Wiki 82491 Denials

[danachock]

Hi - I am hoping someone can help with an issue I am having with these denials. Our lab does a send out on the Prometheus Thiopurine Metabolites - that laboratory test requires us to bill out 82491 x2.
We are finding with many of our payers that they will pay for the first one, but won't pay for the second one. At this point I feel we have tried everything - using 59, or 76, or 91 modifier. I was told to process them under CPT 82492 instead. Does anyone have any thoughts or success billing this out?
Thanks for any advice in advance on this,
Dana Chock, CPC, CCA, CANPC, CHONC
Anesthesia, Pathology, and Laboratory Coder

 

[Quinnies]

I hope this helps

PROMETHEUS(TM) Thiopurine Metabolites
CPT Code
82492

Includes
6-thioguanine (6-TGN) and 6-methyl-mercaptopurine (6-MMPN)

Preferred Specimen(s)
5 mL whole blood collected in a EDTA (lavender-top) tube

Minimum Volume
2.5 mL

The test you are billing as 82491x2 is bundled in the 82492. And is reimbursed approx. at $49.26.