Wiki Urine Drug Screen Test billing

[cluke]

We have just begun Urine Drug Testing in our pain clinic, which we initiate prior to developing a treament plan. We test for 10 different drugs.

The first few I have billed to Medicare as 80101 have been denied. They have stated that this code can not have more than a quanity of 1 and suggested I bill this same code 10 times with a repeat modifier on the last 9 claims lines.

Does this sound right to anyone.

Any advice would be greatly appreciated.

 

[heatherwinters]

80101 modifier 91

Check this out
http://www.health.state.mn.us/auc/hcpcsclosed2005.pdf

52. Billing Multiples of Same Procedure
How do payers prefer to see multiple procedures billed when using the same CPT? Example, CPT 80101 billed nine times. Which of these three options is preferred?
1. One line showing 9 units? If so, should a –91 modifier be applied?
2. Two lines showing 1 unit on the first line and 8 units on the second line with the –91 appended?
3. Nine separate lines with a –91 appended to lines 2 through 9?
(Gretchen Thomson – SMDC)
RECOMMENDATION: BCBSM, Medica, HealthPartners, MHP, UCare, and Preferred One – bill one line
showing 9 units; no modifier required. Preferred One and Medicare B – bill nine
separate lines on the same claim with –91 appended to lines 2 through 9.