Wiki 82784

[hdwyrick]

Per the CPT book 82784 Gammaglobulin: IgA, IgD, IgG, IgM, each: Does this mean that if the provider orders each of these, we can bill 82784 X4? Or if he ordes just the IgG that this code is going to take care of all billed as X1? If the answer is X4, how do you bill on the claim form to get paid? Please advise....

 

[danachock]

Hi hdwyrick;
This is one of those CPT's I actually have stopped in my laboratory work queue to review because if multiple tests are ordered I need to make sure I add the necessary description of the test being done for each procedure prior to billing.
It is very common for me to see the IgA, IgG, and IgM done on the same DOS and I really want to secure reimbursement by identifying each laboratory test being done prior to billing the claim out.
I actually found that using the 59 or 91 modifier will still require a procedure comment or you will with little doubt have to appeal these with the laboratory results and documentation identifying each laboratory test that was done.
Hoping this helps,
Dana Chock, CPC, CCA, CANPC, CHONC, CPMA, CPB
Anesthesia, Pathology, & Laboratory Coder

 

[mcastold]

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.

Good luck.

Mike Castoldi
Laboratory Financial Compliance Analyst