Wiki pathology lab test modifier question

[tonplair@gmail.com]

Our office is now billing for pathology lab test that are been sent to hospital but hospital only bill for certain insurance and therefore the office has to bill the insurance compaines that the hospital doesn't. We are billing flow cytometry and they are running the lab 88185 from anywhere between 10 to 20 times and of course the insurance company thinks it is a duplicate because our billing system will not allow us to bill that test once with how ever many units we have to billed each line separate causing it to dup. Can anyone tell me what modifier we should use to bill these lab test should we bill using modifier 59 or 91? Any feed back on this as soon as possible would be great. Thanks

 

[rcoslett]

would recommend 59

59 is indicating "distinct separate testing event"; 91 indicates a test is repeated, the same test repeated. Flow reports are indicating results for multiple CD markers and are distinct and separate tests done on the same machine. Hope this helps.

 

[karthik.pinnoju@gmail.com]

I think we have to use modifier 91 as it is diagnostic laboratory test repeated