tammy.devane@bcbsnc.com
Guest
Hi fellow CODERS! I hope this message finds you well. I am in need of some clarification around lab billing. I am not very familiar and would like to get some feedback.
our office is billing multiple CPT codes in the Microbiome area. One being 87798, as we know this is an unlisted code therefore causing request for records, denials etc. We are considering moving to 87801. This code is the same except it is for MULTIPLE strains as 87798 is for each strain. The question is, we also bill with other codes on the same claim to describe other strains tested for using the same sample. EX: 87653, 87491. These codes are incidental to 87801 so a modifier 59 would need to be added, however since CPT 87801 is for multiple strains, should it replace the other codes on the claim or be billed in addition to? to sum it up I am wondering if we can bill 87801, 87653, 87491 with the appropriate modifiers together when there was 1 test done, but multiple results yielded OR would the 87801 replace the other codes?
We also test for strains NOT listed in the CPT manual which is why the 87798 is being used.
Thanks in advance for ANY advise you can provide. It would be very helpful!
our office is billing multiple CPT codes in the Microbiome area. One being 87798, as we know this is an unlisted code therefore causing request for records, denials etc. We are considering moving to 87801. This code is the same except it is for MULTIPLE strains as 87798 is for each strain. The question is, we also bill with other codes on the same claim to describe other strains tested for using the same sample. EX: 87653, 87491. These codes are incidental to 87801 so a modifier 59 would need to be added, however since CPT 87801 is for multiple strains, should it replace the other codes on the claim or be billed in addition to? to sum it up I am wondering if we can bill 87801, 87653, 87491 with the appropriate modifiers together when there was 1 test done, but multiple results yielded OR would the 87801 replace the other codes?
We also test for strains NOT listed in the CPT manual which is why the 87798 is being used.
Thanks in advance for ANY advise you can provide. It would be very helpful!