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Wiki Medicare vaginal cultures

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ashfaye814

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Curious if anyone has any insight on billing out diagnostic vaginal cultures (affirms) for medicare patients? We've been using 87800, but they're increasingly coming back as denied. I've scoured the internet trying to find an alternate code, but am coming up empty. Any info would be greatly appreciated!
 
First - are you the lab processing the culture, or the clinician collecting the sample?
If you are the clinician, this work is included in the visit. Any of the lab codes (80000 series) are to be used by the laboratory/pathologist performing and interpreting the actual testing/specimen. There is a code 99000 for Handling and/or conveyance of specimen for transfer from the office to a laboratory, but I am not aware of any payor that would not bundle this into the visit, and we do not use this code at all.
If you are the lab, the testing is looking for specific items - such as candida, trich, and/or gardnerella. There are specific CPT for each of these. Take a look at 87480, 87510, 87660 to see if those are more appropriate.
 
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