# 87798 Billing Multiple Units



## stacycallean (Dec 26, 2018)

Has anyone had to bill 87798 with multiple units to First Coast / Medicare Mac, for a clinical laboratory, POS 81.

When billing to the Palmeto / Medicare Mac, you can put up to 13 units on one line, with no modifier, and all units pay.

First Coast rejects the claim, stating there are billing submission errors. We have tried using modifier 91 and 59, but they only pay for one unit and deny the rest as a duplicate.

Any insight would be greatly appreciated.

Thank you.


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## Rhurst1 (Jan 8, 2019)

We are seeing the same issue with Noridian our MAC, we are still investigating the issue, will post when we know more. But we are submitting the one line 87798 with the 13 units per the MUE guidelines.


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## asalensky (Mar 26, 2019)

Any updates on your efforts with Noridian?  We are just starting to bill multiple units of 87798 and I'm wondering what to expect.  Thanks!


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## casseciella (Apr 4, 2019)

I was wondering are you billing 87798 instead of 87505-87507? Or, what is your opinion on billing 87798 if we are only looking for ONE organism that's offered in 87505-87507?


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## asalensky (Apr 16, 2019)

casseciella, which organism are you looking for specifically?


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## casseciella (Apr 17, 2019)

E. Coli, Clostridioides Difficule (c.Diff), giardia, salmonella, etc. just to name a few...


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## haraml7 (Apr 19, 2019)

*Units*

The carrier just needs clinical data to verify medical necessity for all of the units. The MAI on the MUEs is a "3" meaning its a clinical data denial. These claims will deny with multiple units as duplicate. Documentation just needs to be submitted.


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## commitsvs (Jun 24, 2022)

Hi @haraml7 We are billing 87798*13 with 90 and XU modifier in13 individual line items, can you please advise how we can avoid duplicate denial and which is the appropriate modifier to get these denials resolved.

POS: 81
Case type: UTI
Medicare MAC : Firstcoast


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## haraml7 (Jun 27, 2022)

commitsvs said:


> Hi @haraml7 We are billing 87798*13 with 90 and XU modifier in13 individual line items, can you please advise how we can avoid duplicate denial and which is the appropriate modifier to get these denials resolved.
> 
> POS: 81
> Case type: UTI
> Medicare MAC : Firstcoast


You cannot bypass this, if this is the procedure performed you bill for it and send documentation. Adding a modifier to bypass an edit is not good practice. If medicare wants to see documentation you would need to send documentation. The MUEs come from CMS, which all MAC carriers follow, i am not sure why firstcoast is denying because the MUEs specifically state 13 units can be billed. What if you put it on one line, with 13 units, instead of individually seperating them?


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