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Thread: modifiers question

  1. #1

    Default modifiers question

    AAPC: Back to School
    As a beginner I started to code labs. There were many cases when on the same form were marked both a comprehensive metabolic panel (80053) that includes total protein(84155) and protein electrophoresis with the same 84155. The software promted me to add a modifier 59 or 91 in order to proceed. I thought that 91 is inappropriate because it seemed to be the same sample done for different markers by different technology and not a subsequential test for the same marker, and therefore I added 59. However, during one of the last seminars at work we were told that it should be 91 . Please help me with my confusion. If I really was wrong putting 59 for a long period of time did I cause a lot of damage in terms of overbilling and what should be done to fix it(all of it happened 5 yr ago).

  2. #2
    Join Date
    Apr 2007
    Des Plaines, Il

    Default CMP Panel-80053

    Good Morning,

    You mentioned that your coding practices occurred approx., 5 years ago. I'm not sure about that timeframe but my current CPT Book shows that the "Total Electrophresis" is not even a component of the CMP Panel. I show it listed as-84165, so I would imagine if this was the case back then, there should have been no modifier use at all, please come again?

    John A., CPC

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