TCampbell5
Guest
We are having denials for CPT 87150, 87798, 87500, 87640, 87653, 87641, and 87651. The subsequent lines are being denied as bundled. Should we use modifier 59 or 91. Each line is for a different organism.
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Wiki Microbiology coding
- Thread starter TCampbell5
- Start date
I know this is a rather old post, but I would like to point that a laboratory panel should not be unbundled. Please see Medicare and Medicaid NCCI edit Manuals Chapter 10. In the introduction section it states:
"If a laboratory procedure produces multiple reportable test results, only a single HCPCS/CPT
code shall be reported for the procedure. If there is no HCPCS/CPT code that describes the
procedure, the laboratory shall report a miscellaneous or unlisted procedure code with a single
unit of service."
https://www.cms.gov/medicare/coding-billing/ncci-medicaid/medicaid-ncci-policy-manual
www.cms.gov
"If a laboratory procedure produces multiple reportable test results, only a single HCPCS/CPT
code shall be reported for the procedure. If there is no HCPCS/CPT code that describes the
procedure, the laboratory shall report a miscellaneous or unlisted procedure code with a single
unit of service."
https://www.cms.gov/medicare/coding-billing/ncci-medicaid/medicaid-ncci-policy-manual