I am looking for documentation stating whether or not you can bill for contaminated specimens.
For example, if urine culture results are resulted as contaminated.
My research for documentation found that the CPT code 87086 all components are not met as the definition is culture, bacterial; quantitative colony count, urine. This code should not be reported as in the instructions for instructions for use of the CPT code book it states that we cannot approximate services provided to code selection"
There is also the modifier 91 for repeat lab test, and CMS states that it is inappropriate to use this modifier for labs that have specimen issues. you would only get paid for running the test once. https://med.noridianmedicare.com/web/jfb/topics/modifiers/91. on a side note, I am concerned that medical necessity of the test is lost if it is not repeated as the results were not then needed for treatment of the patient.
Thank you in advance!
For example, if urine culture results are resulted as contaminated.
My research for documentation found that the CPT code 87086 all components are not met as the definition is culture, bacterial; quantitative colony count, urine. This code should not be reported as in the instructions for instructions for use of the CPT code book it states that we cannot approximate services provided to code selection"
There is also the modifier 91 for repeat lab test, and CMS states that it is inappropriate to use this modifier for labs that have specimen issues. you would only get paid for running the test once. https://med.noridianmedicare.com/web/jfb/topics/modifiers/91. on a side note, I am concerned that medical necessity of the test is lost if it is not repeated as the results were not then needed for treatment of the patient.
Thank you in advance!