87481 Billed with multiple units HELP!!!! Insurance will only pay 1 unit

Sue2424

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Benton, IL
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We have been billing code 87481 with 4 units and the insurance companies are only paying for 1 unit. We have billed with and without modifier 91, w/mod 91 we got denial. Multiple Ins. companies are wanting to process only 1 unit. PLEASE HELP ME WITH THIS ISSUE!!!!

CPT Code(s): 87481x4

Test Includes: Candida albicans, Candida tropicalis, Candida parapsilosis, & Candida glabrata

Any help or advice would be greatly appreciated!! Thank you!
 
Last edited:

CodingKing

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Thank you for your Help!!

Is there a way to code per strain??
No, its not given as an option because a CMS Workgroup decided that its so common to test for multiple strains that it's already accounted for in the RVU.
 
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