Ob-Gyn Coding Alert

Question: My ob-gyn performed a rapid strep and flu test in the office. We were going to report 87880 for the rapid stress test and 87804 for the influenza test, which shows results for both A and B strains, but a colleague pointed out her office is reporting 87804 and 87804-59. Who is correct? Also, should we include modifier QW?

New Hampshire Subscriber

Answer: For the rapid strep test, you should report 87880 (Infectious agent detection by immunoassay with direct optical observation; Streptococcus, group A) with modifier QW (CLIA-waived test). Adding modifier QW means that the test is so simple that little risk of error exists, so your physician can perform it in the office without obtaining a higher-level certificate. But of course, you must have applied for and been given the waived test certificate.

For the influenza test, you would report 87804 (... influenza) with modifier QW. You would, however, only bill this procedure once because you have only one specimen. The rapid test will distinguish between the two types of influenza.