Wiki PSA question

[TammyHF]

Question regarding billing for PSA Testing CPT 84153…most PSAs are done once per patient per visit. However, sometimes we have patients whose PSA #s are so high, they are higher than the machine will output an accurate count. The lab then has to dilute the sample and run the test again to get the correct PSA #. Is this something that should be billed for twice as we are running the test twice? I think it will they deny for same DOS same test; is there an appropriate modifier to use to allow second PSA to be paid? Or would this be considered an equipment error or malfunction since the original specimen had to be diluted to get the accurate count?

Thank you,

 

[drewvinson23]

I don't think that you can charge for this.

Modifier 91, repeat clinical diagnostic laboratory test, seems to be the correct modifier.

Here is a little article from AAPC about modifier 91:

https://www.aapc.com/blog/28269-proper-use-of-modifier-91/

If you notice, he says in the article:

"you should not append modifier 91 for lab tests: That are repeated due to malfunctions of either the testing equipment or the specimen...If the test is repeated to confirm the initial results or because of a malfunction of the equipment, the service cannot be coded and modifier 91 would not apply."

I think this would be seen as a malfunction of equipment or specimen.

Drew Vinson
CPC
NW Urology