Sdrivera
Contributor
Hi! I'm needing some assistance/guidance in how to properly bill 82784. I saw a previous forum post from 2015 with this answer:
Are these guidelines current today when billing 82784?
We have a provider who billed it as such to Medicare:
Line item 1: 82784 - 1 unit
Line item 2: 82784-91 - 1 unit
Line item 3: 82784-91 - 3 units
The first time the claim went out there were no modifiers and only line item 1 was paid. It then went out as a corrected claim with the modifiers and then line item 2 was paid. My assumption after researching is that 82784 is only allowed up to 4 units billed because there are only 4 immunoglobulins in the code description (IgA, IgD, IgG, IgM).
I am unable to locate specific guidelines/policies to correctly bill this code to Medicare. I was only able to locate the Medicare Claims Processing Manual: Chapter 16 - Laboratory Services.
Thanks in advance!
You definitely can bill that CPT for each test ordered, and most payers will want the quantity bundled on a single line with no modifier necessary (no line 19 description should be necessary as they're already assigned to the CPT selected).
If on separate lines on the claim, the 59 or 91 modifier (depending on payer interpretation) would be required on lines 2,3 & 4.
Are these guidelines current today when billing 82784?
We have a provider who billed it as such to Medicare:
Line item 1: 82784 - 1 unit
Line item 2: 82784-91 - 1 unit
Line item 3: 82784-91 - 3 units
The first time the claim went out there were no modifiers and only line item 1 was paid. It then went out as a corrected claim with the modifiers and then line item 2 was paid. My assumption after researching is that 82784 is only allowed up to 4 units billed because there are only 4 immunoglobulins in the code description (IgA, IgD, IgG, IgM).
I am unable to locate specific guidelines/policies to correctly bill this code to Medicare. I was only able to locate the Medicare Claims Processing Manual: Chapter 16 - Laboratory Services.
Thanks in advance!