by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Feb 13th, 2019
This question was asked on the following lab codes used for testing during pregnancy. "Can the codes below be billed together? 87491- 59, 87591-59. 87081, 87150."
YES- CPT code 87081 is used when a specific pathogen is suspected and is appropriate.
YES- (X2) 87150 is used for culture, typing, and identification by nucleic acid (DNA or RNA) probe, amplified probe technique. However, this code is used per culture or isolate, each organism probed and includes both codes below 87491 and 87591. Therefore, you would report if appropriate 87150 X2 UOS. According to the MUE edits assigned it would be appropriate to report up to 12 cultures, typing, and identification.
NO - 87491 (Included in 87150) used when looking for detection by nucleic acid (DNA or RNA), using an amplified probe technique, for Chlamydia trachomatis.
NO - 87591 (Included in 87150) also used for detection by nucleic acid (DNA or RNA), using an amplified probe technique, for Neisseria gonorrhoeae.Modifier 59 would not be applicable on either of these codes as 87491 and 87591 are bundled into 87150 unless there is specific documentation with an educated decision to use modifier 59.
For information on Nucleic Acid Probe review the NCCI Edits Manual under Pathology/Lab services.
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.
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