AAPC - Back to school
Results 1 to 5 of 5

Thread: 87804 and modifier 92

  1. #1

    Default 87804 and modifier 92

    AAPC: Back to School
    Can modifier 92 be used with87804? Given in office.

  2. #2
    Join Date
    Apr 2007

    Default Modifier 92

    I don't believe that modifier 92 is the correct modifier to use with 87804 Influenza. If you are doing both the Influenza A and B tests then you would bill 87804 and 87804-59 to get paid for both. Most insurances I have found will pay for both when you bill this way. I hope this helps!

  3. #3


    Medicare will not pay with the 59 modifier on the second 87804. Since 87804 cannot be quantity billed we have billed Medicare as 87804 and 87804-76.

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    The correct modifier would be the 91 for repeat lab

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Join Date
    Apr 2007
    North Carolina


    I find that this can become carrier discretion. My carriers recommend 59. CPT Assistant, dated 5-2009, also recommends this...

    Whether to report one or two units of code 87804, Infectious agent antigen detection by immunoassay with direct optical observation; influenza, varies according to the type of rapid testing method used distinguishing influenza A from influenza B. The rapid detection of influenza virus types A and B may be part of two entirely separate procedures or may be included within the same test device. If the assays provide two separate results (ie, a result for influenza virus A and a result for influenza virus B), it would be appropriate to report two units of code 87804. When two units of code 87804 are submitted, modifier 59, may be used to indicate that the two results represent separate services (codes 87804 and 87804-59).

Similar Threads

  1. 87804, help please!?
    By nreynolds in forum Billing/Reimbursement
    Replies: 4
    Last Post: 06-11-2015, 11:11 AM
  2. Modifier for cpt 87804
    By SHERRY SCHEXNAYDER in forum Modifiers
    Replies: 3
    Last Post: 04-15-2015, 02:50 PM
  3. CPT 87804 with modifier X{EPSU}
    By Squiabro in forum Pathology & Clinical Laboratory
    Replies: 5
    Last Post: 02-05-2015, 10:19 AM
  4. 87804
    By cingram in forum Internal Medicine
    Replies: 0
    Last Post: 06-12-2012, 10:51 AM
  5. 87804
    By klp010102 in forum Family Practice
    Replies: 4
    Last Post: 10-29-2009, 09:27 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.