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Pathology/Lab Coding Alert

READER QUESTIONS:

Capture Extra $17 for C. Diff Toxin A and Toxin B

Published on Sun Aug 23, 2009

Question: We've gotten denials when we bill 87324 x 2 for two EIA tests for C. diff toxin A and toxin B. Can our lab code for tests for both toxins if we use the same lab method for both tests? Virginia Subscriber Answer: Yes, you can bill for both Clostridium difficile toxin A and toxin B if a physician orders the tests for medically necessary reasons. C. difficile is a bacterium that can cause diarrhea and can worsen to severe colon inflammation. Although C. difficile occurs in most normal, healthy digestive tracts, the organism can create problems when allowed to grow unchecked, as might happen when a patient takes antibiotics to treat another illness. C. difficile produces toxins A and B that can cause the diarrhea and colitis. That's why lab tests focus on identifying the presence of one or both of these toxins. Labs can detect the toxins [...]
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