Wiki bcbs of il 88305 and modifier 59 and 91

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bernielozada

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Billed 88305 with 2 units and bcbs of il only paid for one stating a modifier 59 or 91 was needed. Since when? I thought modifier 91 was for repeated tests, this is not a repeated test, this is for 2 units. Am I missing something? Help!:
 
I'm not sure how long but BCBS has been requesting a modifier 59 or 91 to pay more than 1 unit for biopsies. They will pay with the added modifier. You can advise BCBS over the phone that the modifier has been added and they will reprocess and pay the claim right away.
 
Thanks for the information on the modifier 59, but I need to find in writing when this change too place. Can you tell me how you heard about this change? I can't find anything in the Blue Review (Illinois) or CMS Guidelines. I really need to show my supervisor this change. Thanks!!
 
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