Wiki 83925

[jennifersellards@hotmail.com]

In Florida toxicology mue is 4 for 83925 shoud this be billed with 4 units or on 4 seperate lines with medicare or commercial insurnace?

 

[Heather.Bonaminio@msj.org]

83925 is billed as quantity of 4 units, with the modifier 91 to indicate multiples of CPT 83925 for same patient on same date of service.
83925 91 Qty 4

 

[vazq123]

First you want to make sure it is appropriate to bill out the 4 units for the Opiates based on the testing performed and the method used.
Some carriers will accept multiple units per line for UDT and some will want to see you break it out on multiple lines with the appropriate modifier, just like any other service that can be performed with multiple units. You'll want to check with the carriers. The major carriers, BCBS, Aetna, etc. have claim check capabilities online and you can verify if they will accept it.

Be cautious when using modifier 91, even though it is a laboratory specific modifier it's intention is to be used when repeat testing is performed on a patient on the same day with a different specimen. Not to be used to bypass the carrier claims editing.

As per the CMS claims processing manual:

Definition - The ?-91? modifier is used to indicate a repeat laboratory procedural service on the same day to obtain subsequent reportable test values. The physician may need to indicate that a lab procedure or service was distinct or separate from other lab services performed on the same day. This may indicate that a repeat clinical diagnostic laboratory test was distinct or separate from a lab panel or other lab services performed on the same day, and was performed to obtain subsequent reportable test values.

If multiple services on different specimens are billed, the ?-91? modifier should be used to indicate that different levels of service were provided for different specimens.