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80101 and Medicare...Please help

  1. #1
    Default 80101 and Medicare...Please help
    Medical Coding Books
    I really need some clarification on how to bill CPT code 80101 to Medicare. The laboratory I work for screens for ten different drugs (qualitative). Should 80101 be entered one time as 10 units or should it be entered 10 times individually (example: 80101, 80101, 80101, 80101, 80101, 80101, 80101, 80101, 80101, 80101)? Does a modifier (e.g. modifier 59) need to be added?

  2. Default
    For Medicare, our office uses G0431. They changed as of April 1st from using the 80101 to using the G code. I'm not sure about your office, but ours uses a QW modifier with ours. And they pay for 9 units. If we send more than that, they deny it. Not sure if it's what you need, but that's the way we bill for Medicare.

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