Part B Coding Coach: Flu Test Status Got You Stumped? Follow This Expert Advice

Why This Topic Matters

Influenza testing is common in outpatient settings, but coding can vary based on the test type, the number of results produced, and payer-specific edits. Understanding the article helps avoid mismatches between the performed test and the claim submitted.

Article Sections

1. Overview of influenza test coding considerations

   Introduces the general issue of flu test reporting in office settings and explains why test method and product type matter. It frames the article’s focus on unit reporting and modifier use.

2. Report 87804-QW for optical analysis

   Discusses CLIA-waived office testing and the broader distinction between optical observation and laboratory methods. It also addresses payer variation in reporting guidance.

3. Apply 87804 coding rule to 3 flu products

   Reviews how different influenza test products can produce one or more results and why that affects reporting. The section compares several commonly used test products in an office setting.

4. Consider 2 alternatives for 87804 denial

   Describes general payer-denial scenarios involving multiple reporting of the same service and discusses fallback approaches involving alternative modifiers. It emphasizes payer communication and documentation considerations.