AHA Coding Clinic® for HCPCS - 2004 Issue 1

Clarifications and corrections

In Coding Clinic for HCPCS, Third Quarter 2003, we addressed the appending of modifier 59 or 91, when a patient has a laboratory panel performed and then due to an abnormal result a repeat test is performed. On further clarification from CMS, the correct coding initiative (CCI) edits won’t allow the appendage of modifier 59 with repeat laboratory tests. The CCI edits will only allow modifier 91 for the reporting of a repeat laboratory test that was part of a laboratory panel or a laboratory test completely different from the laboratory panel performed. Although coding guidelines dictate the...

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