When billing 87491 and 87591 should we also include 87800? for Medicare plans?
Are you a lab billing for these services? And if are the additional organisms to be tested for documented? If you are physician practice, you would not bill for the lab tests unless you are qualified to perform them or are billing on behalf of the lab in which case a modifier -90. There is a Medicare coding guidance on testing for STD's as follows:
Effective for claims with dates of service on and after November 8, 2011, the claims processing instructions for payment of screening tests for STI will apply to the following HCPCS codes:
• Chlamydia: 86631, 86632, 87110, 87270, 87320, 87490, 87491, 87810, 87800 (used for combined chlamydia and gonorrhea testing)
• Gonorrhea: 87590, 87591, 87850, 87800 (used for combined chlamydia and gonorrhea testing)
• Syphilis: 86592, 86593, 86780
• Hepatitis B: (hepatitis B surface antigen): 87340, 87341