# 87804 and modifier 92



## codecrazy (Jan 14, 2010)

Can modifier 92 be used with87804?  Given in office.


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## HBULLOCK (Jan 15, 2010)

*Modifier 92*

I don't believe that modifier 92 is the correct modifier to use with 87804 Influenza.  If you are doing both the Influenza A and B tests then you would bill 87804 and 87804-59 to get paid for both.  Most insurances I have found will pay for both when you bill this way.  I hope this helps!


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## cpcgal (Jan 16, 2010)

Medicare will not pay with the 59 modifier on the second 87804.  Since 87804 cannot be quantity billed we have billed Medicare as 87804 and 87804-76.


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## mitchellde (Jan 16, 2010)

The correct modifier would be the 91 for repeat lab


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## RebeccaWoodward* (Jan 17, 2010)

I find that this can become carrier discretion.  My carriers recommend 59.  CPT Assistant, dated 5-2009, also recommends this...

Whether to report one or two units of code 87804, Infectious agent antigen detection by immunoassay with direct optical observation; influenza, varies according to the type of rapid testing method used distinguishing influenza A from influenza B. The rapid detection of influenza virus types A and B may be part of two entirely separate procedures or may be included within the same test device. If the assays provide two separate results (ie, a result for influenza virus A and a result for influenza virus B), *it would be appropriate to report two units of code 87804. When two units of code 87804 are submitted, modifier 59,* may be used to indicate that the two results represent separate services (codes 87804 and 87804-59).


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