diann
Networker
Good morning!
Hope someone can help me with this one. Our biller billed a claim with 87086 and 87088. The insurance (Healthcare USA) came back stating there was a "global code" that includes urine, culture, identification and sensitivity test. They stated they follow Medicare guidelines but when she bills these two codes together to Medicare it pays both codes. She asked our consultants and they stated the global code is 87088, however reimbursement is better if both codes are used and that Medicare and all third party payers are reimbursable. I see in the CPT book that 87088 is the hierarchy of the two codes. so the question is should she use a modifier on the 87086 to get it reimbursed?
thanks,
Diann DoBran CPC, CPC-H
Hope someone can help me with this one. Our biller billed a claim with 87086 and 87088. The insurance (Healthcare USA) came back stating there was a "global code" that includes urine, culture, identification and sensitivity test. They stated they follow Medicare guidelines but when she bills these two codes together to Medicare it pays both codes. She asked our consultants and they stated the global code is 87088, however reimbursement is better if both codes are used and that Medicare and all third party payers are reimbursable. I see in the CPT book that 87088 is the hierarchy of the two codes. so the question is should she use a modifier on the 87086 to get it reimbursed?
thanks,
Diann DoBran CPC, CPC-H