So I got an account with 19 units of 88341. I went to the MUE and allowing 9 to be billed and others are needing a modifier. I am not sure which modifier to use. I think it would be -91 because it was the same lab testing on multiple units. Payer is Medicare; they will allow 9 of them but the other 10 need modifier or we have to adjust them off. Any help would be appreciated.
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Wiki Multiple Units of 88341
- Thread starter hbarney1
- Start date
Sundancer
Networker
This MUE is a per line limit at least, no limit per DOS.
You bill the extra units of 88341 on additional lines, up to 9 per line, and add modifier 59 to the extra lines. So I am going to assume you have 20 total IHC single antibody stains and just aren't including the first one (charged as 88342x1) in this question leaving you with the 19 additional stains.
So 19 additional stains of 88341 would look like:
1st line: 88341 x9
2nd line: 88341-59 x9
3rd line: 88341-59 x1
I would not use modifier 91 here on surgical pathology. Mod 91 is for 'repeat clinical diagnostic lab test' i.e. CBC, CMP, etc. most usually. You're not rerunning a repeat test on the same day to obtain subsequent test results. You are showing that separate stain antibodies were performed on the specimen(s).
I hope that helps.
You bill the extra units of 88341 on additional lines, up to 9 per line, and add modifier 59 to the extra lines. So I am going to assume you have 20 total IHC single antibody stains and just aren't including the first one (charged as 88342x1) in this question leaving you with the 19 additional stains.
So 19 additional stains of 88341 would look like:
1st line: 88341 x9
2nd line: 88341-59 x9
3rd line: 88341-59 x1
I would not use modifier 91 here on surgical pathology. Mod 91 is for 'repeat clinical diagnostic lab test' i.e. CBC, CMP, etc. most usually. You're not rerunning a repeat test on the same day to obtain subsequent test results. You are showing that separate stain antibodies were performed on the specimen(s).
I hope that helps.
psacco
Networker
88341
when coding for multiple units over the MUE, it is our practice to use one of the new "X" modifiers:
88341 x 9
88341 x 9/"X"
88341 x 1/"X"
this is our companies policy due to medicare crying about the "misuse" of the -59 modifier.
we have no issues getting them paid.
when coding for multiple units over the MUE, it is our practice to use one of the new "X" modifiers:
88341 x 9
88341 x 9/"X"
88341 x 1/"X"
this is our companies policy due to medicare crying about the "misuse" of the -59 modifier.
we have no issues getting them paid.