Wiki Modifier with 81003 and go477

[marynichols79]

If we are doing a Drug Screen and a Urine dip with a possible UTI or other Urine issues, Is there a modifier that can be used showing they are totally separate. We have used 59 and 91 and both were denied. thank you for any help...

 

[jrclark1987@yahoo.com]

This may help you. We were running into denials as well. I found this article and have appended mod 25 on the E/M's and it has been paying so far. http://www.medicarepaymentandreimbursement.com/2016/08/cpt-codes-81001-81002-81003-and-81025.html

 

[jkyles]

59 would be the correct modifier (91 means the exact same test was performed), but some payers interpret the definition of the G codes to mean NO interpretive tests are allowed, ever. It may work to submit an appeal explaining in detail the patient's symptoms etc that made the separate UTI necessary.