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Mar 24th, 2015 - pigaPLLC1   4 

I am having trouble getting reimburse on 87999. Does anyone know anything about this or does it require a modifier?

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Mar 24th, 2015 -

re: I am having trouble getting reimburse on 87999. Does anyone know anything about this or does it require a modifier?

That is an unlisted procedure code that is found in all the catergories of the CPT® book. To use unlisted procedure codes you should submit a Special Report that suppports the documentation along with the billing that provides a description of the procedure and why it is being done. If you read the guidelines found at the beginning of all chapters on the CPT® book it gives you a description of how to use these codes.....Are you sure there is not another suitable code you could be using??

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Mar 24th, 2015 - pigaPLLC1   4 

re: I am having trouble getting reimburse on 87999. Does anyone know anything about this or does it require a modifier?

thanks for the information. This code 87999 is being with 87804 & 87804-59. The doctors received a new machine to get testing more accurate and she was advised by the rep to use 87999.

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Mar 24th, 2015 - Codapedia Editor 1,399 

re: I am having trouble getting reimburse on 87999. Does anyone know anything about this or does it require a modifier?

Reps are not always reliable sources of coding information. Many can be very informative and helpful, because their companies have coding research. But, you always need to verify for yourself.

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Mar 25th, 2015 - LBAROGIANIS 250 

re: I am having trouble getting reimburse on 87999. Does anyone know anything about this or does it require a modifier?

There are no RVU's and and it's integral to the laboratory test, and usually billed by a pathologist. Maybe there is a better code out there you can use. What are you trying to get paid?

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Mar 25th, 2015 - LBAROGIANIS 250 

re: I am having trouble getting reimburse on 87999. Does anyone know anything about this or does it require a modifier?

Oh if you are a provider that does not have clia certification , you will need to add modifier QW (Clia waived).

Found this on another site: See supporting documentation:

http://www.medscape.com/viewarticle/587649
New instructions in the microbiology section indicate that, when separate results are reported for different species or strains of organisms, each result should be coded separately. Use modifier 59 when separate results are reported for different species or strains that are described by the same code. For most family physicians, this may only be relevant in one instance: reporting codes 87804 and 87804-59 when testing for both Influenza A and B.
http://blogs.aafp.org/fpm/gettingpaid/tags/medicare
hen providing in-office testing for influenza, code 87804QW represents CLIA-waived testing for influenza by immunoassay with direct optical observation. Most rapid tests do not differentiate between Influenza A and B. However, for those that do produce two separate results, payers may accept 87804QW on one claim line and 87804QW59 on a separate claim line. As always, you should check with your individual payers for specific coverage and billing guidelines.
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