Wiki Using modifier 59 w/Quantitative Drug Testing

[cvpeachy@yahoo.com]

We are a toxicology reference lab. There seems to be some confusion with our coders/billers as when to bill tests that have one CPT code such as 82542 with just multiple units or multiple units and modifier 59. We are confused as to why we would bill both? ie..82542-59 7 units.

 

[danachock]

modifier 59

It really depends on who you are billing.
I have a cheat sheet for many different tidbits I am coding whether its anesthesia, pathology or labs.
Unsure which program you are using for coding, but we use Epic. Whenever I would come up on a problem especially consistent denials - I would have my go to tech person create an edit and drop that code into my work queue to take care of it's needs (adding description, adding modifier, changing it from billing x number of line items to billing it out as a quantity instead because THAT IS HOW THEY - the insurance company wants it billed).
Dana Chock, CPC, CCA, CANPC, CHONC
Anesthesia, Pathology, & Laboratory Coder

 

[beck2004]

How to bill (3) Units of CPT 80299

When testing (3) different drugs, do you bill 80299x3 or 80299
80299-91
80299-91
The description of the drugs will be added to the claim.
We bill Medicare and commercials.

Any help will be appreciated.

Thank you.


Violeta A Collier, CPC