Wiki Billing same set of codes twice for same date of service

[carrie.leeman@pehp.org]

Is a lab provider able to bill the same set of codes twice (84311, 83516, 86140, 87499) on the same date of service if one sample was taken from the left knee and the other from the right knee?

 

[MrLittlefoot]

Yes. Assuming they are two different samples that the same tests were run on. You would just have to bill a modifier 59 or one of the XE,XU,XS,XP modifiers depending on why you ran both samples and who you are trying to get to pay for the service.

 

[danachock]

reply - billing same set of codes twice for same DOS

Yes you may bill the tests for each knee, with a necessary modifier, but may I offer my two cents working rejections on how to assist your claim getting out the door for procedures 84311, 83516, 86140, 87499 -
84311 is a spectrophotometry, analyte not elsewhere specified. Please be sure to add a procedure description.
I also deal with 83516 all the time and that test could be several different tests - please be sure to add procedure description.
87499 I'm unsure about - almost seems like an unlisted procedural code but not in either of my CPT books.
Thanks for listening & have a great evening,
Dana Chock CPC, CANPC, CHONC, CPMA, CPB