or not.
If two draws are on same DOS but different time of day by same provider - I would apply the modifier to 80048 "if" documentation supports it.
Epic isn't always user friendly and doesn't provide one provider lab results another provider may have ordered for same DOS.
However if these labs are done on a different DOS - absolutely billable.
Hope this helps!
Dana Chock, CPC, CCA, CANPC, CHONC, CPMA, CPB
 
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