I am running into denials from BCBS and Medicare when we bill 87880,QW (quick strip strep) and 87650,90 (DNA probe for strep) on the same claim.

Sometimes the NP or the patient wants the additional test when the the quick strip does not give the expected answer.

The quick strip (87880,QW) is done at our clinic and the swab (87650,90) is sent to the lab.

Is it the 90 modifier?? (we are not a CLIA certified lab referring to another lab) or is it two tests for the same thing that the payors do not like? or something else entirely????