Hello, Our office is billing influenza A and B with Strep Tests on one claim for hundreds of kiddos. We use CPT 87804 QW, 87804 59,QW and 87880 QW with the ICD code for Fever. Our claims were being denied for not having a valid principal diagnosis. We switched to billing with J02.9 Acute Pharyngitis and J10.1 but these are denied for the same reason. Can anyone help me with this? I read online that we can't bill both strep and flu together? Is that correct? Any help is appreciated!!
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Wiki Flu and strep tests
- Thread starter ljamsen
- Start date
mitchellde
True Blue
If you look in the code book under the sub heading for codes in categories J00-J06 it states:
Acute upper respiratory infections J00-J06 >
Type 1 Excludes
•chronic obstructive pulmonary disease with acute lower respiratory infection (J44.0)
•influenza virus with other respiratory manifestations (J09.X2, J10.1, J11.1)
That means this excludes 1 note applies to all categories in this section
The J10.1 includes the pharyngitis so you do not need to code it again.
Acute upper respiratory infections J00-J06 >
Type 1 Excludes
•chronic obstructive pulmonary disease with acute lower respiratory infection (J44.0)
•influenza virus with other respiratory manifestations (J09.X2, J10.1, J11.1)
That means this excludes 1 note applies to all categories in this section
The J10.1 includes the pharyngitis so you do not need to code it again.
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