Wiki Prostate Biopsy

[rbynmnk]

Is anyone else having a problem billing out 12 or more units per line for commercial carriers for 88305?

We have found that UHC only allows 6 per line and we have to append a -59 modifier to the other line with the 6 additional units.

Any information regarding this matter is greatly appreciated.

Robyn

 

[bbooks]

We recently discovered that Wellmark now requires us to use the Medicare G-codes for 10 or more. This was effective June 1, 2014. Here is a link to their policy. http://www.wellmark.com/Provider/Co...s/S5782_LabPathRadiologyPractitionerGuide.pdf
Prostate specific information is on page 7.