Wiki Modifier for Glucose Testing


State College, PA
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Hello! I have a claim where a Glucose fingerstick (82948) and a Glucose blood sample (82947) were done on the same day. My scrubber kicked this out saying that these two codes can't be billed together. Can I append modifier 59 to get the insurance to pay for both of these tests? Thank you!
Hi krr1420,
"If appropriate", 82948 would need a modifier to be billed with 82947 on the same day of service. I am unsure of the payer so cannot properly predict (modifier 59, XE, XS, XP) for this scenario. I don't have additional details but will provide a few if that is alright, please.
#1) Possibly, patient presented to a convenient care facility with Provider A and due to their symptom(s), they performed an 82948 test and based on the results possibly sent the patient to the ER for immediate follow up which Provider B ordered 82947. It would be appropriate based on payer to bill 82948 with either Modifier 59 or XE (separate encounter) or XP (different provider). But please only assign one modifier based on the circumstances. Do not use them all; that just creates denial madness.
#2) Patient presents to a medical facility lets hypothetically state the Emergency Room with symptom(s) so Provider C orders an 82948 that is performed and let's say for this example it's just simply horribly abnormal, so they (Provider C) have to stabilize it with medication or elsewise and also to confirm that it has been stabilized later that DOS (day of service) so the patient may be discharged so they order an 82947. Again, I am unsure of the payer so cannot properly predict modifiers so I would use either Modifier 59 (distinct/separate service) or XS (separate site - finger stick versus venipuncture draw) or even XE (separate exam - first one was probably provider taking the sample and the second was the lab technician stopping in the patient's room awhile later for a venipuncture) for this scenario in my opinion.
Hopefully I offered a scenario that you are faced with; if not please reach out and provide a few more details okay.
Have a fantastic evening & thank you for listening!