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Tag Archives: Testing

Glutamic Acid Decarboxylase Autoantibody testing

Posted on by
Does anyone have reference documents for CPT reporting to share on Glutamic Acid Decarboxylase Autoantibody testing?

In googling information it looks like CPT code 86341, Islet cell antibody, may be appropriate but cannot find supporting coding references.

I’m unable to locate an index entry in CPT for this. Thanks for any assistance.

Medical Billing and Coding Forum

Neuropsychological Testing by Tech HELP!! :)

Posted on by
Need some help!

When billing for CPT codes 96138 and 96139 Neuropsychological testing by Technician, (1st 30 min and each additional 30) Who is the billing provider?

there is a post doctorate fellow performing as the technician, and the supervising PhD will be completing the reports, etc. I assume it is billed under the supervising? I have never used these codes and this is a new service we will be thinking of doing.

anyone have experience with this?

Thanks!

Medical Billing and Coding Forum

Oral Fluid Drug Screen Testing

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We are a CLIA approved lab that does in-house urine drug screens using cpt code 80305 with modifier QW. Recently our clinic started offering Vivitrol injections and part of the patients therapy is to be drug screened. It was decided to do the drug screens using oral fluid due to the swab being capable of detecting the presence of alcohol along with 13 other drug classes through optical observation. Some of the medical staff are concerned that this method isn’t CLIA approved and another would like to test for both the urine and the oral fluid; so can anyone tell me if there is a specific brand of swab we need to use or it doesn’t matter as long as it is coded once per day with 80305 – QW. Any input would be appreciated.

Thank you,
Lisa

Medical Billing and Coding Forum

Tech Testing

Posted on by
Hello – A patient comes in for testing with a technician ordered by Dr. B. Dr. B does not review the results until the patients appointment a few days later, can you bill globally for the test on the day the test was administered? Or do you have to bill with a TC modifier on the day of testing and 26 on the day of the Dr visit?

Thank you!

Medical Billing and Coding Forum

Drug Testing for Oral Fluid instead of Urine

Posted on by
I’m with an SIU and we are consistently seeing labs that are billing for Oral Fluid Drug Testing using the G0480-G0483 series codes. Does anyone have a better code recommended for billing using Oral Fluid drug testing in both Pain Management and Substance Abuse?

We usually follow Medicare Guidelines and our Policy is based on the LCD for UDT’s and we are having difficulty finding any guidance surrounding Oral Fluids as LCD L36393 only mentions Oral Fluid in a very general sense, everything is aimed directly at urine. There are no specific CPT or HCPCs codes mentioned as appropriate to be used for Oral Fluid testing or guidance.

We did locate 0011U-Prescription drug monitoring, evaluation of drugs present by LC-MS/MS, using oral fluid, reported as a comparison to an estimated steady-state range, per date of service including all drug compounds and metabolites. This is listed as a PLA code but I’m not entirely sure what would be required to verify that the lab performing this service is properly set up to perform this service.

Any help would be greatly appreciated.

Medical Billing and Coding Forum

Billing an E/M when patients come in to review testing results

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Is it acceptable to bill an E/M level of service when a patient comes in to discuss/review testing that was done? Should an E/M level 99211 be appropriate for billing, or should the visit be coded based on time spent counseling the patient? Currently, the provider is billing an established patient level of service, usually a 99213 or 99214. The provider documents a History, Exam, and MDM.

Any thoughts?

Thanks,
Cheryl

Medical Billing and Coding Forum

Impact Testing for Concussions

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I have been trying to research this and I am getting mixed results. Example: pt presents to ortho for post injury impact testing. Provider documentation supports the E/M visit along with the impact testing. We have been billing the E/M along with the 96120 for the impact testing. Some carriers are accepting these with a 25 modifier on the E/M with no issue, but the majority are denying these stating that they are bundled with the E/M. I have conflicting information on whether the 25 should be used, information stating that the 96120 needs a modifier, and another source stated that we should be using a psych dx in addition to the concussion dx. Can anyone give me any guidance on this?

Medical Billing and Coding Forum