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88342 and 88361

  1. Default 88342 and 88361
    Exam Training Packages
    I bill for multi-specialties. I am having a problem understanding CPT's 88342 and 88361. Our providers are billing them on the same day, different invoices. One CPT will get paid, but when the other "hits" the insurance, the money is either retracted or one of the CPT codes is denied inclusive. What should I be identifying in the lab report that will indicate whether or not they can be billed together? I understand that we should not bill them together if they are for the same antibody. However, the report does not even read as talks about the specimen(s) specifically. What verbiage should I be on watch for?

    Sorry to sound so ignorant (I am on this topic). Just wondering if these are truly inclusive or if there is an opportunity to appeal. Any help offered is greatly appreciated!

  2. #2
    Frederick, MD
    Our office uses the 59 modifier on the 88342 when using 88360. Perhaps this would work? If that fails we send in the Path Report.
    Always Seeking

  3. Default 88342 and 88361
    It's worth a try, thanks a bunch!

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