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Thread: Coding rapid flu testing

  1. #1

    Default Coding rapid flu testing

    Does anyone know how to code for the rapid flu test. Each rapid flu test is for both influeza A and B viruses.

    My thought was 87804x2 with a 59 modifier. Please advise

  2. #2
    Join Date
    Apr 2007
    Location
    SALEM NH
    Posts
    283

    Default

    We bill the rapid flu test with 87275 (b) and 87276 (a)

  3. #3
    Join Date
    Apr 2007
    Location
    Seacoast- Dover New Hampshire
    Posts
    604

    Default

    We use 87804.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  4. #4
    Join Date
    Apr 2007
    Location
    Kokomo, IN
    Posts
    769

    Default rapid flu

    Here's what CPT assistant has to say:

    Differentiating rapid influenza test, A and B strains on one device
    CPT Assistant, December 2007 Page: 15 Category: Bonus Issue
    Pathology and Laboratory

    Question:

    Please clarify whether reporting code 87804 two times, once with modifier 59 (87804, 87804 59), would be appropriate for differentiating rapid influenza tests; those providing separate, distinct results for both strains A and B on one device.

    Answer:

    The detection of both influenza A and B strains may be part of two entirely separate procedures or may be included within the same test device because these two analyses are not uncommonly requested by the clinician together. If the assays provided two separate results (eg, a result for influenza A and a result for influenza B), two units of 87804 would be appropriate. Modifier 59, Distinct procedural service, may be used to indicate that the two results represent separate services, when two units of 87804 are submitted.




    CPT Assistant © Copyright 1990–2009 American Medical Association. All Rights Reserved

  5. #5
    Join Date
    Apr 2007
    Location
    Colorado Springs
    Posts
    173

    Default

    We were told by the manufactorer of our rapid flu test to bill like this:
    87804
    87804/59
    One unit on each.
    We've been doing this for months and have no problems getting it paid.

  6. #6

    Unhappy Rapid Flu Test

    I just got a denial from Medicaid for duplicate line item for my rapid flu test A & B. I billed them as 87804 QW and 87804 QW, -59. Any suggestions? I had also billed for an E/M. Do I use a modifier -91 or -99 on the second flu test?

  7. #7
    Join Date
    Apr 2007
    Location
    Columbia, MO
    Posts
    11,896

    Default

    Quote Originally Posted by DianeLundberg View Post
    I just got a denial from Medicaid for duplicate line item for my rapid flu test A & B. I billed them as 87804 QW and 87804 QW, -59. Any suggestions? I had also billed for an E/M. Do I use a modifier -91 or -99 on the second flu test?
    On your second item the 59 needs to be first the QW second

    Debra A. Mitchell, MSPH, CPC-H

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