Wiki I am looking for guidance billing for laboratory services and modifiers.

[sarnold]

Our pathologists bill for 88342 and 88341 with 26 modifiers. They in turn will sometimes send these stains out to an outside lab to review. This lab, bills our pathologists for this work done. My question, is there a modifier we can use to capture payment for the services the outside lab does? Would 90 or 91 modifiers be appropriate to bill for these outside services?

 

[notatthebeach@gmail.com]

Who doesn't the other lab bill the patient's insurance themselves?

 

[sarnold]

Not sure what type of arrangement they have, was asked if we can capture the payment for both??

 

[notatthebeach@gmail.com]

Let me check with a lab that I know of that we have the same sort of arrangement for. I will respond when I can get ahold of their client billing dept.

 

[sarnold]

Thank you so much, I appreciate your help.

 

[notatthebeach@gmail.com]

No one is getting back to me from their office. Definitely not a good way of doing business. But, this is my thinking, I don't think that you need a modifier to bill for the charges if the lab that is doing the reading doesn't bill the insurance at all.