Wiki BIOFIRE Respiratory Panel testing in-office Documentation

[awberry@charterinternet.com]

Our office has purchased the machine that performs the BIOFIRE Respiratory Panel in-office and there are many questions from providers about sufficient documentation to meet medical necessity. In reading this test is a "Highly Audited" test. We are located in North Carolina and I would like to know if there are other practices currently using this machine that could share experience with billing and documentation. My concern is should there be a office visit when billing for the test. The PLA code is 0202U. There are CPT codes of 87631-87633 that could be billed for this test as well.

Any help is greatly appreciated.

 

[leidys73]

I have the same question. We just started using Biofire and I can't seem to find any help online.

 

[BrandiDove]

We always bill an office visit with the 0202U.

 

[massmtngirl]

Hi all, I know this is an older thread but I'm curious if anyone has any recent experience with the BioFire testing. Our clinic just switched over and was given this guide from the rep for billing but we've been having a heck of a time getting any private payer to pay on this. Any input is greatly appreciated!

Reimbursement/ Coding-

RST Mini ALL payors	RST Large Panel (AMA billing Guidelines) Medicare of CO, with ICD codes from group 1&6	RST Large Panel (NCCI Billing Guidelines) Medicaid of Colorado BCBS
R Side (5 Targets)	ST Side (5 Targets)	R Side (15 Targets)	ST Side (14 Targets)	R Side (15 Targets)	ST Side 14 (Targets)
87631-QW	87631-QW 87651-QW	87632-QW + 87486-QW + 87581-QW + 87798-QW	87632-QW + 87486-QW + 87581-QW + 87798-QW+ 87651-QW	87633-QW	87633-QW

**The yellow highlighted CPT codes are additional bacterial codes to enhance reimbursement. 87651- STREP should be used always when doing the ST side of the test for 87631 & 87632. QW is the CLIA waived modifier. Medicare does require proper coding for the large panel for medical necessity. Code stacking is not recognized with 87633**