modifier -90 discussion

[Girlzsmom66]

When I read the note behind modifier 90, I am understanding that it is not necessary to include it. Am I reading this correctly?

The other discussion that is happening in our clinic is, some insurance companies are denying claims that we are sending out with -90. We are paying the lab directly, so we are billing the insurance companies our send out labs. In this scenario, we should or should not be using the -90? My supervisor insists we should be using it and also should be using -92. (She is not certified in coding)

Thank you for any input you have!

 

[erjones147]

I do not know about the modifier -92 suggestion, but your lab situation is the same as ours

We do bill all sendout labs with modifier -90 for private insurance and just take the write-off if the insurance company refuses to pay. We don't even bother with Medicare