Pathology/Lab Coding Alert

READER QUESTIONS:

Distinguish Qualitative Fecal Lactoferrin

Question: The lab provided two fecal lactoferrin measurements from specimens taken during and following treatment for diarrhea. How should we code the case to get paid for both tests?


Iowa Subscriber


Answer: First you have to select the appropriate CPT code based on whether the lab performed a qualitative or quantitative test:

- 83630--Lactoferrin, fecal; qualitative

- 83631--Lactoferrin, fecal; quantitative.

Because the fecal lactoferrin level is an important indicator of intestinal inflammation, a physician may order the quantitative test to identify inflammatory gastrointestinal disease or monitor patient response to therapy.

Assuming the lab performs the quantitative test to monitor treatment effects, you should report two units of 83631. Depending on your payer, you may need to append modifier 91 (Repeat clinical diagnostic laboratory test) to indicate that you performed two separate tests on the same day.

Reader Questions were prepared with the assistance of R.M. Stainton Jr., MD, president of Doctors- Anatomic Pathology Services in Jonesboro, Ark.