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different specimens different referring dr's

  1. #1
    Default different specimens different referring dr's
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    I have two claims that went to Medicare the same day. Each have the same CPT codes billed. The issues is that there are two referring doctors. Do We need to just add the 59 modifier to the denied claim or is there a way to combine them in one claim and use units but still have two referring doctors noted?

    Thanks in advance
    Debbie Potts England
    Lyles, TN 37098

  2. #2
    I would use a modifier 76 or 77.

  3. Default
    I realize that replying now is not helping you but maybe someone will read this and it will help them. You should add a 59 modifier . the 77 and 76 modifiers are not correct on pathology services. I realize that our medicare plan doesn't mind them but many other insurances do as they are improper for different specimens, they should only be used on a repeat procedures

  4. #4
    Smile two referring physicians for 88305's
    We have tried using the 59 modifer but they still would not accept them. thanks for your help though
    Debbie Potts England
    Lyles, TN 37098

  5. Default
    I would file an appeal sending in both reports, I think it would pay. We file many appeals for this reason and are paid by almost all insurances, excluding medicaid, which we don't appeal to, because they have a one unit max on most codes ( although they do allow 2 88305s but they must be billed together on one claim with 2 units, if seperate claim lines they deny)

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