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Wiki Lab Billing -code for various reasons

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torihamill

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I'm new to billing for labs. My client is using the same code for various reasons and getting denied for duplicate charges. Should I use the 76 or 59 modifier? Or do I need to change the quantity? They are non-par with all carriers.

Example: For one patient they billed CPT 83516 as a food panel test for an adrenal stress profile and also used CPT 83516 twice for Gliadin IGG AB on the same day.

Thanks
 
For repeat Lab tests on the same day, like when you test for A and B you would be using modifier 91. This modifier can be used on lab tests. You will more than likely get denials with the other modifiers you mentioned 76 or 59 because those are procedure modifiers to be used on EKGs, excision of lesions, not lab tests.

Janell Kangas, BBA, CPC
 
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