Wiki 80307 modifier 91

[katediaz]

I work for an independent laboratory that does urine drug testing and we have a question regarding repeat drug screen tests....

Here's the scenario-
A counselor orders a 6 panel drug screen for a patient and the results come back negative... but the counselor has suspicion the patient was on something that day. They want to do another test on the same specimen looking for 6 different drugs... does that scenario allow us to bill 80307 with modifier 91?

Please let me know your thoughts on this, thank you!

 

[Cavalier40]

I think that modifier 59 would be more appropriate as far as the billing goes, as modifier 91 would be a repeat test of the same sample.

I would refer to the original doctor order to make sure the tests are ordered PRN. If the order is specific, then it might not be reimbursable without a new script. Not sure what documentation other than the requisition order the lab itself would have, but if the lab is truly independent of the treatment center, I would let the treatment center know to document the reason for the second test so that the lab can get paid when the inevitable medical records requests comes.